Question 1

A patient who has cancer is about to begin chemotherapy. The patient asks the nurse why two chemotherapeutic agents are being used instead of just one. Which response by the nurse is correct?&#10;A) &#34;The drugs may be given in less toxic doses if two drugs are used.&#34;&#10;B) &#34;Two agents used together can have synergistic effects.&#34;&#10;C) &#34;Use of two drugs will increase tumoricidal activity in the G0 phase of the cell.&#34;&#10;D) &#34;Using two agents will shorten the length of time chemotherapy is needed.&#34;

Accepted Answer

Using two chemotherapeutic agents can have synergistic effects, meaning that their combination can be more effective in killing cancer cells than either drug alone. This allows the drugs to be used in lower doses, reducing toxicity and side effects while increasing their overall effectiveness. Using two drugs does not necessarily shorten the length of time chemotherapy is needed, and while it may increase tumoricidal activity, this is not the primary reason for combining drugs.

Question 2

A patient is prescribed raloxifene as a cancer prophylactic agent. Which type of cancer is this being used to prevent?&#10;A) Prostate cancer.&#10;B) Colon cancer.&#10;C) Multiple myeloma.&#10;D) Breast cancer.

Accepted Answer

Raloxifene is a selective estrogen receptor modulator (SERM) and is used to prevent breast cancer in high-risk postmenopausal women. It works by blocking the effects of estrogen on breast tissue, which can promote the growth of some types of breast cancer. Raloxifene is not used to prevent prostate cancer, colon cancer, or multiple myeloma.

Question 3

A patient who is about to begin chemotherapy asks the nurse when the risk of infection is highest. The nurse will tell the patient that infection risk is greatest at which point?&#10;A) A week to 10 days after each chemotherapy dose&#10;B) During the week immediately after chemotherapy&#10;C) Immediately prior to each dose of chemotherapy&#10;D) When the patient's temperature is elevated by 1&#176; F

Accepted Answer

The risk of infection is highest a week to 10 days after each chemotherapy dose because this is when the patient's white blood cell count is typically at its lowest (nadir), making them more susceptible to infections.

Question 4

The nurse is teaching a patient who is receiving vincristine (Oncovin) about long-term management of the treatment regimen. Which information will the nurse provide in teaching the patient?&#10;A) &#34;If you experience numbness of your hands, it will eventually resolve.&#34;&#10;B) &#34;If your IV starts to hurt, you should pull the IV out immediately.&#34;&#10;C) &#34;You should ask for anti-nausea medication at the first sign of nausea.&#34;&#10;D) &#34;You should report difficulty buttoning your clothes to your provider.&#34;

Accepted Answer

Vincristine can cause peripheral neuropathy, which can lead to difficulty with small motor activities such as buttoning clothes. It is important for the patient to report this to their provider as it may require a dosage adjustment or discontinuation of the medication. Options A and B are incorrect as numbness may be a long-term effect and pulling out the IV can lead to complications. Option C is not specific to long-term management of vincristine.

Question 5

The nurse is caring for a patient who is receiving vincristine (Oncovin), a plant alkaloid chemotherapeutic agent, to treat non-Hodgkin lymphoma. The nurse observes that the patient has difficulty walking. What action will the nurse take?

A) Ask about numbness or tingling in the fingers and toes.
B) Assess heart rate and blood pressure to evaluate for orthostatic hypotension.
C) Assess the temperature to evaluate for infection.
D) Request an order for a complete blood count and electrolytes.

Accepted Answer

Difficulty walking is a common side effect of vincristine and can be indicative of peripheral neuropathy. The nurse should ask about numbness or tingling in the fingers and toes as this is a common manifestation of peripheral neuropathy. Assessing heart rate and blood pressure, temperature, or requesting a complete blood count and electrolytes will not provide information related to this specific side effect of vincristine.

Question 6

The nurse is teaching a patient who will take oral cyclophosphamide (Cytoxan). Which statement by the patient indicates understanding of the teaching?&#10;A) &#34;I should follow a diet high in organ meats and beans while taking this drug.&#34;&#10;B) &#34;I should brush my teeth and gums vigorously twice daily.&#34;&#10;C) &#34;I should report any low-grade temperature elevation immediately.&#34;&#10;D) &#34;I should take the drug at bedtime to minimize side effects.&#34;

Accepted Answer

Oral cyclophosphamide can cause bone marrow suppression, which can result in fever and infection. It is important for the patient to report any signs of fever or infection to the healthcare provider immediately. Following a diet high in organ meats and beans may be contraindicated, as these foods are high in purine and can increase the risk of hyperuricemia, which can lead to kidney damage. Brushing the teeth and gums vigorously can also increase the risk of infection, especially if the patient is neutropenic. Taking the drug at bedtime may not minimize side effects, as some side effects, such as nausea and vomiting, may occur more frequently during the day. The timing of the medication should be discussed with the healthcare provider.

Question 7

A patient is receiving bleomycin (Blenoxane) as part of a chemotherapeutic regimen to treat leukemia. During IV administration of this drug, what will the nurse observe the patient closely for?&#10;A) Hypotension and visual disturbances&#10;B) Pain and blistering at the IV site&#10;C) Pink to red urine&#10;D) Shortness of breath and wheezing

Accepted Answer

During IV administration of bleomycin, the nurse should monitor the patient closely for signs of pulmonary toxicity, which is a potential side effect of this medication. Symptoms of pulmonary toxicity include shortness of breath, cough, wheezing, and fever. If these symptoms occur, the administration of bleomycin should be stopped immediately. The other options listed are not commonly associated with the administration of bleomycin.

Question 8

The nurse is caring for a patient who is receiving vincristine (Oncovin), a plant alkaloid chemotherapeutic agent, to treat non-Hodgkin lymphoma. The nurse observes that the patient has difficulty walking. What action will the nurse take?

A) Ask about numbness or tingling in the fingers and toes.
B) Assess heart rate and blood pressure to evaluate for orthostatic hypotension.
C) Assess the temperature to evaluate for infection.
D) Request an order for a complete blood count and electrolytes.

Accepted Answer

Cyclophosphamide (Cytoxan) can cause hemorrhagic cystitis, which is inflammation of the bladder that can lead to blood in the urine (hematuria). Increasing fluid intake can help dilute the urine and reduce the risk of bladder irritation. Asking about fluid intake is a relevant action to assess if the patient is adequately hydrated to help mitigate this side effect.

Question 9

A woman who has advanced breast cancer will begin receiving androgen therapy. The nurse will explain to the patient that androgen therapy is used to:&#10;A) enhance her own estrogen production.&#10;B) give her a sense of well-being.&#10;C) minimize hot flashes.&#10;D) oppose the activity of estrogen.

Accepted Answer

Androgens can oppose the activity of estrogen by competing for the same receptor sites in breast tissue. This can slow the growth and spread of estrogen-sensitive breast cancer cells.

Question 10

A patient is receiving the antitumor antibiotic doxorubicin (Adriamycin) to treat lung cancer. The patient is experiencing shortness of breath and palpitations. The nurse is concerned that the patient has developed which condition?

A) Anemia
B) Cardiotoxicity
C) Hypersensitivity
D) Pulmonary infection

Accepted Answer

Shortness of breath and palpitations are common symptoms of cardiotoxicity, which is a potential adverse effect of doxorubicin. Cardiotoxicity refers to damage to the heart muscle that can lead to heart failure or other cardiac problems. Anemia, hypersensitivity, and pulmonary infection are possible side effects of chemotherapy, but they are not specifically associated with doxorubicin or the symptoms described in this scenario.

Deck 32: Anticancer Drugs