Question 1

A provider orders tamoxifen for a premenopausal woman with ER-positive breast cancer. What rationale supports the provider's decision to prescribe tamoxifen over anastrozole?&#10;A) Anastrozole is more likely to cause hot flushes than tamoxifen.&#10;B) Anastrozole is more likely to promote endometrial carcinoma.&#10;C) Cancer recurrence is higher with anastrozole.&#10;D) Anastrozole will not be effective until she is postmenopausal.

Accepted Answer

Anastrozole is an aromatase inhibitor, which is not effective in premenopausal women because it works by inhibiting the synthesis of estrogen from androgens in peripheral tissues and the adrenal glands, a process that is minimal in premenopausal women due to the primary production of estrogen by the ovaries. Tamoxifen, on the other hand, is a selective estrogen receptor modulator (SERM) that blocks the effects of estrogen in the breast tissue and is effective in both premenopausal and postmenopausal women with ER-positive breast cancer.

Question 2

A provider considers cancer prophylaxis with tamoxifen for a 45-year-old patient with a family history of breast cancer. According to her health history, she had one child at age 35 and developed deep vein thrombosis (DVT) during the pregnancy. She has not had a hysterectomy. What information from the patient's history informs the provider's decision regarding tamoxifen?

A) Because of her family risk and late childbearing, this drug is a good choice for her.
B) Her history of DVT outweighs any possible benefits she may have with this drug.
C) Since she has not had a hysterectomy, the risk of endometrial cancer is too great.
D) When she turns 50 years old, this drug will carry fewer risks for her.

Accepted Answer

Tamoxifen increases the risk of thromboembolic events, such as deep vein thrombosis (DVT), which the patient has a history of. This history makes the use of tamoxifen more risky for her.

Question 3

The provider can prescribe a monoclonal antibody medication for the patient with which condition?&#10;A) Crohn disease&#10;B) Acne&#10;C) Psoriatic arthritis&#10;D) Multiple myeloma

Accepted Answer

Psoriatic arthritis is an autoimmune disease that affects the joints and skin. Monoclonal antibody medications are used to treat autoimmune diseases by targeting specific proteins involved in the disease process.

Question 4

A patient with cancer uses a fentanyl transdermal patch for pain relief. The patient reports having three or four episodes of severe pain lasting 30 minutes most days. What action will the provider take to address the patient's pain? .

A) Discuss the use of an adjuvant analgesic with the patient.
B) Order an NSAID for break-through pain.
C) Prescribe a strong, short-acting opioid PRN.
D) Prescribe an opioid agonist-antagonist for break-through pain.

Accepted Answer

The correct action is to prescribe a strong, short-acting opioid PRN (as needed) for break-through pain. This is because the patient is already on a long-acting opioid (fentanyl patch) for chronic pain, and the episodes of severe pain indicate the need for additional, immediate relief that a short-acting opioid can provide.

Question 5

A provider considers prescribing cancer prophylaxis with tamoxifen for a 43-year-old patient with a strong family history of breast cancer. Which assessment finding will the prescriber view as a possible contraindication?

A) History of deep vein thrombosis (DVT)
B) Diagnosis of osteoporosis
C) Current hyperlipidemia
D) Prior hysterectomy

Accepted Answer

Tamoxifen increases the risk of thromboembolic events, such as deep vein thrombosis (DVT), making a history of DVT a possible contraindication for its use.

Question 6

A patient with advanced renal carcinoma is prescribed aldesleukin as part of the treatment regimen. What adverse effect of this drug will be a concern for the provider?&#10;A) Hypertension&#10;B) Capillary leakage syndrome&#10;C) Hyperglycemia&#10;D) Hyperuricemia

Accepted Answer

Aldesleukin can cause capillary leakage syndrome, which leads to fluid and protein leakage from the capillaries into the surrounding tissues, potentially causing severe hypotension and organ damage.

Question 7

A provider teaches a patient about a vesicant chemotherapeutic agent. Which statement by the patient indicates a need for further teaching about this type of drug?&#10;A) &#34;Leakage of this type of drug around the IV site may result in the need for skin grafts.&#34;&#10;B) &#34;If the medicine in the IV line leaks around the IV site, it must be discontinued immediately.&#34;&#10;C) &#34;These drugs may be administered orally as well as intravenously.&#34;&#10;D) &#34;This type of drug may not be infused at a site of radiation therapy.&#34;

Accepted Answer

Vesicant chemotherapeutic agents are primarily administered intravenously due to their potential to cause severe tissue damage if they leak into the surrounding tissue. Oral administration of these agents is not common or recommended due to their high potential for causing severe side effects and tissue damage.

Question 8

A patient with cancer has taken oxycodone and a nonsteroidal anti-inflammatory drug (NSAID) for a year. At a follow-up visit, the patient reports an increase in pain intensity with a new "burning and shooting" pain. What prescription will the provider write to address the patient's current pain?

A) A combination opioid/NSAID and an adjunctive analgesic
B) A fentanyl transdermal patch, acetaminophen, and an adjunctive analgesic
C) An increase in the oxycodone and NSAID doses
D) Intramuscular morphine sulfate and acetaminophen

Accepted Answer

The patient's new "burning and shooting" pain suggests neuropathic pain, which is often treated with adjunctive analgesics (e.g., antidepressants, anticonvulsants) in addition to opioids like fentanyl and non-opioid analgesics such as acetaminophen.

Question 9

Which statement correctly informs a provider's decision regarding whether to order an antiestrogen drug or an aromatase inhibitor for treatment of breast cancer.&#10;A) Antiestrogen drugs decrease the risk for thromboembolic events.&#10;B) Antiestrogen drugs increase the risk for endometrial cancer.&#10;C) Aromatase inhibitors block the production of estrogen by the ovaries.&#10;D) Aromatase inhibitors can be used for tumor cells that lack estrogen receptors.

Accepted Answer

Antiestrogen drugs, such as tamoxifen, are known to increase the risk for endometrial cancer. This is a significant consideration for providers when choosing a treatment plan for breast cancer, especially in patients with a uterus.

Question 10

Which conditions may be treated with monoclonal antibody (mAb) therapy? (Select all that apply.)&#10;A) Breast cancer&#10;B) Heart murmur&#10;C) Hemophilia&#10;D) Asthma&#10;E) Migraine headaches

Accepted Answer

The answer of Which conditions may be treated with monoclonal...

Question 11

A patient newly diagnosed with cancer reports having pain at a level of 7 to 8 on a scale of 10. Which type of pain management will be prescribed initially by the provider to manage this patient's pain?

A) Acetaminophen
B) Ibuprofen
C) Nonpharmacologic measures
D) Opioid analgesics

Accepted Answer

The answer of A patient newly diagnosed with cancer reports...

Question 12

A patient with cancer who has been taking an opioid analgesic reports new onset pain at a new location even though the previous pain is well controlled. What will the provider suspect is the cause of this latest report of pain?

A) Breakthrough pain
B) Drug-seeking behavior
C) Infection or metastasis.
D) A developing tolerance to the drug therapy.

Accepted Answer

The answer of A patient with cancer who has been...

Question 13

A patient reports &#34;burning and shooting&#34; foot pain alternating with sensations of numbness. Which medication will the provider discuss with the patient?&#10;A) Acetaminophen&#10;B) Ibuprofen&#10;C) Imipramine&#10;D) Oxycodone

Accepted Answer

The answer of A patient reports &#34;burning and shooting&#34; foot...

Question 14

A patient who takes hydrocodone and ibuprofen for cancer pain is admitted to the hospital for chemotherapy. What action will the prescriber take regarding the prescribed ibuprofen.&#10;A) Decrease the dosage of ibuprofen.&#10;B) Discontinues the ibuprofen.&#10;C) Increases the dosage of both drugs.&#10;D) Discontinue the ibuprofen and order aspirin (ASA) instead.

Accepted Answer

The answer of A patient who takes hydrocodone and ibuprofen...

Question 15

A patient asks why a combination product containing an opioid analgesic and a nonsteroidal antiinflammatory drug (NSAID) has been prescribed to manage cancer pain. Which response will the provider give the patient?

A) "A combination product decreases harm to the gastrointestinal tract."
B) "By combining these drugs, the side effects of one drug cancels out the side effects of the other drug."
C) "There is a decreased likelihood of opioid dependence when it is given in combination with a NSAID."
D) "The combination provides increased pain relief than when either product is used alone."

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Accepted Answer

The answer of A patient asks why a combination product...

Question 16

Oxycodone is ordered every 4 to 6 hours PRN for a patient newly diagnosed with cancer who is admitted to the hospital. The patient requests pain medication whenever reporting pain as a 7 or 8 on a scale of 1 to 10 (10 being the worst pain), but then tells the nurse the medication is not working well. What action will the provider take when learning of this situation?

A) Prescribe a fixed dosing schedule for the oxycodone.
B) Order intramuscular meperidine.
C) Order intravenous morphine sulfate.
D) Prescribe a transdermal fentanyl patch.

Accepted Answer

The answer of Oxycodone is ordered every 4 to 6...

Question 17

A patient diagnosed with C. difficile infection is considered a high risk for recurrence. Which medication will the provider prescribed?&#10;A) Dupilumab&#10;B) Omalizumab&#10;C) Bezlotoxumab&#10;D) Mepolizumab

Accepted Answer

The answer of A patient diagnosed with C. difficile infection...

Deck 19: Cancer Therapy