Deck 45: Antineoplastic Drugs Part 1: Cancer Overview and Cell Cyclespecific Drugs

Question 1

During treatment of a patient who has brain cancer, the nurse hears the oncologist mention that the patient has reached the "nadir." The nurse knows that this term means the

A) lowest level of neutrophils reached during therapy.
B) highest level of neutrophils reached during therapy.
C) point at which the adverse effects of chemotherapy will stop.
D) point at which the cytotoxic action against cancer cells is the highest.

Answer 1

lowest level of neutrophils reached during therapy.

Question 2

The nurse is developing a plan of care for a patient who is experiencing gastrointestinal adverse effects, including anorexia and nausea, after the first course of antineoplastic therapy. What is an appropriate goal for this patient when dealing with this problem? The patient will

A) eat three balanced meals a day within 2 days.
B) return to normal eating pattern within 4 weeks.
C) maintain normal weight by consuming healthy snacks as tolerated.
D) maintain a diet of small, frequent feedings with nutrition supplements within 2 weeks.

Answer 2

maintain a diet of small, frequent feedings with nutrition supplements within 2 weeks.

Question 3

The nurse is monitoring a patient who has severe bone marrow suppression following antineoplastic drug therapy. Which is considered the principal early sign of infection?

A) Fever
B) Diaphoresis
C) Tachycardia
D) Elevated white blood cell count

Answer 3

Fever

Question 4

A patient who has been on methotrexate therapy is experiencing mild pain. Her husband calls to see if he can give her aspirin for the pain. The nurse's response is based on the fact that aspirin

A) aggravates diarrhea.
B) masks signs of infection.
C) can lead to methotrexate toxicity.
D) will cause no problems for the patient on methotrexate.

Question 5

Methotrexate is ordered for a patient with a malignant tumor, and the nurse is providing education about self-care after the chemotherapy is given. Which statements by the nurse are appropriate for the patient receiving methotrexate? (Select all that apply.)

A) Report unusual bleeding or bruising.
B) Hair loss is not expected with this drug.
C) Prepare for hair loss.
D) Avoid straight-edged razors.
E) Avoid foods that are too hot or too cold or rough in texture. e. Gastrointestinal (GI) mucous membrane cells

Question 6

The nurse is providing education regarding chemotherapy to a patient who is about to receive the first course of treatment. Which statement by the nurse is appropriate?

A) "Report black, tarry stools if they occur."
B) "Perform daily oral care with mouthwash."
C) "Limit your fluid intake to reduce nausea and vomiting."
D) "Contraceptive measures can be discontinued as soon as chemotherapy is completed."

Question 7

A patient is to receive a daily dose of fludarabine (Fludara), 25 mg/m²/day for 5 consecutive days. Each dose is diluted in a 125-mL bag of normal saline and is to infuse over 30 minutes. The nurse will set the infusion pump to what rate in mL/hr?

Question 8

A patient is receiving her third course of 5-fluorouracil therapy and knows that stomatitis is a potential adverse effect of antineoplastic therapy. What will the nurse teach her about managing this problem?

A) "You can take aspirin to prevent stomatitis."
B) "Be sure to watch for and report black, tarry stools immediately."
C) "You need to increase your intake of foods containing fiber and citric acid."
D) "Be sure to examine your mouth daily for bleeding, painful areas, and ulcerations."

Question 9

A patient is receiving irinotecan (Camptosar), along with other antineoplastic drugs, as treatment for ovarian cancer. The nurse will monitor for which potentially life-threatening adverse effect that is associated with this drug?

A) Severe stomatitis
B) Bone marrow suppression
C) Delayed-onset cholinergic diarrhea
D) Immediate and severe nausea and vomiting

Question 10

When administering chemotherapy for treatment of cancer, the nurse implements which intervention that treats or even prevents chemotherapy-induced nausea and vomiting?

A) Instructing the patient to avoid caffeine while on chemotherapy
B) Giving an antiemetic when the chemotherapy is started
C) Giving an antiemetic 30 to 60 minutes before the chemotherapy is started.
D) Increasing mobility before and during chemotherapy

Question 11

A patient is receiving high doses of methotrexate and is experiencing severe bone marrow suppression. The nurse expects which intervention to be ordered with this drug to reduce this problem?

A) A transfusion of whole blood
B) Leucovorin rescue
C) Therapy with filgrastim (Neupogen)
D) Administration of allopurinol (Zyloprim)

Question 12

The nurse is reviewing infection-prevention measures with a patient who is receiving antineoplastic drug therapy. Which statement by the patient indicates the need for further teaching?

A) "I will avoid those who have recently had a vaccination."
B) "I will eat only fresh fruits and vegetables."
C) "I will report a sore throat, cough, or low-grade temperature."
D) "It is important for both my family and me to practice good hand washing."

Question 13

A patient, diagnosed with lymphoma, has an allergy to one of the proposed chemotherapy drugs. The tumor has not responded to other types of treatment. The nurse expects the oncologist to follow which course of treatment?

A) The physician will choose another drug to use.
B) The chemotherapy will be given along with supportive measures to treat a possible allergic reaction.
C) The patient will receive reduced doses of chemotherapy for a longer period of time.
D) The chemotherapy cannot be given because of the patient's allergy.

Question 14

When giving chemotherapy as cancer treatment, the nurse recognizes that toxicity to rapidly growing normal cells also occurs. Which rapidly growing normal cells are also harmed by chemotherapy? (Select all that apply.)

A) Bone marrow cells
B) Retinal cells
C) Hair follicle cells
D) Nerve myelin cells
E) Gastrointestinal (GI) mucous membrane cells

Question 15

The nurse is administering a combination of three different antineoplastic drugs to a patient who has metastatic breast cancer. Which statement best describes the rationale for combination therapy?

A) There will be less nausea and vomiting.
B) Increased cancer-cell killing will occur.
C) The drugs will prevent metastasis.
D) Combination therapy reduces the need for radiation therapy.

Question 16

One patient has cancer of the bone; another has cancer in the connective tissues of the thigh muscles; a third patient has cancer in the vascular tissues. These patients have a type of tumor referred to as a

A) sarcoma.
B) leukemia.
C) carcinoma.
D) lymphoma.