Deck 12: Pharmacology of Anti-Neoplastic Diseases

Question 1

A client has been diagnosed with stage 4 pancreatic cancer. The family asks the nurse what staging is. What is the nurse's response? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.
1) "Staging determines the location of the cancer."
2) "The involvement of lymph nodes is assessed during staging."
3) "Staging changes as the cancer progresses."
4) "The lower the stage of cancer at diagnosis, the better the prognosis."
5) "Staging examines cancerous cells under a microscope and compares them to normal cells."

Answer 1

1,2,4

Question 2

The community health nurse is addressing a neighbourhood group concerned about high rates of cancer. what chemical carcinogens that contribute to the incidence of cancer does the nurse include in her presentation. Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.
1) tobacco.
2) alcohol.
3) asbestos.
4) ultraviolet light.
5) human papillomavirus (HPV).

Answer 2

1,2,3

Question 3

The nurse is providing teaching to a client who has just been diagnosed with breast cancer. How would the nurse describe a malignant tumour? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.
1) Slow growing
2) Invasive
3) Lethal if left untreated
4) May be classified as a carcinoma
5) May be classified as a sarcoma

Answer 3

2,3,4,5

Question 4

The nurse recognizes that teaching about secondary prevention has been effective when the client states:
1) "If I stop smoking, I can decrease my risk of lung cancer."
2) "I need to have a Pap smear annually to detect any signs of cervical cancer."
3) "If I get a cancerous lesion removed early, I can prevent more areas of skin cancer."
4) "If I wear sunscreen, I can prevent skin cancer."

Question 5

A client is receiving chemotherapy in the treatment of breast cancer. Which of the following are not considered goals of chemotherapy?
1) Control the cancer.
2) Provide palliation.
3) Cure the cancer.
4) Prevent transmission of the cancer.

Question 6

Which statement is not true of adjuvant chemotherapy?
1) Adjuvant therapy is the administration of antineoplastic drugs after surgery or radiation therapy.
2) Adjuvant therapy is the administration of antineoplastic drugs before surgery or radiation therapy.
3) A goal of adjuvant therapy is to treat any micrometastases that might be developing.
4) A goal of adjuvant therapy is to rid the body of any cancerous cells that were not removed during surgery.

Question 7

The nurse is caring for a client with cancer. The family asks the nurse to explain the differences between benign and malignant tumours. The nurse states that the main difference is:
1) "Benign tumours are fast growing, remain localized, and can kill the host."
2) "Malignant tumours are slow growing but invasive, and they can kill the host."
3) "Benign tumours are slow growing but invasive."
4) "Malignant tumours are rapidly growing and invasive, and they can kill the host."

Question 8

Which statement is true regarding grading of cancer cells?
1)
1) Grading has very few limitations, as tumours contain cell types that are similar in appearance.
2) If the biopsy cells appear differentiated and similar to parent cells, the tumour receives a grade of
3) Grading does not change much over time as the tumour evolves.
4) If the biopsy cells appear differentiated and similar to parent cells, the tumour receives a grade of 4.

Question 9

What is an inaccurate statement about the process of staging cancer?
1) Determines where the cancer is located.
2) Determines the extent of the cancer invasion.
3) Helps the health care provider determine the best course of treatment.
4) Compares the appearance of cancer cells with that of normal cells.

Question 10

The nurse assesses several clients for their potential risk for developing cancer. Which client does the nurse assess to be at greatest risk for developing cancer?
1) The client who is an alcoholic and eats a diet high in fatty foods
2) The client who frequently forgets breast self-exams but has routine mammograms
3) The client who is 10 pounds overweight but exercises regularly
4) The client who applies sunscreen when arriving at the beach

Question 11

The nurse on an oncology unit recognizes that a patient with which type of advanced cancer would most likely require palliation therapy?
1) Bladder cancer
2) Liver cancer
3) Skin cancer
4) Pancreatic cancer

Question 12

Which causes are not part of the etiology of cancer?
1) Biological causes
2) Chemical causes
3) Structural causes
4) Physical causes

Question 13

A client with cancer asks the nurse where cancer comes from. What is the best explanation by the nurse?
1) "Cancer cells are body cells that have lost the ability to regulate growth."
2) "Cancer is caused primarily by viruses in the environment."
3) "Cancer is genetic; you inherited the predisposition for your cancer."
4) "Cigarette smoking and secondhand smoke are the primary causes of cancer."

Question 14

The staging and grading of cancer are performed:
1) after the last chemotherapy treatment is completed.
2) when the client's symptoms start to worsen.
3) after the first chemotherapy treatment is completed.
4) upon initial diagnosis of cancer.

Question 15

Receiving the HPV vaccine to prevent cervical cancer is an example of what type of prevention?
1) Secondary
2) Tertiary
3) Palliation
4) Primary

Question 16

The nurse on an oncology unit anticipates that which clients are most likely to receive palliative cancer treatment? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.
1) A client with Hodgkin lymphoma
2) A client with osteosarcoma
3) A client with choriocarcinoma
4) A client with advanced pancreatic cancer
5) A client with Kaposi sarcoma

Question 17

Unlike most normal cells, cancerous cells are able to move to other places in the body, traveling to distant sites where they populate new tumours. What is this process called?
1) Grading
2) Carcinogenesis
3) Metastasis
4) Angiogenesis

Question 18

Cancer is a disease characterized by:
1) Normal, controlled cell division.
2) Normal, uncontrolled cell division.
3) Normal, uncontrolled cell division.
4) Abnormal, controlled cell division.

Question 19

The community health nurse is planning programs aimed at reducing the incidence of cancer. Which strategies would the nurse plan to implement as part of primary prevention? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.
1) Providing health counselling and education
2) Reducing tobacco use
3) Providing annual Papanicolaou (Pap) smears
4) Instructing women in breast self-examination
5) Helping clients maintain weight within recommended levels

Question 20

What is the acronym used to help people remember what to assess for prevention of cancer?
1) CAUTION.
2) CANCER.
3) CHANGES.
4) PREVENTION.

Question 21

A female client has experienced alopecia due to chemotherapy. She is distraught and feels that no one will want to look at her. How can the nurse best address the client's concerns?
1) Show the client photos of cancer survivors whose hair grew back more thickly
2) Discuss the client's feelings about the effects of her hair loss
3) Have a cancer survivor visit the client and discuss wearing a wig
4) Tell the client that her hair will grow back in a few weeks

Question 22

The nurse on an oncology unit is planning care for clients with various Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply.
1) Leukemia cells.
2) Lymphoma cells.
3) Breast cancer cells.
4) Lung cancer cells.
5) Bone marrow cells.

Question 23

The nurse is caring for a client for myelosuppression. Which lab values would the nurse monitor for this client? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.
1) RBC
2) WBC
3) Platelets
4) Potassium
5) Sodium

Question 24

The client experiences nausea and vomiting soon after chemotherapy treatments. What is the best action by the nurse?
1) Administer an antiemetic 1-2 hours before chemotherapy.
2) Increase fluid intake to flush the kidneys prior to chemotherapy.
3) Restrict food on the day the client receives chemotherapy.
4) Administer a sleeping medication during chemotherapy.

Question 25

A client who is receiving chemotherapy frequently complains of headache. The most effective nursing intervention would be to administer:
1) Ibuprofen.
2) Naproxen.
3) Aspirin.
4) Acetaminophen.

Question 26

A common theme among all the antineoplastic agents is:
1) Their adverse effects.
2) Their ability to kill cancer cells.
3) Their drug interactions.
4) Their mechanism of action.

Question 27

Which statement most accurately describes the action that occurs during stage S (synthesis) of the cell cycle?
1) The cell undergoes prophase, metaphase, anaphase, and telophase.
2) The cell makes additional proteins that are necessary for cell division.
3) The cell conducts metabolism, impulse conduction, contraction, or secretion.
4) The cell duplicates its DNA.

Question 28

The client receives several chemotherapeutic agents as treatments for cancer. The client asks the nurse why he needs so many drugs. What is the best response by the nurse?
1) "Using multiple drugs means a shorter treatment time."
2) "Using multiple drugs will help kill more of the cancer."
3) "Using multiple drugs is more cost-effective in treating cancer."
4) "Using multiple drugs decreases the incidence of side effects."

Question 29

Most chemotherapeutic medications are administered intermittently, using specific dosing schedules. Which factor does not affect the dosing schedule?
1) The psychological stage of the client.
2) The condition of the client.
3) The type of tumour.
4) The stage of the disease.

Question 30

The client receives cisplatin as therapy for cancer. Which assessment finding would prompt the nurse to contact the client's health care provider immediately?
1) Nausea and projectile vomiting
2) buzzing, ringing, or tingling sensation in the ears,
3) An elevation in blood glucose
4) A complaint of painful leg cramps

Question 31

A client is receiving a cell-cycle-specific medication for the treatment of leukemia. How should these medications be delivered in order to kill the most cancer cells?
1) Divided, infrequent doses.
2) Divided, frequent doses.
3) A single dose each day.
4) A large, one-time dose.

Question 32

Which statement most accurately describes the cell kill hypothesis?
1) It is a model that predicts the amount of normal cells that will be affected by antineoplastic drugs.
2) It is a model that predicts the ability of antineoplastic drugs to eliminate cancer cells.
3) It is a model that predicts how invasive a cancer has become.
4) It is a model that compares the appearance of potential cancer cells with that of normal parent cells.

Question 33

A client is being prepared for the delivery of an intravenous chemotherapeutic agent. The client asks why the drug cannot be given by mouth. The nurse explains that an advantage to intravenous delivery is that:
1) It protects the client from environmental infections.
2) A consistent serum drug level can be obtained.
3) It is administered outside of the home.
4) It can protect the veins during administration.

Question 34

The nurse is explaining the mechanisms of action for alkylating agents and states that alkylating agents kill cancer cells by: Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.
1) Altering the shape of the DNA double helix.
2) Preventing the DNA from duplicating during cell division.
3) Becoming incorporated into the DNA of cancer cells.
4) Interfering with DNA replication and function.
5) An unknown mechanism of action.

Question 35

The nurse tells the client that alkylating agents kill cancer cells by:
1) Containing substances from bacteria that can kill cancer cells.
2) Disrupting critical cellular pathways of cancer cells.
3) Changing the shape of the DNA double helix and preventing DNA from duplicating during cell division.
4) Blocking substances necessary for continued growth of tumours.

Question 36

When discussing the outcome of treatment with a client, how does a nurse describe theoretically when a cancer is considered cured?
1) The client no longer experiences the physiologic effects of cancer.
2) Every single cancer cell in the tumour has been eliminated.
3) The tumour cannot be identified on a CT scan.
4) The client's absolute neutrophil rises back to a normal level.

Question 37

Which statement is not a reason that clients undergoing chemotherapy usually receive several rounds of treatment spaced over time?
1) Side effects can occur, and the client needs time to recover.
2) The neutrophil count can decrease, so time between treatments is necessary for the body to make more neutrophils to boost the immune system.
3) The cost of treatments is very high.
4) Each round of chemotherapy kills only a set percentage of cancer cells.

Question 38

A client receiving antineoplastic agents in the treatment of lung cancer has been told that treatment options are limited. What is the reason that lung cancer cells have a decreased sensitivity to antineoplastic drugs?
1) Have a very erratic cell cycle, and there is little difference between the number of replicating and resting cells.
2) Grow for a long time before detection and are therefore less sensitive to antineoplastic agents.
3) Grow in a high-oxygen environment and are therefore not very sensitive to antineoplastic agents.
4) Have a low growth fraction, so there is little difference between the number of replicating and resting cells.

Question 39

The nurse is describing the mechanism of action of antimetabolites to a client with cancer. Which statement best describes how the antimetabolites kill cancer cells?
1) "They use the body's immune system to kill tumour cells."
2) "They disrupt metabolic pathways, slowing growth of cancer cells."
3) "They contain bacterial substances that can kill cancer cells."
4) "They change the shape of the DNA and prevent division of cancer cells."

Question 40

The nurse is preparing to administer methotrexate by mouth to a client with cancer. For what reasons would the nurse use the PO route rather than the other routes of administration? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.
1) The PO route is more acceptable to the client.
2) The PO route decreases the risk for phlebitis.
3) The PO route decreases the risk for tissue necrosis.
4) The PO route decreases the risk for nausea.
5) The PO route decreases the risk for vomiting.

Question 41

A nurse is preparing to give an initial dose of Doxorubicin (Adriamycin)to a client diagnosed with cancer. What information in the client's health history does the nurse immediately report to the physician?
1) Peptic ulcer
2) History of heart failure
3) Pancreatitis
4) History of hepatitis

Question 42

Folic acid analogs can be toxic to normal cells as well as to cancer cells. Which drug will the nurse administer following the administration of methotrexate to "rescue" the normal cells, causing them to be able to continue replication and development?
1) Leucovorin
2) Iron therapy
3) Immunoglobulin
4) Vitamin B₁₂

Question 43

The nurse is preparing a teaching pamphlet on cancer prevention to distribute at the local health clinic Which of the following guidelines should the nurse include? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.
1) Eliminate tobacco use and exposure to secondhand smoke
2) Women should have periodic mammograms
3) Choose a diet high in protein and complex carbohydrates
4) Have periodic diagnostic testing performed at recommended intervals.
5) Males between 9 and 26 years should be vaccinated for HPV

Question 44

The nurse is planning care for a client that has been ordered Cyclophosphamide for treatment of Hodgkin's disease. What does the nurse include in her teaching for this client? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.
1) Use gloves and mask when handling the drug
2) Take with meals
3) Can use echinacea to boost your immune function
4) Hair loss is usually reversible
5) Nausea and vomiting are common side effects

Question 45

Which statement is true regarding hormone antagonists?
1) They are cytotoxic.
2) They enhance substances essential for hormone growth.
3) They produce similar debilitating adverse effects that other antineoplastics produce.
4) They can produce debilitating adverse effects at high doses for prolonged periods.

Question 46

The nurse is discussing the use of tamoxifen with a client who has a family history of breast cancer. The nurse states that a unique approved use for tamoxifen is:
1) Treatment for advanced lung cancer.
2) For prophylaxis of breast cancer.
3) Treatment for estrogen receptor-negative cancers.
4) For the cure of advanced breast cancer.

Question 47

The nurse knows that client education on drug interactions with doxorubicin (Adriamycin) has been successful when the client states:
1) "I can take acetaminophen if I get a fever."
2) "I can take my Celebrex for my arthritis."
3) "I can take ibuprofen for my back pain."
4) "I can take an aspirin for a headache."

Question 48

What is a difference between alkylating agents and antitumour antibiotics?
1) Antitumour antibiotics are not given orally.
2) Antitumour antibiotics have severe adverse effects.
3) Antitumour antibiotics have no dose-limiting toxicities.
4) Antitumour antibiotics are not mitotic inhibitors.

Question 49

What is the advantage of radiation treatment over the other two methods of treating cancer?
1) Treatment's effect is limited to specific tumour site
2) It is non invasive and eliminates the need for surgery
3) It eliminates the need for chemotherapy
4) It is effective for when cancer metastasizes.

Question 50

The nurse is describing the mechanism of action for antibiotic antineoplastics to a client who is being treated for cancer. Which description by the nurse is most appropriate?
1) "They contain substances from bacteria that have the ability to kill cancer cells."
2) "They contain substances from plants that have the ability to kill cancer cells."
3) "They contain substances from viruses that have the ability to kill cancer cells."
4) "They contain substances from hormones that have the ability to kill cancer cells."

Question 51

The client receives tamoxifen for treatment of breast cancer. She asks the nurse why the medicine works. What is the best response by the nurse?
1) "Tamoxifen works by inhibiting the metabolism of breast cancer cells."
2) "Tamoxifen works by inhibiting the cellular mitosis of breast cancer."
3) "Tamoxifen works by blocking estrogen receptors on breast tissue."
4) "Tamoxifen works by binding to the DNA of breast cancer cells."

Question 52

MCSA A student on the oncology is working with an experienced nurse preparing medications for administration. The student asks the nurse why she is gowning up to give Doxorubicin (Adriamycin). What is the best response of the nurse?
1) "I use full protective devices because the client is immunosuppressed."
2) "Clients are often nauseated, and may vomit during administration."
3) "This drug is highly toxic and can be absorbed through my skin."
4) "This medication must remain in a sterile state to maintain effectivemness."

Question 53

Students are completing their oncology module and are preparing for their final exam. A question ask them why it is important to understand the cell cycle in relation to antineoplastic therapy. What is the correct response to this question?
1) Cell growth are only vulnerable to antineoplastics during their synthesis stage.
2) Some antineoplastics target specific phases of cancer cell growth
3) Particular stages of cell growth put normal cells at risk during antineoplastic therapy.
4) Different cancer cell growth result in fewer adverse effects during chemotherapy.