Question 1

Which of the following laboratory test results would be of least concern to the nurse who is recording a client's baseline status before chemotherapy for cancer is started?&#10;A) Serum electrolytes&#10;B) Blood urea nitrogen&#10;C) Complete blood count&#10;D) Serum osmolarity&#10;

Accepted Answer

Serum osmolarity is not typically a part of the baseline laboratory workup before chemotherapy, and abnormal results are less likely to impact treatment decisions or contraindicate chemotherapy. The other laboratory values (serum electrolytes, blood urea nitrogen, and complete blood count) are important in monitoring for electrolyte imbalances, renal dysfunction, and hematological changes during treatment.

Question 2

Which of the following chemotherapeutic drugs is considered to be cell-cycle specific for the G₁ phase of the cell life cycle? A) Mercaptopurine B) Pegaspargase C) Docetaxel D) Vinblastine

Accepted Answer

Pegaspargase is an enzyme that depletes asparagine, an amino acid necessary for protein synthesis, and is considered to be cell-cycle specific for the G1 phase.

Question 3

A client with cancer will be receiving chemotherapy with cisplatin.To reduce the risk of renal toxicity,the nurse anticipates an order for which of the following drugs to preserve renal tissue?&#10;A) Amifostine (Ethyol)&#10;B) Prednisone (Deltasone)&#10;C) Furosemide (Lasix)&#10;D) Epoetin alfa (Epogen)&#10;

Accepted Answer

Amifostine has been shown to protect the kidneys from the effects of cisplatin by reducing oxidative stress and preserving renal tissue. Prednisone may be used to reduce inflammation and treat other side effects, but it does not protect the kidneys. Furosemide is a diuretic and may exacerbate cisplatin-induced nephrotoxicity. Epoetin alfa is used to stimulate red blood cell production and treat anemia, but it does not protect the kidneys from cisplatin-induced nephrotoxicity.

Question 4

When a client is scheduled to receive cyclophosphamide (Cytoxan),the nurse places highest priority on ensuring that the client&#10;A) is adequately anesthetized before the drug is administered.&#10;B) is monitored by electrocardiogram during its administration.&#10;C) is prehydrated to prevent hemorrhagic cystitis.&#10;D) receives information about the drug's life-threatening neurotoxicity.&#10;

Accepted Answer

The highest priority for a client receiving cyclophosphamide is prehydration to prevent hemorrhagic cystitis, a potential side effect of the drug. Adequate hydration before and after administration of the medication helps reduce the risk of damage to the bladder wall. While monitoring the client with electrocardiogram and educating them about potential side effects are important nursing interventions, they do not take priority over preventing a potentially serious complication such as hemorrhagic cystitis. Anesthesia is not typically required for administration of cyclophosphamide.

Question 5

A client with cancer will be receiving chemotherapy with ifosfamide.To reduce the risk of hemorrhagic cystitis,the nurse anticipates an order for which of the following drugs?&#10;A) Phenazopyridine (Pyridium)&#10;B) Sulfisoxazole (Gantrisin)&#10;C) Mesna (Mesnex)&#10;D) Bumetanide (Bumex)&#10;

Accepted Answer

Mesna is a uroprotective agent used to prevent hemorrhagic cystitis caused by ifosfamide chemotherapy. It works by binding to and inactivating the toxic metabolites of ifosfamide that can damage the bladder lining. Phenazopyridine is a urinary tract analgesic and does not prevent hemorrhagic cystitis. Sulfisoxazole is an antibiotic and Bumetanide is a loop diuretic, neither of which prevent hemorrhagic cystitis.

Question 6

A client is experiencing bone marrow suppression as an adverse effect of chemotherapy used to treat cancer.The nurse administers which of the following medications to increase the client's red blood cell count?

A) Pegfilgrastim (Neulasta)
B) Darbepoetin alfa (Aranesp)
C) Oprelvekin (Neumega)
D) Galantamine (Reminyl)

Accepted Answer

Sargramostim (GM-CSF) is a medication that stimulates the bone marrow to produce white blood cells. It is commonly used to treat bone marrow suppression caused by chemotherapy. Epoetin alfa (Epogen) is a medication used to stimulate the production of red blood cells and is not effective in increasing white blood cell count. Oprelvekin (Neumega) is a medication used to prevent severe thrombocytopenia (low platelet count) and is not effective in increasing white blood cell count. Levetiracetam (Keppra) is an antiepileptic medication and is not used for treating bone marrow suppression.

Question 7

Which of the following statements is the most appropriate to share with a client who is wondering about the alopecia that occurs as a result of chemotherapy?&#10;A) &#34;With hair regrowth,the hair often changes in appearance.&#34;&#10;B) &#34;Hair loss is permanent and an irreversible adverse effect of the chemotherapy.&#34;&#10;C) &#34;Hair regrowth occurs 8 to 10 months after chemotherapy is discontinued.&#34;&#10;D) &#34;There are many interventions to prevent chemotherapy-induced alopecia.&#34;&#10;

Accepted Answer

Option A is the most appropriate statement to share with a client wondering about the alopecia that occurs as a result of chemotherapy. It reassures the client that hair regrowth is possible but the hair may look different from before. Option B is incorrect because hair loss is usually temporary and reversible. Option C may mislead the client as hair regrowth typically takes 2 to 3 months after chemotherapy ends. Option D may also be misleading as there are no guaranteed interventions to prevent chemotherapy-induced alopecia.

Question 8

What is the physiologic effect of prednisone that the nurse expects to assess in a client who is receiving the MOPP treatment?&#10;A) Increased sedation&#10;B) Improved appetite&#10;C) Induced malaise&#10;D) Decreased appetite&#10;

Accepted Answer

Prednisone, a corticosteroid included in the MOPP regimen, often leads to an improved appetite as one of its side effects, contrasting with many cancer treatments that may decrease appetite.

Question 9

Which of the following chemotherapeutic drugs is considered to be cell-cycle specific for the M phase of the cell life cycle?&#10;A) Thioguanine&#10;B) Pegaspargase&#10;C) Bleomycin&#10;D) Vinblastine&#10;

Accepted Answer

Vinblastine is a cell-cycle specific chemotherapeutic drug that targets the M phase of the cell cycle by inhibiting the formation of microtubules required for spindle formation and chromosome segregation during mitosis. Thioguanine and pegaspargase are not cell-cycle specific, while bleomycin targets the G2 phase of the cell cycle.

Question 10

A client is experiencing bone marrow suppression as an adverse effect of chemotherapy used to treat cancer.The nurse administers which of the following medications to increase the client's red blood cell count?

A) Pegfilgrastim (Neulasta)
B) Darbepoetin alfa (Aranesp)
C) Oprelvekin (Neumega)
D) Galantamine (Reminyl)

Accepted Answer

Darbepoetin alfa is a medication that stimulates the production of red blood cells in the bone marrow and is commonly used to treat anemia caused by chemotherapy-induced bone marrow suppression. Pegfilgrastim (Neulasta) is used to prevent infection in patients receiving chemotherapy, Oprelvekin (Neumega) is used to stimulate platelet production in patients with thrombocytopenia, and Galantamine (Reminyl) is used to treat Alzheimer's disease.

Question 11

The nurse concludes that the client who is receiving chemotherapy is in danger of infection when the absolute granulocyte count drops to less than A) 100,000 cells/mm³. B) 10,000 cells/mm³. C) 1000 cells/mm³. D) 100 cells/mm³.

Accepted Answer

The answer of The nurse concludes that the client who...

Question 12

Which of the following chemotherapeutic drugs is considered to be cell-cycle specific for the S phase of the cell life cycle?&#10;A) Methotrexate&#10;B) Asparaginase&#10;C) Bleomycin&#10;D) Vincristine&#10;

Accepted Answer

The answer of Which of the following chemotherapeutic drugs is...

Question 13

The nurse would try to prevent or reduce chemotherapy-induced nausea and vomiting by taking which of the following actions?&#10;A) Providing liquids at meal times only&#10;B) Administering hot and cold foods every 2 hours&#10;C) Administering an antiemetic 1 to 3 hours before chemotherapy is administered&#10;D) Increasing mobility before and after eating&#10;

Accepted Answer

The answer of The nurse would try to prevent or...

Question 14

Nursing interventions associated with the nursing diagnosis of impaired oral mucous membranes related to stomatitis include which of the following?&#10;A) Encourage continued dental checks or dental work while receiving the chemotherapy&#10;B) Inspect the oral cavity at least once weekly for any changes&#10;C) Encourage spicy or acidic foods in moderation&#10;D) Provide soothing foods such as cool foods (Popsicles),bland foods,or cool liquids&#10;

Accepted Answer

The answer of Nursing interventions associated with the nursing diagnosis...

Question 15

A client is experiencing bone marrow suppression as an adverse effect of chemotherapy used to treat cancer.The nurse administers which of the following medications to increase the client's red blood cell count?

A) Pegfilgrastim (Neulasta)
B) Darbepoetin alfa (Aranesp)
C) Oprelvekin (Neumega)
D) Galantamine (Reminyl)

Accepted Answer

The answer of A client is experiencing bone marrow suppression...

Question 16

The pediatric oncology nurse shares with a group of new nurses being oriented on the unit that which of the following cancers is most common in children?&#10;A) Lung cancer&#10;B) Neuroblastoma&#10;C) Leukemia&#10;D) Wilms tumor&#10;

Accepted Answer

The answer of The pediatric oncology nurse shares with a...

Question 17

Which of the following chemotherapeutic drugs is considered to be cell-cycle specific for the G₂ phase of the cell life cycle? A) Fludarabine B) Asparaginase C) Paclitaxel D) Vinorelbine

Accepted Answer

The answer of Which of the following chemotherapeutic drugs is...

Question 18

Which of the following statements most accurately reflects the selection of drugs used in the MOPP protocol?&#10;A) Prednisone is a weak monoamine oxidase inhibitor that is active in the S phase.&#10;B) Vincristine (Oncovin)stimulates mitosis by working in the mitotic spindle.&#10;C) Mechlorethamine (Mustargen)is an alkylating agent that interferes with DNA replication.&#10;D) Procarbazine has lympholytic properties that also improve appetite and feelings of well-being.&#10;

Accepted Answer

The answer of Which of the following statements most accurately...

Question 19

The nurse is aware that which of the following should not be used as a sole factor in a decision reducing the dose of a chemotherapeutic drug for an older adult client?&#10;A) Presence of concurrent illnesses&#10;B) Age&#10;C) Reduced renal function&#10;D) Decreased bone marrow cellularity&#10;

Accepted Answer

The answer of The nurse is aware that which of...

Question 20

The nurse administers which of the following drugs on the medication administration record concurrently with doxorubicin to prevent or diminish chemotherapy-induced cardiac toxicity?&#10;A) Desmopressin (CCAVP)&#10;B) Dexrazoxane (Zinecard)&#10;C) Dexamethasone (Decadron)&#10;D) Desirudin (Iprivask)&#10;

Accepted Answer

The answer of The nurse administers which of the following...

Question 21

The nurse would assess a client receiving chemotherapy that carries a risk of neurotoxicity for which of the following signs of encephalopathy?&#10;A) Hearing loss&#10;B) Ataxia&#10;C) Paresthesias&#10;D) Disorientation&#10;

Accepted Answer

The answer of The nurse would assess a client receiving...

Question 22

The nurse would remove which of the following desserts from the meal tray of a client who has bone marrow suppression as a result of chemotherapy for cancer?&#10;A) Vanilla pudding&#10;B) Fresh peach&#10;C) Baked apple&#10;D) Gelatin&#10;

Accepted Answer

The answer of The nurse would remove which of the...

Question 23

A client who is receiving chemotherapy to treat cancer also has an order for allopurinol (Zyloprim).The nurse expects that the client's therapy is elevating which of the following laboratory test results?

A) Potassium
B) Blood urea nitrogen
C) Uric acid
D) Prothrombin time

Accepted Answer

The answer of A client who is receiving chemotherapy to...

Question 24

The nurse should encourage the client who has impaired oral mucous membranes caused by cancer chemotherapy to use which of the following liquids as a mouth rinse?&#10;A) Normal saline&#10;B) Mouthwash with alcohol&#10;C) Hydrogen peroxide mixture&#10;D) Lemon-flavored mouthwash&#10;

Accepted Answer

The answer of The nurse should encourage the client who...

Question 25

The nurse is assigned to the care of a client who is receiving cancer chemotherapy and has thrombocytopenia from bone marrow suppression as an adverse effect.The nurse should do which of the following in the care of this client?

A) Ensure the client uses dental floss to reduce mouth bacteria
B) Take the temperature by the rectal route
C) Administer pain medication by the intramuscular route
D) Encourage the client to use a nail file rather than clippers

Accepted Answer

The answer of The nurse is assigned to the care...

Question 26

The nurse is working with a client who has diarrhea as an adverse effect of chemotherapy being administered as treatment for cancer.The nurse plans with the dietitian to provide the client with which of the following diets?

A) High-residue,low-fat,high-calorie
B) Low-residue,high-protein,high-calorie
C) High-residue,low-protein,and moderate-calorie
D) Low-residue,high-fat,and moderate-calorie

Accepted Answer

The answer of The nurse is working with a client...

Question 27

Which of the following strategies for managing nausea and vomiting should the nurse offer to a client who is receiving chemotherapy as treatment for cancer?&#10;A) Eat the biggest meal of the day at noon&#10;B) Drink liquids with meals&#10;C) Avoid foods that are hot&#10;D) Increase intake of red meat for protein content&#10;

Accepted Answer

The answer of Which of the following strategies for managing...

Question 28

The nurse would select which of the following nursing diagnoses as being most pertinent to a client who finished a course of chemotherapy for cancer and has now developed anemia?&#10;A) Impaired gas exchange&#10;B) Fatigue&#10;C) Risk for injury&#10;D) Anxiety&#10;

Accepted Answer

The answer of The nurse would select which of the...

Question 29

A client has undergone treatment for cancer and is scheduled for follow-up chemotherapy.The nurse reviews the medical record to ensure that at least how much time has passed since the last radiation treatment to ensure client safety?

A) 3 days
B) 1 week
C) 4 weeks
D) 2 months

Accepted Answer

The answer of A client has undergone treatment for cancer...

Question 30

A client receiving chemotherapy as treatment for cancer has developed granulocytopenia.The nurse would avoid doing which of the following as part of the care of this client?&#10;A) Giving acetaminophen (Tylenol)for discomfort&#10;B) Encouraging fluids&#10;C) Monitoring temperature&#10;D) Allowing the client to walk to the bathroom&#10;

Accepted Answer

The answer of A client receiving chemotherapy as treatment for...

Deck 55: Principles of Antineoplastic Chemotherapy