Deck 38: Drugs for Neoplasia

Question 1

The client receives methotrexate (Rheumatrex). The nurse assesses for side effects of this drug. Which side effects are a primary concern for the nurse?

A) Hyperglycemia and fatigue
B) Nausea and vomiting
C) Hypertension and seizures
D) Ulcerative stomatitis and diarrhea

Answer 1

Ulcerative stomatitis and diarrhea

Question 2

The client receives cisplatin (Platinol) as therapy for cancer. Which assessment finding would prompt the nurse to contact the client's physician immediately?

A) A temperature greater than 101°F
B) An elevation in blood glucose
C) Nausea and projectile vomiting
D) A complaint of painful leg cramps

Answer 2

A temperature greater than 101°F

Question 3

The nurse who is presenting community education about cancer prevention would evaluate understanding of the message when he overhears which statements at the break?

A) "I've been thinking about trying a vegetarian diet. Now may be a good time."
B) "I am going to call my doctor and schedule a pap smear."
C) "I think I will start taking vitamin A and selenium."
D) "I've never been a drinker, but I am going to start drinking a glass of wine with dinner."
E) "I am going to read the label on that new bottle of sunscreen I bought."

Answer 3

"I've been thinking about trying a vegetarian diet. Now may be a good time."
"I am going to call my doctor and schedule a pap smear."
"I am going to read the label on that new bottle of sunscreen I bought."

Question 4

The client has cancer. He asks the nurse where cancer comes from. What is the best explanation by the nurse?

A) "Cancer is genetic; you inherited the predisposition for your cancer."
B) "Cancer cells are your body's cells that have lost the ability to control their growth."
C) "Cancer is caused primarily by viruses in the environment."
D) "Cigarette smoking and second-hand smoke are the primary causes of cancer."

Question 5

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?

A) "Using multiple drugs means a shorter treatment time."
B) "Using multiple drugs decreases the incidence of side effects."
C) "Using multiple drugs will help kill more of the cancer."
D) "Using multiple drugs is more cost-effective in treating cancer."

Question 6

The client is prescribed tamoxifen for the treatment of breast cancer. The nurse should advise the client to monitor for which adverse effect?

A) Fatigue
B) Cough
C) Vaginal discharge
D) Signs of dehydration

Question 7

The main mechanism of action of alkylating agents is

A) they stimulate the body's immune system.
B) unknown.
C) they change the shape of the DNA double helix and prevent nucleic acid from completing normal cell division.
D) they disrupt metabolic pathways.

Question 8

The most important nursing consideration for clients receiving alkylating agents is

A) monitoring nausea and vomiting.
B) monitoring nutritional intake.
C) monitoring skin integrity.
D) monitoring CBC with differential.

Question 9

The client receives cyclophosphamide (Cytoxan). The nurse evaluates the client's laboratory work. Which laboratory finding would support canceling the client's next treatment with this drug?

A) Hemoglobin of 14 g/dl
B) Blood urea nitrogen of 12 mg/dl
C) WBC count of 8000 cells/mcl
D) Platelet count of 8000/mm³

Question 10

The client receives tamoxifen (Nolvadex) for treatment of breast cancer. She asks the nurse why the medicine works. What is the best response by the nurse?

A) "Tamoxifen (Nolvadex) works by blocking estrogen receptors on breast tissue."
B) "Tamoxifen (Nolvadex) works by inhibiting the cellular mitosis of breast cancer."
C) "Tamoxifen (Nolvadex) works by inhibiting the metabolism of breast cancer cells."
D) "Tamoxifen (Nolvadex) works by binding to the DNA of breast cancer cells."

Question 11

The nurse assesses several clients for their potential risk for developing cancer. Which client does the nurse assess to be at highest risk for developing cancer?

A) The client who drinks alcohol daily and eats red meat at most meals
B) The client who is 10 pounds overweight but exercises regularly
C) The client who usually applies sunscreen when arriving at the beach
D) The client who frequently forgets self-breast exams but has routine mammograms

Question 12

A nurse suspects that the IV line through which doxorubicin (Adriamycin) is infusing has infiltrated. The nurse has discontinued the IV site. What additional action should be taken?

A) No special action is necessary.
B) A warm, wet compress should be placed on the site.
C) Wash the area thoroughly with soap and water.
D) Apply ice packs to the area immediately.

Question 13

The nurse teaches a family support group about the causes of cancer. The nurse evaluates that learning has occurred when the clients make which statements?

A) "Some cancers have a strong genetic component."
B) "Cancer often results from an injury such as a bruise."
C) "Cancers have a very strong environmental component."
D) "Cancer can result from suppressed anger and rage."
E) "Cancer can result from damaged tumor-suppressor genes."

Question 14

In understanding the difference between normal cells and cancer cells, the nurse knows that cancer is the result of

A) cell division occurring extensively in normal cells.
B) cell division occurring via controlled cell division.
C) damage to genes controlling cell growth.
D) suppressor genes continuing cell growth for cell division.

Question 15

The client receives cyclophosphamide (Cytoxan) as treatment for cancer and is experiencing oral irritation as an adverse effect. What does the best plan by the nurse include as it relates to providing oral comfort?

A) Teach the client to avoid extreme temperatures of food selections.
B) Teach good oral hygiene, including the use of an antiseptic mouthwash.
C) Administer megestrol (Megace ES) to the client.
D) Teach the client to inspect the mouth weekly.

Question 16

A client states, "I get so sick to my stomach after chemotherapy. Why can't they just put it directly into my tumor?" Which nursing response is indicated?

A) "There is no technology available to directly place chemotherapy in a tumor."
B) "These are such strong medications that they would eat up your tissues."
C) "That type of therapy does exist, but it does not work for your particular type of cancer."
D) "I know you get sick, but the nausea and vomiting is not severe and passes quickly."

Question 17

The client has recently been diagnosed with cancer. The nurse develops a plan to teach the client about the most effective treatments for cancer. What treatment options will the nurse include in this teaching?

A) Surgery
B) Chemotherapy
C) Nutrition therapy
D) Alternative medicine
E) Radiation therapy

Question 18

In understanding the growth fraction as it pertains to the success of chemotherapy, the nurse knows that the growth fraction is a ratio of

A) the number of replicating cells to the number of active cells.
B) the number of non-replicating cells to the active cells.
C) the number of replicating cells to the number of resting cells.
D) the number of non-replicating cells to the number of resting cells.

Question 19

The client experiences nausea and vomiting soon after chemotherapy treatments. What is the best action by the nurse?

A) Administer a sleeping medication during chemotherapy.
B) Increase fluid intake to flush the kidneys prior to chemotherapy.
C) Administer an antiemetic 1-2 hours before chemotherapy.
D) Restrict food on the day the client receives chemotherapy.

Question 20

The nursing instructor teaches student nurses about chemotherapy for cancer. Which statement best explains why lung cancers are less sensitive to antineoplastic agents than other types of cancers?

A) "Lung cancer cells have a very erratic cell cycle, and this is why there isn't much difference between the number of replicating and resting cells."
B) "Lung cancer cells have been growing for a long time before detection, so they are less sensitive to antineoplastic agents."
C) "Lung cancer cells have a low-growth fraction, which means there isn't much difference between the number of replicating and resting cells."
D) "Lung cancer cells grow in a high-oxygen environment, so they are not very sensitive to antineoplastic agents."

Question 21

A nurse suspects that the IV line infusing vincristine (Oncovin) has infiltrated. The nurse discontinued the line. Which other actions are indicated?

A) Apply local ice packs.
B) Inject hyaluronidase per protocol.
C) Place a tourniquet on the client's arm above the IV site.
D) Place warm compresses on the site.
E) Administer prednisone per protocol.

Question 22

A client is prescribed methotrexate (Rheumatrex) for treatment of osteogenic sarcoma. The client says, "My friend took methotrexate, but she has never had cancer." How should the nurse respond to this statement?

A) "Does your friend have rheumatoid arthritis?"
B) "She must have had cancer and not told you."
C) "Methotrexate is used to treat some autoimmune disorders as well."
D) "You must have misinterpreted what your friend said."
E) "Methotrexate is used to treat some forms of liver disease."

Question 23

A nurse has just initiated a patient's first dose of doxorubicin (Adriamycin). Which assessment finding would cause the nurse to stop the infusion and seek immediate collaboration with the oncologist?

A) The patient's cardiac monitor reveals sinus bradycardia.
B) The patient reports being nauseated.
C) The patient mentions drinking green tea for breakfast.
D) The patient becomes dyspneic.
E) The patient becomes pale.

Question 24

A client is diagnosed with a small lipoma on his arm and is being discharged from the clinic. The client says, "I have a tumor, but I am not being treated with anything. I don't understand." How should the nurse respond?

A) "I am supposed to make an appointment for you to see the oncologist who will recommend treatment."
B) "Lipomas are benign and usually do not require treatment."
C) "Lipomas grow slowly and are not cancerous."
D) "Lipomas do not metastasize and are not cancer."
E) "The physician will consult with a surgeon and will contact you later."

Question 25

What is the nurse's priority when preparing to administer intravenous vesicant chemotherapy?

A) Notify the physician that a central line is necessary.
B) Wear gloves when drawing up the medication.
C) Know the protocol for extravasation.
D) Wear a mask when injecting the medication.

Question 26

A nurse is managing the care of a patient who is approaching nadir during the first round of chemotherapy. The nurse evaluates that neutropenia has occurred when the patient's white blood cell count reaches _________ cells/mL.
Standard Text: Record your answer rounding to the nearest whole number.

Question 27

The patient has been prescribed interferon as treatment against cancer. What information should the nurse provide?

A) "You can increase your intake of interferon by eating grapes and drinking a glass of red wine daily."
B) "Interferons act to suppress cancer cell division."
C) "Interferons enhance your body's ability to remove cancer cells."
D) "Interferons are a type of hormone therapy, so side effects are limited."
E) "The danger with using interferons is that they may cause cancer to develop in sites distant from your original tumor."

Question 28

A student visits the college health nurse and asks, "I am concerned about when I should start getting Pap tests." What questions should the nurse ask?

A) "How old are you?"
B) "Do you drink alcohol?"
C) "Is there a history of cancer in your family?"
D) "Do you use tobacco?"
E) "Are you sexually active?"

Question 29

A client with pancreatic cancer is receiving chemotherapy even though prognosis is grim. How does the nurse explain the rationale for this treatment?

A) "It is a long shot, but maybe the chemotherapy will cure him."
B) "Sometimes the chemotherapy can reduce the size of the tumor."
C) "We just hate to give up on him. He is such a nice man."
D) "Chemotherapy can sometimes reduce the pain."
E) "Hopefully, the chemotherapy will improve his quality of life."

Question 30

A client's dosage schedule includes chemotherapy for each of 5 days and then no chemotherapy for 5 days. The client says, "Why don't they just keep giving me the chemo? I want to kill this cancer and get on with my life." How should the nurse respond?

A) "This chemotherapy is so strong that you cannot physically stand to take it for more than 5 days."
B) "We need to give your normal cells time to recover from the medication before you get more chemotherapy."
C) "You should let the doctors worry about that."
D) "We need to let some of the cancer cells develop into the stage where the chemotherapy can kill them."
E) "The chemotherapy is not always immediately available, so pauses are taken to allow for more stock to arrive."