Deck 12: Anticancer Drugs

Question 1

Which biologic feature is specific to normal differentiated cells but not to cancer cells?

A) Anaplasia
B) Hypertrophy
C) Aneuploidy
D) Loose adherence

Answer 1

Hypertrophy

Question 2

A patient who is receiving intravenous (IV)chemotherapy asks why you are wearing a mask,gloves,and gown when giving the drugs.What is your best response?

A) "These drugs will reduce your immune response,and with these coverings I am protecting you from getting an infection from me."
B) "Because your immunity is reduced by this therapy,I am preventing the spread of infection from you to me or any other patient here."
C) "The drugs are powerful and I handle them every day.The clothing protects me from accidentally absorbing these strong drugs."
D) "The hospital policy is for any person giving these drugs to wear gowns,gloves,and masks to prevent other people from getting cancer."

Answer 2

"The drugs are powerful and I handle them every day.The clothing protects me from accidentally absorbing these strong drugs."

Question 3

What is the most important intervention for extravasation of an IV chemotherapy drug?

A) Ensure that the drug given is the exact drug and dosage ordered.
B) Administer the chemotherapy through an 18-gauge IV catheter.
C) Instruct the patient to keep his or her arm below heart level.
D) Prevent extravasation from ever occurring.

Answer 3

Prevent extravasation from ever occurring.

Question 4

When it is time for a patient's third round of chemotherapy for colon cancer,the patient's white blood cell count is low and the treatment is delayed.The patient is upset at this delay.What is your best response?

A) "This extra time will give your hair a chance to grow back in."
B) "This is for the best.You are too weak to receive chemotherapy now."
C) "I will call the physician and request a prescription for something to calm your nerves."
D) "Try not to worry.Your counts will probably be high enough next week and the chemotherapy will work just as well then."

Question 5

A patient arrives to receive a second round of combination chemotherapy.What is the most important patient assessment finding to report to the prescriber?

A) Height
B) Weight
C) Blood pressure
D) Pulse rate and rhythm

Question 6

A patient who is to receive a third round of combination chemotherapy today reports that mouth sores were present for 4 days within a week of receiving the last round of chemotherapy.What is your best action?

A) Hold today's dose of chemotherapy and notify the prescriber immediately.
B) Ask the patient whether sores were also present after the first round of chemotherapy.
C) Reassure the patient that this is an expected chemotherapy side effect and no action is needed.
D) Administer the chemotherapy as prescribed and call the prescriber to determine whether preventive drugs are needed.

Question 7

Which statement regarding "dose dense" chemotherapy is true?

A) It requires large volumes of intravenous fluids because it is very thick.
B) It can be given only to patients whose cancers have a specific target.
C) The dosage is based on the type of cancer and not on patient size.
D) The side effects are more severe and harder to control.

Question 8

How do most chemotherapy drugs help rid the body of cancer cells?

A) They interfere with cancer cell division.
B) They prevent cancer cells from receiving oxygen.
C) They enhance the immune system's ability to recognize and kill cancer cells.
D) They force cancer cells to undergo reverse transformation to become normal cells.

Question 9

How does oncogene activation cause normal cells to transform into cancer cells?

A) By inhibiting the ability of suppressor gene products to regulate the cell cycle
B) By increasing the amount of cyclins present so that cells keep entering the cell cycle and dividing
C) By preventing the immune system from recognizing and eliminating cells that are no longer totally normal
D) By reducing the amount of glucose and other nutrients that reach normal cells,resulting in the starvation and death of normal cells

Question 10

Why is it necessary to wear personal protective equipment (PPE)when preparing or administering chemotherapy?

A) To allow maximum potency to be maintained
B) To keep the drugs from becoming contaminated
C) To prevent absorption through skin and mucous membranes
D) To ensure the patient's blood does not come into direct contact with another person

Question 11

Which normal tissue often shows side effects of therapy with any of the epidermal growth factor receptor inhibitor (EGFRI)drugs?

A) Skin
B) Kidney
C) Heart
D) Lungs

Question 12

Why is chemotherapy considered "systemic" treatment for cancer?

A) The dosage of chemotherapy is based on weight or square meters.
B) The drugs are all cytotoxic and can cause serious harm if given at the wrong dose.
C) It attacks rapidly dividing cells rather than cells that are either slowly dividing or not dividing.
D) It circulates throughout the body and exerts its effects wherever the cells are located.

Question 13

Which health care worker is the most appropriate person to administer intravenous (IV)chemotherapy?

A) Licensed practical/vocational nurse who has worked on an oncology unit for 10 years
B) Registered nurse who has completed menopause 5 years ago and can no longer get pregnant
C) Registered nurse who has completed an approved chemotherapy course
D) Pharmacy technician with 5 years' experience in mixing chemotherapy

Question 14

Which term means a substance that can cause cancer development?

A) Malignant transformation
B) Thrombocytopenia
C) Carcinogen
D) Emetogenic

Question 15

Which side effect of chemotherapy puts patients at increased risk for infection?

A) Anemia
B) Hypoxemia
C) Neutropenia
D) Thrombocytopenia

Question 16

Which type of chemotherapy drug causes tissue damage on direct contact?

A) Cyclins
B) Vesicants
C) Biologics
D) Emetogenics

Question 17

Which class of chemotherapy drugs works by interfering with the formation of tubules so that new cells cannot separate during cell division?

A) Antimetabolites
B) Antitumor antibiotics
C) Antimitotics
D) Alkylating agents

Question 18

A patient with breast cancer asks why her hair is falling out while receiving chemotherapy when the cancer is in her breast.What is your best response?

A) "Breast cells and hair cells are similar.Any drug that affects one can be expected to affect the other."
B) "The chemotherapy is interfering with your nutritional status.Eating more protein will help stop the hair loss."
C) "It is possible that some cancer cells have escaped from your breast.Chemotherapy will kill cancer cells wherever they are."
D) "Chemotherapy is delivered to all tissues and exerts the same damaging effects on some normal cells as well as on cancer cells."

Question 19

To what cancer therapy drug class does anastrozole (Arimidex)belong?

A) Alkylating agent
B) Biological response modifier
C) Hormone inhibitor
D) Miscellaneous agent

Question 20

Which action is most important to perform the first time a patient receives intravenous chemotherapy?

A) Close the door to the room and do not let children visit.
B) Wear a gown,mask,and gloves while taking vital signs.
C) Stay with the patient during the first 15 minutes of the infusion.
D) Be sure that two units of blood for the patient are on the unit before starting the infusion.

Question 21

Calculate the meter square body surface area for a man who is 5 feet 9 inches tall and weighs 157 lb.

Question 22

Which intervention is most important to teach a patient receiving chemotherapy with a drug that causes thrombocytopenia?

A) "Eat a low bacteria diet."
B) "Take your temperature daily."
C) "Use a soft-bristled toothbrush and do not floss."
D) "Avoid using mouthwashes that contain alcohol."

Question 23

How is therapy with biological response modifiers (BRMs)different from targeted therapy?

A) There is no difference;the terms mean the same thing.
B) Targeted therapy only works on cancers that are inherited and BRMs work on all cancers.
C) BRMs are administered as oral agents whereas targeted therapies must be injected directly into the tumor to be effective.
D) BRMs affect the general immune response of anyone who takes the drug and targeted therapies only work in cancer cells that have a specific target.

Question 24

A patient is receiving intravenous (IV)chemotherapy through a peripheral line.Which IV site assessment finding indicates that the IV access needs to be discontinued?

A) Bruising at the insertion site
B) Coolness of the skin below the site
C) Tissue swelling above and below the site
D) Wetness of the dressing over the access site

Question 25

A male patient is prescribed estrogen as hormone treatment for cancer.Which assessment is most important to perform for this patient?

A) Ask whether there has been a change in the level of sexual activity.
B) Compare breast size after therapy to that from before therapy.
C) Check for swelling and hard,cordlike veins in the legs.
D) Measure the patient's abdominal girth.

Question 26

Which chemotherapy agents in this list have a high emetogenic potential? (select all that apply)

A) Busulfan (Myleran)
B) Capecitabine (Xeloda)
C) Dactinomycin (Cosmegen)
D) Floxuridine (FUDR)
E) Melphalan (Alkeran)

Question 27

Which complications or responses to chemotherapy have a greater impact among older adults who receive intravenous chemotherapy? (select all that apply)

A) Alopecia
B) Headache
C) Nausea/vomiting
D) Neutropenia
E) Peripheral neuropathy

Question 28

How does flutamide (Eulexin)control prostate cancer?

A) It prevents the adrenal gland from producing testosterone and lowers blood testosterone levels.
B) It stimulates the lymphocytes of the immune system to attack and destroy prostate cancer cells as if they were foreign tissues.
C) It is an antiandrogen that binds to testosterone receptors and prevents or slows prostate cancer cell growth.
D) It is a synthetic estrogen (an estrogen agonist)that binds testosterone receptors and prevents or slows prostate cancer cell growth.

Question 29

Which physical change indicates the patient receiving interferon therapy for melanoma may have peripheral neuropathy?

A) Alopecia
B) Numb toes
C) Frequent urination
D) Diarrhea

Question 30

Which side effects are most common among patients receiving therapy with biological response modifiers (BRMs)?

A) Alopecia and bad breath
B) Abdominal cramps and constipation
C) Productive cough and wheezing
D) Fever,chills,and flulike symptoms

Question 31

Which chemotherapy problem,experienced by a patient after the first round of chemotherapy,do you report to the prescriber to reduce the chemotherapy dose or delay the next treatment?

A) Productive cough and fever
B) Loss of scalp and body hair
C) Moderate nausea/vomiting
D) Fatigue and increased sleep time

Question 32

An infant with cancer is to receive vincristine (Oncovin)0.05 mg/kg intravenously.The infant weighs 18 lb.What is the appropriate dose,in mg?

Question 33

A patient receiving hormone manipulation as cancer therapy has all of the following side effects.For which one should you notify the prescriber immediately?

A) Redness,pain,and swelling of the calf
B) Fluid retention with weight gain
C) Acne and darkening of the skin
D) Breast swelling and tenderness