Deck 38: Drugs for Neoplasia

Question 1

Which therapeutic interventions should the nurse include when teaching a client about the primary treatments for cancer? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

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

Answer 1

Surgery
Chemotherapy
Radiation therapy

Question 2

Which client should the nurse recognize has the highest risk for developing cancer?

A) The client who consumes excessive alcohol
B) The client who is 25 pounds overweight but exercises regularly
C) The client who usually applies sunscreen when going outdoors
D) The client who frequently forgets self-breast exams but has routine mammograms

Answer 2

The client who consumes excessive alcohol

Question 3

Which action should the nurse take after discontinuing an intravenous infusion of doxorubicin (Adriamycin) that has extravasated?

A) Inspect the area for irritation.
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.

Answer 3

Apply ice packs to the area immediately.

Question 4

The nurse has provided education about cancer prevention to a community group. Which statements made by the participants indicate an understanding of the information? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

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."

Question 5

A client asks the nurse why he is receiving several chemotherapeutic agents as treatment for cancer. Which response should the nurse provide the client?

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

A client with cancer asks the nurse how cancer occurs. Which response should the nurse provide the client?

A) "Cancer is genetic; you inherited the predisposition for cancer."
B) "Cancer cells are the 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 7

Which adverse effects should the nurse monitor the client receiving vincristine (Oncovin) for?

A) Neurotoxicity
B) Cardiotoxicity
C) Nephrotoxicity
D) Hepatotoxicity

Question 8

Which intervention should the nurse integrate into the plan of care for a client receiving cyclophosphamide (Cytoxan) experiencing oral irritation?

A) Instruct the client to avoid extreme temperatures of food selections.
B) Instruct the client to use an antiseptic mouthwash.
C) Instruct the client to rinse her mouth with normal saline.
D) Instruct the client to drink cold beverages.

Question 9

Which describes the main mechanism of action of alkylating agents?

A) The agents can become incorporated into the structures of DNA and RNA, resulting in a disruption of nucleic acid function.
B) When cancer cells attempt to synthesize proteins, RNA, or DNA metabolic pathways are disrupted and the cancer cells die or their growth is slowed.
C) They change the shape of the DNA double helix and prevent nucleic acid from completing normal cell division.
D) They either directly or indirectly bind to cancer cells causing an activation of the immune response which results in the destruction of the cancer cells.

Question 10

A client with leukemia asks the nurse where the cancer in her body is located. Which response should the nurse provide the client?

A) Epithelial tissue
B) Bone marrow
C) Connective tissue
D) Lymphoid tissue

Question 11

A client asks the nurse why lung cancers are less sensitive to antineoplastic agents. Which response should the nurse provide the client?

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 12

Which should the nurse include as the causes of cancer when providing client education? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) "Some cancers have a strong genetic component."
B) "Cancer can result from tissue trauma."
C) "Cancers have a very strong environmental component."
D) "Cancer can result from increased levels of stress."
E) "Cancer can result from damaged tumor suppressor genes."

Question 13

A client asks why tamoxifen is so effective for the treatment of breast cancer. Which response should the nurse provide the client?

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

Question 14

For which adverse effect should the nurse monitor the client prescribed tamoxifen?

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

Question 15

Which is the most important nursing consideration for clients receiving alkylating agents?

A) Nausea and vomiting
B) Nutritional intake
C) Skin integrity
D) CBC with differential

Question 16

Which describes the growth fraction ratio?

A) The number of replicating cells to the number of active cells.
B) The number of nonreplicating cells to the number of active cells.
C) The number of replicating cells to the number of resting cells.
D) The number of nonreplicating cells to the number of resting cells.

Question 17

Which clinical finding indicates the nurse should hold the dose of methotrexate (MTX)?

A) Ulcerative stomatitis
B) Elevated serum uric acid level
C) Deep vein thrombosis
D) Elevated white blood cell count

Question 18

Which adverse effect should the nurse monitor the client receiving doxorubicin (Adriamycin) for?

A) Neurotoxicity
B) Cardiotoxicity
C) Nephrotoxicity
D) Hepatotoxicity

Question 19

A client with Hodgkin's disease asks the nurse why he is receiving corticosteroids for chemotherapy. Which response should the nurse include in the discussion?

A) "The red blood cells are destroyed."
B) "They suppress cell division in lymphocytes."
C) "The prescription causes bone marrow suppression."
D) "The prescription blocks substances for tumor growth."

Question 20

Which finding should the nurse instruct the client receiving tamoxifen to immediately report to the healthcare provider?

A) A temperature of 101.1°F
B) Weight gain of 3 pounds in 1 week
C) Size increase of the tumor
D) Nausea and vomiting

Question 21

Which should the nurse identify as pharmacotherapy with natural products that have antineoplastic activity? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) Taxanes
B) Antimetabolites
C) Vinca alkaloids
D) Topoisomerase inhibitors
E) Alkylating agents

Question 22

A client with a benign tumor on his arm asks the nurse why he is not being treated with anything. Which response should the nurse provide? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) "Benign tumors do not metastasize."
B) "Many of the tumors are resistant to treatment."
C) "Treatment will only be required if the tumor continues to grow."
D) "Your tumor is slow growing."
E) "Benign tumors rarely require treatment."

Question 23

For which should the nurse monitor the older adult receiving chemotherapy? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) Hypotension
B) Incontinence
C) Peripheral neuropathy
D) Urinary retention
E) Reduced deep tendon reflexes

Question 24

A client with cancer that has not responded to treatment asks the nurse why he is being offered palliative chemotherapy. Which information should the nurse include in the discussion? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) "Palliative chemotherapy can continue to help slow the growth of the cancer."
B) "Sometimes the chemotherapy can reduce the size of the tumor."
C) "The cancer may still respond to treatment."
D) "Chemotherapy can sometimes reduce the pain."
E) "Chemotherapy may well improve your quality of life."

Question 25

Which should the nurse understand can be used to minimize bone marrow toxicity? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) Alkylating agents
B) Bone marrow transplantation
C) Hormone antagonists
D) Platelet administration
E) Growth factor therapy

Question 26

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

A) Notify the healthcare provider for a central line placement.
B) Wear gloves when drawing up the medication.
C) Understand the protocol for extravasation.
D) Place the client in reverse isolation prior to administering the vesicant.

Question 27

A client asks the nurse when she should start having Pap tests to help detect cervical cancer?
1) "You should start the testing by age 2
1)"
2) "You should start testing by age 21 or if you begin using alcohol."
3) "By age 21, but earlier if you have a family history of cancer."
4) "By age 21 or earlier if you are smoking."

Question 28

Which describes the action of aromatase inhibitors?

A) Block the estrogen receptors that stimulate the growth of ER-positive tumors
B) Block an enzyme that catalyzes the final step in the synthesis of estrogen
C) Suppress the ovary and adrenal gland from producing estrogen
D) Weaken the effect of estrogen on ER-positive tumors

Question 29

Which topics should the nurse include in the education of the client prescribed testosterone treatment for cancer? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) Weight gain
B) Sweating
C) Hair loss
D) Constipation
E) Nervousness

Question 30

Which action should the nurse take after discontinuing an intravenous infusion of vincristine (Oncovin) that has extravasated? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

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.