Chapter 44: Drugs Used for Cancer Treatment My Nursing Test Banks

Chapter 44: Drugs Used for Cancer Treatment

Test Bank

MULTIPLE CHOICE

1. The nurse is educating a patient with cancer about combination chemotherapy. Which is an accurate statement?

a.

Combination chemotherapy is the administration of an antineoplastic drug that will be toxic during a specific phase of cellular growth.

b.

Combination chemotherapy is the administration of an antineoplastic drug that is active throughout the cell cycle.

c.

Combination chemotherapy is the administration of antineoplastic drugs that change the way the body responds to cancer or strengthens the immune system.

d.

Combination chemotherapy is the administration of antineoplastic drugs, which results in cell death during different phases of the cell cycle.

ANS: D

Use of combination drug therapy is superior in therapeutic effect to the use of single agent chemotherapy.

DIF: Cognitive Level: Comprehension REF: p. 699 OBJ: 5

TOP: Nursing Process Step: Implementation

MSC: NCLEX Client Needs Category: Physiological Integrity

2. The cell cyclespecific agent vincristine sulphate (Oncovin) acts in which phase of the cells life cycle?

a.

S phase

b.

Mitotic phase

c.

Phase G1

d.

Phase G0

ANS: B

Vinca alkaloids block the formation of the mitotic spindle during mitosis, thus inhibiting cell division. The S phase is the stage of active synthesis of two sets of DNA. Phase G1 is considered a presynthetic phase in which the cell prepares for DNA synthesis by manufacturing necessary enzymes. G0 is the largest variable in the cell cycle and, during this resting phase, the cell is not actively replicating.

DIF: Cognitive Level: Knowledge REF: p. 698 OBJ: 3

TOP: Nursing Process Step: Implementation

MSC: NCLEX Client Needs Category: Physiological Integrity

3. What is the importance of correlating the dosage schedule with cell cyclespecific drug therapy?

a.

Ongoing proliferation of neoplastic tissue

b.

The known cellular kinetics of the neoplasm

c.

The hormonal requirements of the patient

d.

The bodys response in strengthening the immune system

ANS: B

Cell cyclespecific agent scheduling should be correlated with the known cellular kinetics of the particular type of neoplasm being treated. This type of drug is schedule dependent and selectively toxic when the cell is in a specific phase of growth. The object of chemotherapy is to stop the proliferation of neoplastic tissue. Hormones are only used in specific types of cancer and are not related to cell cycle specificity. Immunomodulators are used to enhance the bodys response in strengthening the immune system.

DIF: Cognitive Level: Comprehension REF: pp. 698-699 OBJ: 3

TOP: Nursing Process Step: Implementation

MSC: NCLEX Client Needs Category: Physiological Integrity

4. When are cancer cells most sensitive to chemotherapy?

a.

Resting phases

b.

Rapid division

c.

Remission intervals

d.

Slow replication

ANS: B

The cancer cells are the most sensitive to chemotherapy when the cells are dividing rapidly. Cancer cells are not sensitive to chemotherapy during resting phases, remission intervals, or slow replication.

DIF: Cognitive Level: Knowledge REF: p. 699 OBJ: 5

TOP: Nursing Process Step: Implementation

MSC: NCLEX Client Needs Category: Physiological Integrity

5. What is the advantage of combination therapy using cell cyclespecific and cell cyclenonspecific agents?

a.

Decreased expense and time needed for administration

b.

Decreased toxicity to patients and the nurses who administer the drug

c.

Increased cell death in various cycles and decreased toxicity

d.

Increased rate of treatment success

ANS: D

Combination therapy is far superior to the use of single agent therapy. The use of a cell cyclespecific and cell cyclenonspecific agent together facilitates cell death during different phases of the cell cycle. Combination therapy is not more economical or faster. Combination therapy is not less toxic because it exposes patients and nurses to additional medications. The use of combination drug therapy allows for cell death during different phases of the cell cycle, but the agents often have toxic effects on different organs at different time intervals after administration.

DIF: Cognitive Level: Comprehension REF: p. 699 OBJ: 3

TOP: Nursing Process Step: Evaluation

MSC: NCLEX Client Needs Category: Physiological Integrity

6. Why is a patient with prostate cancer prescribed an estrogen?

a.

To achieve hormonal balance

b.

To decrease the rate of production for malignant cells

c.

To soften prostatic tissue

d.

To suppress prostate gland function

ANS: B

Estrogen therapy is used during the treatment of prostate cancer to decrease the rate of production of malignant cells. The use of female hormones decreases the amount of male hormones available for use by the cancer cells. Estrogen is not given for hormonal balance, does not soften prostatic tissue, and does not suppress prostate gland function.

DIF: Cognitive Level: Comprehension REF: p. 707 OBJ: 3 | 5

TOP: Nursing Process Step: Evaluation

MSC: NCLEX Client Needs Category: Physiological Integrity

7. Which assessment by the nurse would be a sign of neurotoxicity related to chemotherapy?

a.

Paresthesia

b.

Euphoria

c.

Nausea

d.

Hallucinations

ANS: A

Signs and symptoms of neurotoxicity include numbness and tingling in extremities, confusion, changes in gait, and motor weakness. Euphoria, nausea, and hallucinations are not signs of neurotoxicity related to chemotherapy.

DIF: Cognitive Level: Knowledge REF: p. 714 OBJ: 7

TOP: Nursing Process Step: Evaluation

MSC: NCLEX Client Needs Category: Physiological Integrity

8. Which symptom is the patient who is receiving bleomycin (Blenoxane) therapy most likely to exhibit?

a.

Increased respiratory rate and cough

b.

Weight gain and peripheral edema

c.

Numbness and tingling of hands and feet

d.

Lethargy and orthostatic hypotension

ANS: A

Compromised respiratory function may occur in patients receiving bleomycin therapy. Increased respiratory rate and cough can be signs that further problems are developing, such as heart failure. Bleomycin does not cause weight gain, peripheral edema, numbness and tingling of hands and feet, lethargy, or orthostatic hypotension.

DIF: Cognitive Level: Comprehension REF: p. 703 OBJ: 7

TOP: Nursing Process Step: Assessment

MSC: NCLEX Client Needs Category: Physiological Integrity

9. What is the purpose of administering filgrastim (Neupogen) to a patient who is postbowel resection resulting from cancer?

a.

Decrease the gastrointestinal (GI) toxicity resulting from chemotherapeutic agents

b.

Suppress the immune response

c.

Work as an antiemetic and stimulate his appetite

d.

Increase the white blood cell (WBC) counts

ANS: D

Filgrastim works to stimulate WBC production and decrease the incidence of infection. Filgrastim is a colony stimulating factor, which stimulates WBC proliferation and maturation. It is particularly helpful for patients prone to neutropenia resulting from cancer therapy. Filgrastim does not affect GI toxicity, suppress immune response (it works to enhance it), or affect appetite or nausea.

DIF: Cognitive Level: Application REF: p. 707 | p. 711

OBJ: 7 TOP: Nursing Process Step: Implementation

MSC: NCLEX Client Needs Category: Health Promotion and Maintenance

10. What is the intended outcome of the chemoprotective drug amifostine (Ethyol)?

a.

Decreased nausea and vomiting

b.

Increased effectiveness of the chemotherapy

c.

Maintenance of body weight

d.

Decreased renal toxicity

ANS: D

Amifostine is used to reduce the cumulative renal toxicity associated with the repeated administration of cisplatin in patients with advanced ovarian cancer. Chemoprotective drugs do not decrease nausea and vomiting, enhance the effectiveness of chemotherapy treatment, or help prevent weight loss.

DIF: Cognitive Level: Comprehension REF: p. 710 OBJ: 5

TOP: Nursing Process Step: Implementation

MSC: NCLEX Client Needs Category: Physiological Integrity

11. Why are bone marrow stimulants used in the treatment of cancer?

a.

To increase uptake of the chemotherapy from the interior of the bones

b.

To strengthen bones weakened by pathologic processes

c.

To enhance the patients immune system during treatment

d.

To protect the bone marrow from destructive actions from the cancer treatment

ANS: C

Bone marrow stimulants trigger the recovery of bone marrow cells several days earlier than would be the natural course of recovery. The major benefit to this earlier recovery is that patients immune systems are able to respond to and stop infections from being so pathologic, and patients can be released from the isolation room several days earlier. Bone marrow stimulants do not increase uptake of drugs, strengthen bones, or protect the bone marrow from destructive effects of chemotherapy or radiation.

DIF: Cognitive Level: Comprehension REF: p. 707 OBJ: 6

TOP: Nursing Process Step: Implementation

MSC: NCLEX Client Needs Category: Physiological Integrity

12. The nurse is providing education about chemotherapy to a patient who is being discharged. Which statement by the patient indicates a need for further teaching?

a.

I will shave with an electric razor.

b.

I will take aspirin for a headache.

c.

I will wash my laundry separate from other family members.

d.

I will flush the toilet twice after using.

ANS: B

Patients should not take any aspirin or aspirin containing products. Shaving with an electric razor is preferable for a patient undergoing chemotherapy because of the decreased risk of bleeding. The clothing of the chemotherapy patient should be washed separately from other household linens. Because most chemotherapeutic agents are excreted in the urine and feces, it is best to flush the toilet two or three times.

DIF: Cognitive Level: Application REF: p. 715 OBJ: 7

TOP: Nursing Process Step: Evaluation

MSC: NCLEX Client Needs Category: Physiological Integrity

13. The nurse is caring for a patient diagnosed with breast cancer. The patient reports that she has been experiencing frequent watery stools following chemotherapy treatment. When educating the patient regarding dietary guidelines to help relieve symptoms the nurse will encourage:

a.

eliminating spicy foods.

b.

eating low protein foods.

c.

implementing a high roughage diet.

d.

eating high fat foods.

ANS: A

Elimination of spicy foods should be encouraged for the patient experiencing diarrhea resulting from chemotherapy. High protein foods, a diet low in roughage, and a diet with low fat foods should be encouraged for the patient experiencing diarrhea resulting from chemotherapy.

DIF: Cognitive Level: Application REF: p. 713 OBJ: 7

TOP: Nursing Process Step: Implementation

MSC: NCLEX Client Needs Category: Physiological Integrity

14. The nurse is preparing to administer medroxyprogesterone acetate as prescribed to a patient diagnosed with endometrial carcinoma. When gathering supplies to provide this medication, the nurse will obtain a(n):

a.

plastic medication cup.

b.

medicine dropper.

c.

subcutaneous needle and syringe.

d.

intramuscular (IM) needle and syringe.

ANS: D

Medroxyprogesterone is ordered at 400-1000 mg IM per week.

DIF: Cognitive Level: Application REF: p. 706 OBJ: 4

TOP: Nursing Process Step: Implementation

MSC: NCLEX Client Needs Category: Physiological Integrity

MULTIPLE RESPONSE

15. Major chemotherapeutic agents include: (Select all that apply.)

a.

alkylating agents.

b.

antineoplastic antibiotics.

c.

hormones.

d.

antimetabolites.

e.

antinuclear antibodies.

f.

chelating agents.

ANS: A, B, C, D

Alkylating agents, antineoplastic antibiotics, hormones, and antimetabolites are considered major chemotherapeutic agents. Antinuclear antibodies are antibodies produced by the immune system that attack the bodys own tissues instead of foreign toxins. They are frequently present in people with systemic lupus erythematosus and, less commonly, in other diseases. Chelating agents are used to detoxify a patient from heavy metal poisoning.

DIF: Cognitive Level: Comprehension REF: p. 707 OBJ: 5

TOP: Nursing Process Step: Implementation

MSC: NCLEX Client Needs Category: Physiological Integrity

16. Which nursing consideration(s) would be taken into account prior to the administration of cisplatin IV? (Select all that apply.)

a.

Review of laboratory data for presence of myelosuppression and hepatic and renal parameters

b.

Administration of IV hydration as prescribed

c.

Administration of epoetin alfa (Epogen)

d.

Administration of prechemotherapy mesna (Mesnex)

e.

Assessment for dermatologic conditions

ANS: A, B, D

Premedication nursing considerations regarding cisplatin, an alkylating agent, include checking laboratory reports for baseline data reflecting hepatic and renal function and baseline hematologic studies that reflect the degree of myelosuppression present before initiating chemotherapy, assessing patient hydration and the health care providers orders for oral and IV hydration instructions before drug therapy, and administering prechemotherapy drugs including mesna, ondansetron, and antianxiety drugs. Epogen is given to treat anemia associated with chemotherapy; it is not given before administration of chemotherapy. Dermatologic assessment is not necessary before administering cisplatin.

DIF: Cognitive Level: Application REF: p. 700 | p. 703 | pp. 712-713

OBJ: 7 TOP: Nursing Process Step: Implementation

MSC: NCLEX Client Needs Category: Physiological Integrity

17. Which sign(s) and symptom(s) assessed by the nurse would indicate thrombocytopenia? (Select all that apply.)

a.

Pinpoint red rash

b.

Casts in urine

c.

Brown, fatty stools

d.

Increase in menstrual flow

e.

Coffee ground emesis

ANS: A, D, E

Pinpoint red rash, an increase in menstrual flow, and coffee ground emesis indicate thrombocytopenia, which causes an increased tendency to bleed. Thrombocytopenia may cause hematuria and dark, tarry stools.

DIF: Cognitive Level: Application REF: p. 713 | p. 715

OBJ: 7 TOP: Nursing Process Step: Assessment

MSC: NCLEX Client Needs Category: Health Promotion and Maintenance

18. Which treatment(s) may be used alone or in combination for the treatment of cancer? (Select all that apply.)

a.

Surgery

b.

Radiation

c.

Chemotherapy

d.

Immunotherapy

e.

Phlebotomy

ANS: A, B, C, D

Treatment of cancer often requires surgery, radiation, chemotherapy, and/or immunotherapy. Phlebotomy does not treat cancer cells.

DIF: Cognitive Level: Comprehension REF: p. 698 OBJ: N/A

TOP: Nursing Process Step: Implementation

MSC: NCLEX Client Needs Category: Physiological Integrity

19. When educating the patient on chemotherapy regarding skin care, the nurse will include: (Select all that apply.)

a.

vigorously drying the skin with a bath towel.

b.

avoiding sunlight.

c.

using mild soap.

d.

avoiding moisturizer.

e.

bathing in lukewarm water.

ANS: B, C, E

The need to avoid sunlight should be stressed to avoid a photosensitive reaction. The patient should bathe in lukewarm water and use mild soap. Skin should be gently patted dry. Use of skin moisturizer should be discussed with the physician.

DIF: Cognitive Level: Application REF: p. 714 OBJ: 7

TOP: Nursing Process Step: Implementation

MSC: NCLEX Client Needs Category: Health Promotion and Maintenance

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