Nokea
A client is receiving cisplatin. Based on the nurse's understanding that this drug can be nephrotoxic, the nurse anticipates that the primary health care provider will prescribe which of the following?
- A. Mesna
- B. Leucovorin
- C. Dexrazoxane
- D. Amifostine
Correct Answer: D
Rationale: Amifostine binds with the metabolites of cisplatin to protect the kidneys from the nephrotoxic effects. Mesna would be used with ifosfamide to protect the bladder from hemorrhagic cystitis. Leucovorin is used to provide folic acid to the cells after methotrexate administration. Dexrazoxane is a cardioprotective agent used with doxorubicin.
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The nurse is providing care to a client with anorexia due to antineoplastic therapy. The nurse identifies a nursing diagnosis of Imbalanced Nutrition: Less Than Body Requirements. Which of the following would be least appropriate for the nurse to include in the client's plan of care?
- A. Offering fatty foods to stimulate the taste buds
- B. Providing small, frequent meals
- C. Avoiding exposure to unpleasant smells
- D. Providing foods that are high in protein
Correct Answer: A
Rationale: Greasy or fatty foods and unpleasant sights, smells, and tastes should be avoided. Small, frequent meals and foods that are high in protein are appropriate.
A nurse is caring for a client who is at risk for erythema during antineoplastic drug therapy. The nurse identifies a nursing diagnosis of Impaired Tissue Integrity. Which of the following would be appropriate to suggest?
- A. Scrub and clean skin often.
- B. Wear loose protective clothing.
- C. Ensure adequate sunlight.
- D. Have frequent baths.
Correct Answer: B
Rationale: The nurse should suggest to the client to wear loose protective clothing and to watch areas of skinfolds for breakdown. The nurse should not suggest that the client scrub and clean the skin often, ensure adequate sunlight, or have frequent baths as these measures may aggravate the condition and cause further impairment to the tissue. The client is advised to avoid sunlight.
A client is receiving an alkylating agent. Which of the following would be used?
- A. Bleomycin (Blenoxane)
- B. Chlorambucil (Leukeran)
- C. Vinblastine (Velban)
- D. Cyclophosphamide (Cytoxan)
- E. Ifosfamide (Ifex)
Correct Answer: B,D,E
Rationale: Alkylating agents make the cell a more alkaline environment, leading to cell damage. Alkylating agents include chlorambucil (Gliadel), cyclophosphamide (Cytoxan), and ifosfamide (Ifex). Bleomycin is classified as an antineoplastic antibiotic. Vinblastine is a plant alkaloid.
If the nurse has to clean up a spill of antineoplastic drug, which of the following personal protective equipment should be worn?
- A. Gloyes
- B. Safety goggles
- C. Gown
- D. Chemical spill boots
- E. NIOSH-approved respirator
Correct Answer: A,B,C,E
Rationale: A nurse should wear a gown, safety goggles, gloves, and a NIOSH-approved respirator when cleaning up a spill of an antineoplastic drug.
Which of the following alkylating agents can cross the blood-brain barrier?
- A. Cisplatin (Platinol-AQ)
- B. Melphalan (Alkeran)
- C. Carmustine (BiCNU)
- D. Streptozocin (Zanosar)
- E. Mechlorethamine (Mustargen)
Correct Answer: C,D
Rationale: Nitrosoureas, like carmustine (BiCNU) and streptozocin (Zanosar), are alkylating agents that can cross the blood-brain barrier.