Nokea
A client is receiving doxorubicin. The nurse suspects that extravasation has occurred based on assessment of which of the following?
- A. Swelling
- B. Petechiae
- C. Lack of blood return
- D. Urticaria
- E. Redness
Correct Answer: A,C,E
Rationale: The nurse should monitor a client receiving doxorubicin (Doxil) for signs of extravasation, including swelling, stinging, burning, or pain at the injection site; redness; and lack of blood return.
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After teaching a group of nursing students about antineoplastic drugs, the instructor determines that the teaching was successful when the students identify which of the following as being classified as a plant alkaloid?
- A. Vincristine (Oncovin)
- B. Capecitabine (Xeloda)
- C. Paclitaxel (Taxol)
- D. Etoposide (Toposar)
- E. Irinotecan (Camptosar)
Correct Answer: A,C,D,E
Rationale: Drugs that are derived from plant alkaloids include vinca alkaloids (vincristine), taxanes (paclitaxel), podophyllotoxins (etoposide), and camptothecin analogs (irinotecan). Capecitabine is an antimetabolite.
A client is to start chemotherapy. The client is worried about going bald in the course of the treatment. How can the nurse assist the client in being comfortable with her body image?
- A. Forewarn about hair loss as permanent
- B. Explain it is not life-threatening
- C. Suggest the use of a wig or cap
- D. Explain that hair preserves body heat
Correct Answer: C
Rationale: The nurse can assist the client in being comfortable with her body image by suggesting that the client use a wig or cap until the hair grows back. The nurse should forewarn about hair loss to prepare the client for the outcome of the treatment. The nurse should explain that hair preserves body heat and loss of hair is not life-threatening, and this will put the client at ease during treatment.
A client has been diagnosed with cancer. The physician prescribes antineoplastic drug therapy to the client. Which of the following would the nurse include in the discussion about the prescribed therapy?
- A. Leads to complete cure of cancer
- B. Destroys only cancerous cells
- C. Provides complete relief of symptoms of cancer
- D. Delays spread of cancer to other sites
Correct Answer: D
Rationale: The nurse should explain to the client that antineoplastic drugs delay the spread of cancer to other sites in the body. These drugs do not always lead to the complete cure of cancer; instead, they slow the growth of the tumor. Antineoplastic drugs destroy not just cancerous cells but all rapidly dividing cells, which may be noncancerous also. These drugs do not provide complete relief from symptoms of cancer but can help in controlling the symptoms.
A client has been prescribed melphalan for the treatment of an ovarian tumor. The client wants to know how the drug acts. Which of the following would the nurse integrate into the response?
- A. Increased acidity of the cell environment
- B. Change to a more alkaline cell environment
- C. Neutralization of the alkalinity of the cell environment
- D. Change in the cell to a neutral environment
Correct Answer: B
Rationale: The nurse should explain to the client that the alkylating agent changes the cell to a more alkaline environment, which in turn damages malignant cells, which are more susceptible to the effects of the alkylating drugs. Alkylating drugs do not increase the acidity of the cell environment, neutralize the alkalinity of the cell environment, or change the cell to a neutral environment.
After teaching a group of nursing students about the cell cycle and how it relates to antineoplastic drugs, the instructor determines that the teaching was successful when the students identify which phase of the cell cycle as being affected by antimetabolites?
- A. S phase
- B. M phase
- C. G2 phase
- D. G1 phase
Correct Answer: A
Rationale: Antimetabolite drugs are substances that incorporate themselves into the cellular components during the S phase of cell division. This interferes with the synthesis of RNA and DNA, making it impossible for the cancerous cell to divide into two daughter cells. The vinca alkaloids interfere with amino acid production in the S phase and formation of microtubules in the M phase. Taxanes also interfere in the M phase with microtubules. Cells are stopped during the S and G2 phases by the podophyllotoxins and thus are unable to divide. DNA synthesis during the S phase is inhibited by camptothecin analog drugs such as topotecan (Hycamtin).