Nokea
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.
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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.
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.
The nurse suspects that a client is developing leukopenia and notifies the primary health care provider based on assessment of which of the following?
- A. Temperature of 100.4°F or higher
- B. Cough
- C. Sore throat
- D. Frequent urination
- E. White blood cell count of less than 2500/mm³
Correct Answer: A,B,C,D,E
Rationale: The nurse should notify the physician immediately if any of the following occur during observation of a client receiving an antineoplastic drug as they may be signs of leukopenia: temperature of 100.4°F or higher, cough, sore throat, chills, frequent urination, or a white blood cell count of less than 2500/mm³.
A nurse is caring for a client who is prescribed Velban, a vinca alkaloid. The client asks the nurse about how the drug acts. Which of the following would the nurse integrate into the response?
- A. Interference with amino acid production in the S phase.
- B. Stoppage of cells during the S and G2 phases.
- C. Inhibition of DNA synthesis during the S phase.
- D. Prevention of cell division during the S and G2 phases
Correct Answer: A
Rationale: Vinca alkaloids interfere with amino acid production in the S phase. Podophyllotoxins stop the cells and prevent cell division during the S and G2 phases. Camptothecin analog drugs inhibit DNA synthesis during the S phase.
The primary health care provider prescribes an antineoplastic antibiotic. The nurse identifies which of the following as a possibility?
- A. Bleomycin (Blenoxane)
- B. Carboplatin (Paraplatin)
- C. Dactinomycin (Cosmegen)
- D. Daunorubicin (DaunoXome)
- E. Busulfan (Busulfex)
Correct Answer: A,C,D
Rationale: Antineoplastic antibiotics have similar action to alkylating drugs and include bleomycin (Blenoxane), dactinomycin (Cosmegen), and daunorubicin (DaunoXome). Carboplatin is an alkylating agent. Busulfan is an alkyl sulfonate alkylating agent.