Nokea
A group of nursing students are reviewing antineoplastic drugs. The students demonstrate understanding of the information when they identify which of the following as cell cycle specific?
- A. Alkylating agents
- B. Plant alkaloids
- C. Antimetabolites
- D. Antineoplastic antibiotics
- E. Retinoids
Correct Answer: B,C
Rationale: Plant alkaloids and antimetabolites are considered cell cycle-specific antineoplastic drugs. Alkylating agents and antineoplastic antibiotics are cell cycle-nonspecific agents. Retinoids are miscellaneous agents.
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A nurse is preparing to administer an antineoplastic drug that is classified as an antimetabolite. Which of the following might the nurse be preparing to give?
- A. Mercaptopurine (Purinethol)
- B. Capecitabine (Xeloda)
- C. Fluorouracil (Adrucil)
- D. Etoposide (Toposar)
- E. Irinotecan (Camptosar)
Correct Answer: A,B,C
Rationale: Antimetabolite drugs are substances that incorporate themselves into the cellular components during the S phase of cell division and include mercaptopurine (Purinethol), capecitabine (Xeloda), and fluorouracil (Adrucil). Etoposide and irinotecan are plant alkaloids.
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.
A nurse is caring for a client undergoing treatment with plant alkaloids for cancer. The client is also receiving warfarin for a history of atrial fibrillation. The nurse would monitor the client for which of the following as a possible interaction?
- A. Increased risk of seizures
- B. Increased risk of ototoxicity
- C. Increased risk of CNS depression
- D. Increased risk of prolonged bleeding
Correct Answer: D
Rationale: The nurse should monitor the client for the increased risk of prolonged bleeding. Increased risk of seizures occurs when phenytoin interacts with a plant alkaloid. Increased risk of ototoxicity is observed in clients receiving plant alkaloids with loop diuretics. Increased risk of CNS depression is observed in clients who are receiving antidepressants along with plant alkaloids.
Which of the following should be included in the nurse's preadministration assessment before administering the first dose of an antineoplastic drug?
- A. Blood glucose
- B. Weight
- C. Fasting lipid panel
- D. Blood pressure
- E. Temperature
Correct Answer: B,D,E
Rationale: The nurse's preadministration assessment before the administration of the first dose of an antineoplastic drug should include the client's vital signs (blood pressure, temperature, pulse, and respiratory rate) and weight (to ensure accurate drug dosing).