Nokea
A nurse is caring for a client being treated with antineoplastic drugs. The client is at risk for thrombocytopenia due to bone marrow suppression. The nurse would assess the client for which of the following?
- A. Bloody urine
- B. Concentrated urine
- C. Frequent micturition
- D. Pain on urination
Correct Answer: A
Rationale: The nurse should monitor for bloody urine in a client at risk for thrombocytopenia due to bone marrow suppression. Concentrated urine, frequent micturition, or pain on urination is not indicative of thrombocytopenia.
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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).
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.
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.
Which of the following are examples of immediate adverse reactions to an antineoplastic drug that the nurse should discuss with the client prior to drug administration?
- A. Fertility problems
- B. Extravasation
- C. Nausea
- D. Cardiotoxicity
- E. Pulmonary fibrosis
Correct Answer: B,C
Rationale: Nausea, vomiting, and extravasation are examples of immediate reactions to an antineoplastic drug that the nurse should discuss with the client prior to drug administration. Fertility problems, cardiotoxicity, and pulmonary fibrosis are more long-term adverse reactions.
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.