Nokea
A nurse notifies the primary health care provider because assessment reveals signs of thrombocytopenia, including which of the following?
- A. Bleeding gums
- B. Petechiae
- C. Tarry stools
- D. Hematuria
- E. Coffee-ground emesis
Correct Answer: A,B,C,D,E
Rationale: The nurse should notify the physician immediately if any of the following occurs during observation of a client receiving an antineoplastic drug as they may be signs of thrombocytopenia: bleeding gums, easy bruising, petechiae, increased menstrual bleeding, tarry stools, hematuria, or coffee-ground emesis.
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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.
Which of the following cytoprotective agents can be given along with antineoplastic drugs to help prevent or lessen certain adverse effects?
- A. Allopurinol (Zyloprim)
- B. Amifostine (Ethyol)
- C. Leucovorin (Wellcovorin)
- D. Mesna (Mesnex)
- E. Dexrazoxane (Zinecard)
Correct Answer: A,B,C,D,E
Rationale: Allopurinol (Zyloprim), amifostine (Ethyol), leucovorin (Wellcovorin), mesna (Mesnex), and dexrazoxane (Zinecard) are cytoprotective agents that can be given along with antineoplastic drugs to help prevent or lessen certain adverse effects.
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.
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 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.