Nokea
A nurse should monitor a client closely for signs of worsening atrial fibrillation when which of the following antineoplastic drugs are used concomitantly with digoxin (Lanoxin)?
- A. Mercaptopurine (Purinethol)
- B. Busulfan (Busulfex)
- C. Thiotepa (Thioplex)
- D. Doxorubicin (Doxil)
- E. Irinotecan (Camptosar)
Correct Answer: A,D,E
Rationale: Plant alkaloids (irinotecan), antimetabolites (mercaptopurine), and antineoplastic antibiotics (doxorubicin) can decrease serum digoxin (Lanoxin) levels and result in worsening atrial fibrillation.
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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.
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 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 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 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.