Nokea
A patient is receiving irinotecan, along with other antineoplastic drugs, as treatment for ovarian cancer. The nurse will monitor for which potentially life-threatening adverse effect that is associated with this drug?
- A. Severe stomatitis
- B. Bone marrow suppression
- C. Delayed-onset cholinergic diarrhea
- D. Immediate and severe nausea and vomiting
Correct Answer: C
Rationale: In addition to producing hematologic adverse effects, irinotecan has been associated with severe diarrhea, known as cholinergic diarrhea, which may occur during infusions. Delayed diarrhea may occur 2 to 10 days after infusion. It is recommended that this condition can be treated with atropine unless use of that drug is strongly contraindicated. This diarrhea can be severe and even life-threatening.
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One patient has cancer of the bone; another has cancer in the connective tissues of the thigh muscles; a third patient has cancer in the vascular tissues. Which of these is the correct term for these tumors?
- A. Sarcoma
- B. Leukemia
- C. Carcinoma
- D. Lymphoma
Correct Answer: A
Rationale: Sarcomas are malignant tumors that arise from connective tissues. These tissues can be found in bone, cartilage, muscle, blood, lymphatic, and vascular tissues. The other options are incorrect.
A patient, diagnosed with lymphoma, has an allergy to one of the proposed chemotherapy drugs. The tumor has not responded to other types of treatment. The nurse expects the oncologist to follow which course of treatment?
- A. The physician will choose another drug to use.
- B. The chemotherapy will be given along with supportive measures to treat a possible allergic reaction.
- C. The patient will receive reduced doses of chemotherapy for a longer period of time.
- D. The chemotherapy cannot be given because of the patient's allergy.
Correct Answer: B
Rationale: Even if a patient has a known allergic reaction to a given antineoplastic medication, the urgency of treating the patient's cancer may still necessitate administering the medication and then treating any allergic symptoms with supportive medications, such as antihistamines, corticosteroids, and acetaminophen.
The nurse is teaching about infection-prevention measures with a patient who is receiving antineoplastic drug therapy. During a Teach-Back session, which statement by the patient indicates the need for further education?
- A. I will avoid those who have recently had a vaccination.
- B. I will eat only fresh fruits and raw vegetables.
- C. I will report a sore throat, cough, or low-grade temperature.
- D. It is important for both my family and me to practice good handwashing.
Correct Answer: B
Rationale: Patients who are neutropenic and susceptible to infections need to adhere to a low-microbe diet by washing fresh fruits and vegetables and making sure foods are well cooked. The other options are correct infection-prevention measures.
The nurse is evaluating the laboratory results of a patient who has received chemotherapy. The loss of which blood cell leads to lack of energy, fatigue, intolerance of activity and hypoxemia?
- A. White blood cells
- B. Red blood cells
- C. Platelets
- D. Albumin
Correct Answer: B
Rationale: Bone marrow suppression from antineoplastics affects RBC values, leading to severe anemia. RBCs carry oxygen-attached to the hemoglobin-from the lungs to the rest of the body. RBCs also help carry carbon dioxide back to the lungs for exhalation. Therefore, if RBC counts are low (e.g., with anemia), the body does not get the oxygen it needs, which leads to lack of energy, fatigue, intolerance of activity, shortness of breath, and hypoxemia.
During treatment of a patient who has breast cancer, the nurse hears the oncologist mention that the patient has reached the 'nadir.' The nurse knows that this term means which of these?
- A. The lowest level of neutrophils reached during therapy.
- B. The highest level of neutrophils reached during therapy.
- C. The point at which the adverse effects of chemotherapy will stop.
- D. The point at which the cytotoxic action against cancer cells is the highest.
Correct Answer: A
Rationale: The lowest neutrophil count reached after a course of chemotherapy is known as the nadir. The other options are incorrect.