Nokea
A patient who has been on methotrexate therapy is experiencing mild pain. The patient is asking for aspirin for the pain. The nurse recognizes that which of these is true in this situation?
- A. The aspirin will aggravate diarrhea.
- B. The aspirin will mask signs of infection.
- C. Aspirin can lead to methotrexate toxicity.
- D. The aspirin will cause no problems for the patient on methotrexate.
Correct Answer: C
Rationale: Methotrexate interacts with weak organic acids, such as aspirin, and can lead to toxicity by displacing the methotrexate from protein-binding sites.
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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.
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.
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.
The nurse is about to administer vincristine to a patient who has brain cancer. The patient has an intravenous port and an epidural line for pain medication. Which of these actions would the nurse question?
- A. Administer the vincristine via the intravenous line.
- B. Administer the vincristine via the intrathecal line (spinal route).
- C. Use an infusion pump for this medication.
- D. Give the vincristine with another chemotherapeutic agent.
Correct Answer: B
Rationale: Vincristine and other vinca alkaloids are not given intrathecally (via the spinal route) or by any other route except intravenously. Administering these drugs through the spinal route is almost always fatal, and the death is slow and excruciating. The error cannot be reversed once the medication is given. These drugs are often given in combination with other chemotherapeutic agents, and an infusion pump must be used for accurate delivery of medication.
The nurse is developing a plan of care for a patient who is experiencing gastrointestinal adverse effects, including anorexia and nausea, after the first course of antineoplastic therapy. What is an appropriate outcome for this patient when dealing with this problem?
- A. The patient will eat three balanced meals a day within 2 days.
- B. The patient will return to normal eating pattern within 4 weeks.
- C. The patient will maintain normal weight by consuming healthy snacks as tolerated.
- D. The patient will maintain a diet of small, frequent feedings with nutrition supplements during therapy.
Correct Answer: D
Rationale: Consuming small, frequent meals with nutritional supplements and maintaining a bland diet help to improve nutrition during antineoplastic therapy.