Nokea
After administering an antineoplastic drug, the nurse bases the ongoing assessment on which of the following factors?
- A. Client's general condition
- B. Client's individual response to the drug
- C. Adverse reactions that may occur
- D. Guidelines established by the oncology physician or clinic
- E. Results of periodic laboratory tests and radiographic scans
Correct Answer: A,B,C,D,E
Rationale: After the administration of an antineoplastic drug, the nurse bases the ongoing assessment on the following factors, client's general condition, client's individual response to the drug, adverse reactions that may occur, guidelines established by the oncology physician or clinic, and results of periodic laboratory tests and radiographic scans.
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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.
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.
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.
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.
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.