Nokea
After teaching a group of nursing students about antineoplastic drugs, the instructor determines that the teaching was successful when the students identify which of the following as being classified as a plant alkaloid?
- A. Vincristine (Oncovin)
- B. Capecitabine (Xeloda)
- C. Paclitaxel (Taxol)
- D. Etoposide (Toposar)
- E. Irinotecan (Camptosar)
Correct Answer: A,C,D,E
Rationale: Drugs that are derived from plant alkaloids include vinca alkaloids (vincristine), taxanes (paclitaxel), podophyllotoxins (etoposide), and camptothecin analogs (irinotecan). Capecitabine is an antimetabolite.
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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 nurse is caring for a client being treated with antineoplastic drugs. The client is at risk for thrombocytopenia due to bone marrow suppression. The nurse would assess the client for which of the following?
- A. Bloody urine
- B. Concentrated urine
- C. Frequent micturition
- D. Pain on urination
Correct Answer: A
Rationale: The nurse should monitor for bloody urine in a client at risk for thrombocytopenia due to bone marrow suppression. Concentrated urine, frequent micturition, or pain on urination is not indicative of thrombocytopenia.
A client is receiving cisplatin. Based on the nurse's understanding that this drug can be nephrotoxic, the nurse anticipates that the primary health care provider will prescribe which of the following?
- A. Mesna
- B. Leucovorin
- C. Dexrazoxane
- D. Amifostine
Correct Answer: D
Rationale: Amifostine binds with the metabolites of cisplatin to protect the kidneys from the nephrotoxic effects. Mesna would be used with ifosfamide to protect the bladder from hemorrhagic cystitis. Leucovorin is used to provide folic acid to the cells after methotrexate administration. Dexrazoxane is a cardioprotective agent used with doxorubicin.
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 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.