Nokea
After teaching a group of nursing students about the cell cycle and how it relates to antineoplastic drugs, the instructor determines that the teaching was successful when the students identify which phase of the cell cycle as being affected by antimetabolites?
- A. S phase
- B. M phase
- C. G2 phase
- D. G1 phase
Correct Answer: A
Rationale: Antimetabolite drugs are substances that incorporate themselves into the cellular components during the S phase of cell division. This interferes with the synthesis of RNA and DNA, making it impossible for the cancerous cell to divide into two daughter cells. The vinca alkaloids interfere with amino acid production in the S phase and formation of microtubules in the M phase. Taxanes also interfere in the M phase with microtubules. Cells are stopped during the S and G2 phases by the podophyllotoxins and thus are unable to divide. DNA synthesis during the S phase is inhibited by camptothecin analog drugs such as topotecan (Hycamtin).
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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.
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 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 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.