Nokea
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.
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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.
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 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.
A patient is receiving her third course of 5-fluorouracil therapy and knows that stomatitis is a potential adverse effect of antineoplastic therapy. What will the nurse teach her about managing this problem?
- A. You can take aspirin to prevent stomatitis.
- B. Be sure to watch for and report black, tarry stools immediately.
- C. You need to increase your intake of foods containing fiber and citric acid.
- D. Be sure to examine your mouth daily for bleeding, painful areas, and ulcerations.
Correct Answer: D
Rationale: The symptoms of stomatitis consist of pain or burning in the mouth, difficulty swallowing, taste changes, viscous saliva, dryness, cracking, and fissures, with or without bleeding mucosa. Teach patients to avoid consuming foods containing citric acid and foods that are hot or spicy or high in fiber. Assessing stools is important but is not related to stomatitis, and aspirin must not be used during this therapy.