The nurse is providing care to a client with anorexia due to antineoplastic therapy. The nurse identifies a nursing diagnosis of Imbalanced Nutrition: Less Than Body Requirements. Which of the following would be least appropriate for the nurse to include in the client's plan of care?
- A. Offering fatty foods to stimulate the taste buds
- B. Providing small, frequent meals
- C. Avoiding exposure to unpleasant smells
- D. Providing foods that are high in protein
Correct Answer: A
Rationale: Greasy or fatty foods and unpleasant sights, smells, and tastes should be avoided. Small, frequent meals and foods that are high in protein are appropriate.
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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.
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).
A nurse is discussing the possible adverse reactions that may occur with antineoplastic therapy. Which of the following would the nurse discuss as examples of long-term adverse reactions?
- A. Fertility problems
- B. Thrombocytopenia
- C. Leukopenia
- D. Stomatitis
- E. Cardiotoxicity
Correct Answer: A,E
Rationale: Fertility problems, cardiotoxicity, pulmonary toxicity, and neurologic problems are examples of long-term reactions to an antineoplastic drug that the nurse should discuss with the client prior to drug administration. Thrombocytopenia, leukopenia, and stomatitis are more immediate adverse reactions.
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.
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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