Nokea
The nurse is teaching about infection-prevention measures with a patient who is receiving antineoplastic drug therapy. During a Teach-Back session, which statement by the patient indicates the need for further education?
- A. I will avoid those who have recently had a vaccination.
- B. I will eat only fresh fruits and raw vegetables.
- C. I will report a sore throat, cough, or low-grade temperature.
- D. It is important for both my family and me to practice good handwashing.
Correct Answer: B
Rationale: Patients who are neutropenic and susceptible to infections need to adhere to a low-microbe diet by washing fresh fruits and vegetables and making sure foods are well cooked. The other options are correct infection-prevention measures.
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A patient who has been on methotrexate therapy is experiencing mild pain. The patient is asking for aspirin for the pain. The nurse recognizes that which of these is true in this situation?
- A. The aspirin will aggravate diarrhea.
- B. The aspirin will mask signs of infection.
- C. Aspirin can lead to methotrexate toxicity.
- D. The aspirin will cause no problems for the patient on methotrexate.
Correct Answer: C
Rationale: Methotrexate interacts with weak organic acids, such as aspirin, and can lead to toxicity by displacing the methotrexate from protein-binding sites.
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.
A patient is receiving high doses of methotrexate and is experiencing severe bone marrow suppression. The nurse expects which intervention to be ordered with this drug to reduce this problem?
- A. A transfusion of whole blood
- B. Leucovorin rescue
- C. Ther9601Therapy with filgrastim
- D. Administration of allopurinol
Correct Answer: B
Rationale: High-dose methotrexate is associated with bone marrow suppression, and it is always given in conjunction with the rescue drug leucovorin, which is an antidote for folic acid antagonists. Basically, leucovorin rescues the healthy cells from methotrexate. The other options are incorrect.
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 irinotecan, along with other antineoplastic drugs, as treatment for ovarian cancer. The nurse will monitor for which potentially life-threatening adverse effect that is associated with this drug?
- A. Severe stomatitis
- B. Bone marrow suppression
- C. Delayed-onset cholinergic diarrhea
- D. Immediate and severe nausea and vomiting
Correct Answer: C
Rationale: In addition to producing hematologic adverse effects, irinotecan has been associated with severe diarrhea, known as cholinergic diarrhea, which may occur during infusions. Delayed diarrhea may occur 2 to 10 days after infusion. It is recommended that this condition can be treated with atropine unless use of that drug is strongly contraindicated. This diarrhea can be severe and even life-threatening.