Nokea
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.
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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 cytoprotective agents can be given along with antineoplastic drugs to help prevent or lessen certain adverse effects?
- A. Allopurinol (Zyloprim)
- B. Amifostine (Ethyol)
- C. Leucovorin (Wellcovorin)
- D. Mesna (Mesnex)
- E. Dexrazoxane (Zinecard)
Correct Answer: A,B,C,D,E
Rationale: Allopurinol (Zyloprim), amifostine (Ethyol), leucovorin (Wellcovorin), mesna (Mesnex), and dexrazoxane (Zinecard) are cytoprotective agents that can be given along with antineoplastic drugs to help prevent or lessen certain adverse effects.
Which of the following alkylating agents can cross the blood-brain barrier?
- A. Cisplatin (Platinol-AQ)
- B. Melphalan (Alkeran)
- C. Carmustine (BiCNU)
- D. Streptozocin (Zanosar)
- E. Mechlorethamine (Mustargen)
Correct Answer: C,D
Rationale: Nitrosoureas, like carmustine (BiCNU) and streptozocin (Zanosar), are alkylating agents that can cross the blood-brain barrier.
A nurse is preparing to administer an antineoplastic drug that is classified as an antimetabolite. Which of the following might the nurse be preparing to give?
- A. Mercaptopurine (Purinethol)
- B. Capecitabine (Xeloda)
- C. Fluorouracil (Adrucil)
- D. Etoposide (Toposar)
- E. Irinotecan (Camptosar)
Correct Answer: A,B,C
Rationale: Antimetabolite drugs are substances that incorporate themselves into the cellular components during the S phase of cell division and include mercaptopurine (Purinethol), capecitabine (Xeloda), and fluorouracil (Adrucil). Etoposide and irinotecan are plant alkaloids.
A client has been prescribed melphalan for the treatment of an ovarian tumor. The client wants to know how the drug acts. Which of the following would the nurse integrate into the response?
- A. Increased acidity of the cell environment
- B. Change to a more alkaline cell environment
- C. Neutralization of the alkalinity of the cell environment
- D. Change in the cell to a neutral environment
Correct Answer: B
Rationale: The nurse should explain to the client that the alkylating agent changes the cell to a more alkaline environment, which in turn damages malignant cells, which are more susceptible to the effects of the alkylating drugs. Alkylating drugs do not increase the acidity of the cell environment, neutralize the alkalinity of the cell environment, or change the cell to a neutral environment.