Nokea
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.
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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.
A nurse notifies the primary health care provider because assessment reveals signs of thrombocytopenia, including which of the following?
- A. Bleeding gums
- B. Petechiae
- C. Tarry stools
- D. Hematuria
- E. Coffee-ground emesis
Correct Answer: A,B,C,D,E
Rationale: The nurse should notify the physician immediately if any of the following occurs during observation of a client receiving an antineoplastic drug as they may be signs of thrombocytopenia: bleeding gums, easy bruising, petechiae, increased menstrual bleeding, tarry stools, hematuria, or coffee-ground emesis.
If the nurse has to clean up a spill of antineoplastic drug, which of the following personal protective equipment should be worn?
- A. Gloyes
- B. Safety goggles
- C. Gown
- D. Chemical spill boots
- E. NIOSH-approved respirator
Correct Answer: A,B,C,E
Rationale: A nurse should wear a gown, safety goggles, gloves, and a NIOSH-approved respirator when cleaning up a spill of an antineoplastic drug.
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.
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.