Nokea
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.
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After administering an antineoplastic drug, the nurse bases the ongoing assessment on which of the following factors?
- A. Client's general condition
- B. Client's individual response to the drug
- C. Adverse reactions that may occur
- D. Guidelines established by the oncology physician or clinic
- E. Results of periodic laboratory tests and radiographic scans
Correct Answer: A,B,C,D,E
Rationale: After the administration of an antineoplastic drug, the nurse bases the ongoing assessment on the following factors, client's general condition, client's individual response to the drug, adverse reactions that may occur, guidelines established by the oncology physician or clinic, and results of periodic laboratory tests and radiographic scans.
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.
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 caring for a client who is at risk for erythema during antineoplastic drug therapy. The nurse identifies a nursing diagnosis of Impaired Tissue Integrity. Which of the following would be appropriate to suggest?
- A. Scrub and clean skin often.
- B. Wear loose protective clothing.
- C. Ensure adequate sunlight.
- D. Have frequent baths.
Correct Answer: B
Rationale: The nurse should suggest to the client to wear loose protective clothing and to watch areas of skinfolds for breakdown. The nurse should not suggest that the client scrub and clean the skin often, ensure adequate sunlight, or have frequent baths as these measures may aggravate the condition and cause further impairment to the tissue. The client is advised to avoid sunlight.
A nurse is caring for a client undergoing treatment with plant alkaloids for cancer. The client is also receiving warfarin for a history of atrial fibrillation. The nurse would monitor the client for which of the following as a possible interaction?
- A. Increased risk of seizures
- B. Increased risk of ototoxicity
- C. Increased risk of CNS depression
- D. Increased risk of prolonged bleeding
Correct Answer: D
Rationale: The nurse should monitor the client for the increased risk of prolonged bleeding. Increased risk of seizures occurs when phenytoin interacts with a plant alkaloid. Increased risk of ototoxicity is observed in clients receiving plant alkaloids with loop diuretics. Increased risk of CNS depression is observed in clients who are receiving antidepressants along with plant alkaloids.