Mr. Lepp is a 63-year-old man who was diagnosed with colon cancer several weeks ago and who is scheduled to begin chemotherapy. He reports to the nurse that he read about the need for erythropoietin in an online forum for cancer patients and wants to explore the use of epoetin alfa with his oncologist. Which of the following facts should underlie the nurse's response to Mr. Lepp?
A) Epoetin alfa is normally contraindicated in patients who are receiving radiotherapy or chemotherapy.
B) Treatment with epoetin alfa will likely begin 4 to 6 days before Mr. Lepp’s first round of chemotherapy and continue indefinitely.
C) The potential benefits of epoetin alfa must be weighed carefully against the potential adverse effects in cancer patients.
D) Mr. Lepp’s oncologist should have begun treatment with epoetin alfa immediately after he was diagnosed.
A nurse is discussing oprelvekin therapy with a male patient. Which of the following will the nurse tell the patient is the most common adverse effect of the drug?
A) Medullary bone pain
C) Fluid retention/weight gain
D) Atrial arrhythmia
A middle-aged patient has received a diagnosis of GI stromal tumor following an extensive diagnostic workup. Imatinib has been recommended as a component of the patient's drug regimen. What patient education should the nurse provide to this patient?
A) "It's important that you let us know if you develop any significant swelling or puffiness."
B) "Try to keep your PICC line dressing as dry as possible at all times."
C) "You'll likely experience a lot of dry mouth while you're taking this drug, so it's helpful to chew ice chips."
D) "If you experience significant nausea after taking a dose, stop taking the drug and schedule an appointment at the clinic."
A patient with non-Hodgkin's lymphoma (NHL) will be starting a course of doxorubicin shortly. When planning this patient's care, what nursing diagnosis should the nurse prioritize?
C) Chills and rigors
An oncology nurse is aware of the risks for injury that exist around the preparation, transportation, and administration of chemotherapeutic agents. In order to reduce these risks of injury, the nurse should take which of the following actions?
A) Dispose of intravenous lines used for chemotherapy administration in a covered trash can in the patient's room.
B) Use an IV system for administration that includes needles to reduce the risk of accidental spills.
C) Prime the IV tubing with an approved IV solution rather than with the drug itself.
D) Encourage patients who have been receiving chemotherapy to use a bedside commode rather than a toilet.
An older adult woman has been diagnosed with acute lymphoblastic leukemia (ALL) and her care team has identified potential benefits of imatinib. Which of the following characteristics of this patient's current health status may preclude the use of imatinib?
A) The patient has type 2 diabetes mellitus that is controlled using diet and oral antihyperglycemics.
B) The patient has chronic heart failure resulting in significant peripheral edema.
C) The patient experienced a mild ischemic stroke several years ago and had transient ischemic attacks last year.
D) The patient had a total knee arthroplasty several months earlier.
A 28-year-old woman has completed rituximab therapy for an autoimmune disease. She tells the nurse that she and her husband would like to start a family. The nurse will advise her to
A) Continue using birth control for at least 12 months.
B) Stop using birth control.
C) Discontinue birth control, but avoid breast-feeding.
D) Continue using birth control for a least 6 more months
A male patient is receiving heparin by continuous intravenous infusion. The nurse will instruct the patient and family members to report which of the following should it occur?
A) A skin rash
B) Sudden occurrence of sleepiness and drowsiness
D) Presence of blood in urine or stools
Intravenous carmustine has been prescribed for a patient with cancer. The nurse should help relieve the discomfort of pain and burning during the infusion by
A) slowing the infusion.
B) decreasing the volume used for dilution.
C) decreasing the total volume of the primary IV infusion.
D) administering a dose of 2 units of bleomycin before carmustine.
Mr. Singh is a 66-year-old man who is receiving chemotherapy for the treatment of lung cancer that has metastasized to his liver. In an effort to prevent infection, Mr. Singh has been prescribed filgrastim (Neupogen). Which of the nurse's following assessment questions most directly addresses a common adverse effect of filgrastim?
A) "Have you noticed any bleeding in your gums or cheeks?"
B) "Do you feel like you're having any pain in your bones?"
C) "Are you experiencing any waves of cool, clammy skin?"
D) "Have you had any shortness of breath lately?"
A patient with a diagnosis of chronic myeloid leukemia has met with her oncologist, who has recommended treatment with the kinase inhibitor imatinib. What route of administration should the nurse explain to the patient?
A) Daily intramuscular injections throughout the course of treatment
B) Peripheral IV administration three times a day for 7 to 10 days
C) Weekly IV infusions over 6 to 8 hours through a central line
D) Oral administration of imatinib in a home setting
Which of the following patients will be at the greatest risk for anemia and would be the most likely candidate for epoetin alfa therapy?
A) A 20-year-old female
B) A 30-year-old pregnant woman
C) A 62-year-old male with cancer
D) A 40-year-old male with a high white blood cell count
A nurse is caring for a 64-year-old female patient who is receiving IV heparin and reports bleeding from her gums. The nurse checks the patient's laboratory test results and finds that she has a very high aPTT. The nurse anticipates that which of the following drugs may be ordered?
D) Protamine sulfate
A patient with chronic heart failure has begun treatment with epoetin alfa, which she will receive in her own home from a home health nurse. The nurse should teach the patient to supplement this treatment with a diet that is high in
A) iron-rich foods such as beans and leafy green vegetables.
B) complex carbohydrates and vegetable-source proteins.
C) calcium, such as dairy products, fish and vegetables.
D) protein and low in carbohydrates.
A nurse is administering rituximab to a patient via the IV route. The nurse will set the IV pump at 50 mg/hour for the first half hour of the initial infusion. If there are not apparent reactions after 30 minutes of the infusion, the nurse will increase the dosage every 30 minutes by 50 mg/hour until the maximum infusion rate reaches which of the following?
A) 250 mg/hour
B) 300 mg/hour
C) 400 mg/hour
D) 500 mg/hour
A nurse educator who coordinates the staff education on an oncology unit is conducting an inservice on targeted therapies. What potential benefit of targeted therapies should the nurse highlight in this education session?
A) Targeted therapies achieve the therapeutic benefits of traditional chemotherapy with no risk of adverse effects.
B) Targeted therapies have the potential to provide prophylactic protection against neoplasia in high-risk individuals.
C) Targeted therapies are significantly more cost-effective than traditional chemotherapeutic drugs.
D) Targeted therapies have the potential to damage cancerous cells while leaving normal body cells less affected.
A patient has completed 4 weeks of treatment with epoetin alfa. Which of the following assessment findings would most strongly indicate that treatment has been effective?
A) The patient white blood cell level is within reference ranges
B) The patient’s hemoglobin level is 11 g/dL
C) The patient maintains an oxygen saturation of 92% on room air
D) Capillary refill in the patient’s nail beds is less than or equal to 3 seconds
A nurse has been assigned to a female patient who is to begin chemotherapy. The nurse will initiate the prescribed oprelvekin therapy
A) 6 to 24 hours after chemotherapy.
B) 2 days after chemotherapy.
C) 6 days after chemotherapy.
D) 10 days after chemotherapy.
A 39-year-old woman is receiving doxorubicin for the treatment of cancer. After each treatment, the patient has acute nausea and vomiting accompanied by a slightly increased heart rate. The nurse will advise her to
A) perform relaxation techniques after the treatments.
B) make an appointment for cardiac function tests.
C) take the drug only at bedtime.
D) perform light exercise after administration of the drug.
When planning care for a patient who is receiving filgrastim (Neupogen) for a nonmyeloid malignancy, the nurse should formulate which of the following patient outcomes? (Select all that apply.)
A) The patient will not develop an infection.
B) The patient will not experience bone pain.
C) The patient will be able to self-administer filgrastim at home.
D) The patient will not develop febrile neutropenia.
E) The patient will not retain fluid.
A nurse has completed a medication reconciliation of a patient who has been admitted following a motor vehicle accident. Among the many drugs that the patient has received in the previous year is rituximab. The nurse would be justified in suspecting the patient may have received treatment for which of the following diseases?
A) Non-Hodgkin's lymphoma
B) Malignant melanoma
C) Nonsmall cell lung cancer
D) Renal cell carcinoma
A patient with a recent diagnosis of chronic myelogenous leukemia (CML) is discussing treatment options with his care team. What aspect of the patient's condition would contraindicate the use of cyclophosphamide for the treatment of leukemia?
A) The patient has a diagnosis of type 2 diabetes and takes oral antihyperglycemics.
B) The patient has had a history of nonadherence to medical treatment.
C) The patient's bone marrow function is significantly depressed.
D) The patient has decreased renal function.
A 45-year-old woman with acute leukemia is going to begin chemotherapy with vincristine. The nurse is aware that vincristine must always be administered
A) at a rapid infusion rate.
B) at a slow infusion rate.
C) through an IV line primed with vincristine.
D) through a central line.
A female patient is taking filgrastim (Neupogen) to decrease the incidence of infection. The nurse notices a small increase in the neutrophil count 2 days after starting therapy. The nurse's evaluation of the increase is that
A) the therapeutic effect of the drug is slow, and it is likely to cause adverse effects.
B) the drug therapy is proving to be ineffective.
C) the therapeutic effect of the drug is fully evident.
D) the increase in the neutrophil count is only transient.
A nurse is to use a single-dose 1 mL vial to administer 0.5 mL of epoetin alfa to a 39-year-old woman who is being treated for chemotherapy-induced anemia. Which of the following will the nurse do with the unused portion of the drug?
A) Refrigerate the medication for a future use.
B) Discard the unused portion of the drug.
C) Store the medication in the drug cart for the next dose.
D) Put the medication in the freezer compartment of the refrigerator.
A 67-year-old man who is being treated for prostate cancer is taking epoetin alfa. The nurse will instruct the patient to
A) stop taking the drug after a 2-week period.
B) schedule an appointment to measure hemoglobin twice a week for at least 2 to 6 weeks.
C) schedule an appointment to check if the patient has a high WBC count.
D) begin taking a calcium channel blocker to treat hypertension, which usually develops as an adverse effect of epoetin alfa therapy.
A patient with chronic lymphocytic leukemia (CLL) will imminently begin a course of treatment with rituximab. In order to minimize the risk of adverse effects, what strategy for administration will be adopted?
A) Admitting the patient to the intensive care unit in anticipation of the initial bolus of the drug
B) Administering diphenhydramine 30 minutes prior to the initial dose of rituximab
C) Administering the drug by slow infusion to two peripheral IV sites simultaneously
D) Administering the initial doses by slow infusion while observing for adverse reactions
A male patient has been on long-term bicalutamide (Casodex) therapy. In order to assess adverse effects of the drug therapy, the nurse will closely monitor which of the following?
A) Visual function
B) Blood counts
C) Pap test results
D) Liver function
A 60-year-old patient experienced a sudden onset of chest pain and shortness of breath and was subsequently diagnosed with a pulmonary embolism in the emergency department. The patient has been started on an intravenous heparin infusion. How does this drug achieve therapeutic effect?
A) By promoting the rapid excretion of vitamin K by the gastrointestinal mucosa
B) By inhibiting the action of vitamin K at its sites of action
C) By inhibiting platelet aggregation on vessel walls and promoting fibrinolysis
D) By inactivating clotting factors and thus stopping the coagulation cascade
A patient will soon begin targeted therapy as a component of her treatment plan for chronic leukemia. The nurse is conducting health education about this new aspect of the patient's drug regimen and the patient has asked about the potential side effects of treatment. How should the nurse best respond?
A) "Chemotherapy causes a lot of unpleasant side effects, and the advantage of targeted therapies is that these are all avoided."
B) "Targeted therapies are often more effective than traditional chemotherapy, but the downside of this effectiveness is that adverse effects are more common and severe."
C) "The adverse effects to targeted therapies are most often a result of the patient’s cancer, not the drugs themselves."
D) “Both classes of drugs have adverse effects, but targeted therapies tend to have less of an effect on healthy body cells.”
A female patient is prescribed oprelvekin therapy to treat thrombocytopenia. Which of the following should the nurse continuously monitor to determine the efficacy and duration of the oprelvekin therapy?
A) Weight gain
B) Platelet count
C) Red and white blood cell count
D) Cardiac arrhythmias
During ongoing assessment of a patient receiving 5-FU therapy, the nurse finds the patient's platelet count to be 92,000 cells/mm3.The nurse should do which of the following?
A) Consult the prescriber for an increase in dosage
B) Consult the prescriber for a decrease in dosage
C) Consult the prescriber for discontinuation of the drug
D) Continue the therapy as prescribed
A nurse on an oncology unit is aware of the need to assess for adverse effects in patients who are being treated with rituximab. The risks of adverse effects are highest at what point during the course of treatment?
A) Shortly after the initiation of the first infusion of rituximab
B) After 6 to 8 weeks of treatment at the maximum dose
C) At each point that the dosage of rituximab is increased
D) 48 to 72 hours after the first dose has been administered
A patient receiving high-dose cisplatin therapy exhibits symptoms of hypomagnesemia. Which of the following should the nurse suggest to help offset the magnesium losses from the cisplatin therapy?
A) Consuming dairy products
B) Consuming chocolates
C) Drinking 2 to 3 liters of fluid a day
D) Consuming potassium-rich foods
A patient has been scheduled to begin treatment with rituximab for non-Hodgkin's lymphoma. The nurse who will administer this drug should understand that it targets
A) the function of the complement system.
B) specific antigens on the surface of malignant B cells.
C) the DNA of mature plasma cells.
D) the molecular structure of the cells making up the semipermeable membrane of cancerous cells.
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- Submitted On 17 Jun, 2018 12:20:58