Chemotherapy
The nurse is educating a client on post chemotherapy care. Which of the following teaching points is the priority?
A. Hand Washing
B. Foods to eat
C. Exercise
D. Types of water to drink
A. Handwashing
Note: Patient would be immunosuppressed throughout chemo treatment
What are the three principles the nurse uses to protect self when caring for a client receiving radiation? Select all that apply.
A. Time
B. Avoidance
A. Time
C. Shielding
E. Distance
A client with a diagnosis of cancer is receiving epoetin alfa (Epogen, Procrit) as part of the treatment regimen. The nurse evaluates the effectiveness of this drug by:
A. Assessing the client's energy level.
B. Monitoring the hematocrit and hemoglobin levels.
C. Monitoring the client's blood pressure.
D. Assessing the client's level of consciousness.
B. Monitoring the hematocrit and hemoglobin levels
Note: This medication does not cure the primary disease condition; however, it helps reduce the anemia that dramatically affects the client's ability to function.
A patient who is receiving an immune modulator has been admitted to the unit. The nurse knows which of the following would be a priority action for the nurse?
A. Establishing a support system for the patient
B. Protecting the patient from infection
C. Monitoring for bleeding
D. Getting vitals and labs
B. Protecting the patient from infection
A hospitalized 7 week old infant is receiving medication for a fever of 102.3 F. Which of the following orders would the nurse hold and contact the provider?
A. Tylenol
B. Motrin
C. Aspirin
D. All of the above
C. Aspirin
The nurse is caring for a thin, older adult client who is diagnosed with cancer and is receiving aggressive chemotherapy. The client is experiencing severe side effects from the therapy and has lost 10 pounds in the past week. What should the nurse teach the client to do? Select all that apply.
A. Purchase fast foods and prepared foods.
B. Eat cold foods rather than hot foods.
C. Keep a food diary and record intake.
D. Eat large frequent meals high in calories.
E. Drink liquid supplements to increase intake of nutrients.
B. Eat cold foods rather than hot foods.
C. Keep a food diary and record intake.
E. Drink liquid supplements to increase intake of nutrients.
A nurse is caring for a client the morning after internal radiation therapy for treatment of uterine cancer in which an implant was placed. Which of the following actions demonstrate safe practice by the nurse? Select all that apply.
A. The nurse stays at least six feet away from the client if possible
B. The nurse wears a radiation monitor badge for no less than half of the encounters with this client
C. A sign is placed on the door at the beginning of the hallway alerting visitors that a client on the unit has received radiation
D. The nurse does not allow visitors to enter the room
E. The client is assigned a private room
A. The nurse stays at least six feet away from the client if possible
E. The client is assigned a private room
The nursing care plan for a client receiving epoetin alfa (Epogen, Procrit) should include careful monitoring for symptoms of:
a. Angina, or a change in level of consciousness.
b. Severe hypotension.
c. Impaired liver function.
d. Severe diarrhea.
A. Angina, or a change in level of consciousness
Note: This drug increases the risk of thromboembolic disease. The client should be monitored for early signs of stroke or heart attack.
Before administering sargramostim (Leukine), the nurse should assess:
A. Blood pressure.
B. CBC.
C. Level of consciousness.
D. Bowel sounds.
B. CBC
Note: The CBC should be assessed prior to administration, because this drug is contraindicated when excessive leukemic myeloid blasts are present in blood or bone marrow.
The nurse recognizes which drugs as NSAIDS? Select all that apply.
A. Tylenol
B. Ibuprofen
C. Naproxen
D. Ketorolac
E. Salicylate Acid
B. Ibuprofen (Motrin)
C. Naproxen
D. Ketorolac (Tordol)
E. Salicylate Acid (Aspirin)
During a treatment meeting on an oncology unit, the nurse learns that a client is scheduled for chemotherapy before and after surgery. What are the purposes for this client to receive chemotherapy at these specific times? Select all that apply.
A. Eradicate all cancer cells.
B. Shrink the tumor.
C. Kill remaining cancer cells.
D. Allow the immune system to kill cancer cells.
E. Improve wound healing.
B. Shrink the tumor.
C. Kill remaining cancer cells.
A 59-year-old client is undergoing radiation treatment for uterine cancer. Which of the following best describes an acute adverse effect following external radiation therapy to this area?
A. Skin erythema
B. Mucous membrane atrophy
C. Bladder fibrosis
D. Nephritis
A. Skin erythema
The nurse administers filgrastim (Neupogen) to the client. The nurse explains that this drug is used in the treatment of:
A. Clients with Hodgkin's disease who are having bone marrow transplants.
B. Acute lymphoblastic leukemia.
C. Hodgkin's lymphoma.
D. Neutropenia, or neutropenia secondary to chemotherapy.
D. Neutropenia, or neutropenia secondary to chemotherapy.
Note: Filgrastim is a colony-stimulating factor used primarily for chronic neutropenia, or neutropenia secondary to chemotherapy.
The nurse knows that which of the following is an immune stimulating drug class?
A. Interferons
B. Monoclonal Antibodies
C. Hematopoietic
D. None of the above
A. Interferons
The nurse is caring for a patient with acetaminophen overdose. Which of the following treatments would the nurse anticipate administering?
A. Naloxone
B. Calcium gluconate
C. N-acetylcysteine
D. Epi-Pen
C. N-acetylcysteine
The infusion nurse is reviewing the schedule of chemotherapy clients for the day. The nurse knows that chemotherapy is given for which of the following scenarios? Select all that apply.
A. To treat cancer
B. To eliminate BRCA-1 and BRCA-2
C. To delay the progression of cancer
D. To prevent cancer
E. To reduce cancer symptoms
A. To treat cancer
C. To delay the progression of cancer
E. To reduce cancer symptoms
A. Erythema
B. Nausea and vomiting
C. Anorexia
D. Bone marrow depression
E. Alopecia
A. Erythema
B. Nausea and vomiting
C. Anorexia
D. Bone marrow depression
Note: Radiation causes alopecia only to the site of radiation. The patient would not lose their hair from radiation therapy on the hip.
The client receiving filgrastim (Neupogen) should be monitored for common adverse effects, which include:
A. Hypotension and hypoglycemia.
B. Elevated liver enzymes.
C. Elevated BUN and creatinine.
D. Hypertension and skeletal pain.
D. Hypertension and skeletal pain.
Note: The nurse should assess for both hypertension and skeletal pain, which are adverse effects of filgrastim therapy.
The nurse knows that which drug class triggers the natural immune system to help fight cancer cells?
A. NSAIDs
B. Monoclonal antibodies
C. Colony stimulating factors
D. Erythopoietic drugs
B. Monoclonal antibodies
The nurse knows which of the following medications should be used with caution in patients with hepatic disease?
A. Meloxicam
B. Naproxen
C. Ketorolac
D. Ibuprofen
E. Acetaminophen
E. Acetaminophen
What is the most common reason a patient cannot receive chemotherapy?
A. Nausea and vomiting
B. Mucositis
C. Absolute neutrophil count
D. Fatigue
C. Absolute neutrophil count
A client with throat cancer is receiving radiation treatment to the head and neck and has developed xerostomia as a result. Which of the following interventions should the nurse suggest to this client?
A. See a dentist to pull any teeth that are causing problems
B. Use a mouthwash that contains fluoride each day
C. Avoiding drinking flavored water or electrolyte solutions
D. Do not eat for 12 hours after the radiation dose
B. Use a mouthwash that contains fluoride each day
Note: Xerostomia is the sensation of oral dryness
To best monitor for therapeutic effects from filgrastim (Neupogen), the nurse will assess which laboratory finding?
A. Hbg and Hct
B. WBC or ANC counts
C. Serum electrolytes
D. RBC count
B. WBC or ANC counts
Note: Filgrastim stimulates granulocytes (WBCs).
A client diagnosed with pernicious anemia is to start cyanocobalamin (Nascobal) injections. Which of the following client statements demonstrates an understanding of the nurse's teaching? (select all that apply.)
A. "I need to be careful to avoid infections."
B. "I will need to take this drug for the rest of my life."
C. "I should increase my intake of foods that contain vitamin B12."
D. "I need to take the liquid preparation through a straw."
E. "I may be able to switch over to nasal sprays once my vitamin B12 levels are normal."
B. "I will need to take this drug for the rest of my life."
E. "I may be able to switch over to nasal sprays once my vitamin B12 levels are normal."
Note: The client with pernicious anemia is unable to absorb vitamin B12 from the stomach and must take life-long supplements of the vitamin. Once vitamin levels reach normal, a weekly nasal spray may be ordered.
Options A, C, and D are incorrect. Because clients with pernicious anemia lack a factor (intrinsic factor) that allows gastric absorption of vitamin B12, oral use is not effective and increasing the amount of foods containing the vitamin will not be effective. Clients with pernicious anemia have a decrease in RBC's, not WBC's, and are not at increased risk for infections.
A hospitalized patient is being treated for a fever of 101.8. The patient also has a medical history significant for multiple GI bleeds and peptic ulcer disease. Which of the following medications should be used with extreme caution in this patient given his medical history?
A. Acetaminophen
B. NSAIDs
C. Oxycodone
D. Morphine
B. NSAIDs