Adams, Pharmacology for Nurse: A Pathophysiologic Approach, 4/E Chapter 37

Question 1 Type: MCSA The client has cancer. He asks the nurse where cancer comes from. What is the best explanation by the nurse? 1. "Cancer is enetic! you inherite" the pre"isposition for your cancer." 2. "Cancer cells are your bo"y#s cells that ha$e lost the ability to control their rowth." 3. "Cancer is cause" primarily by $iruses in the en$ironment." 4. "Ci arette smokin an" secon"%han" smoke are the primary causes of cancer." Correct Answer: & ationa!e 1' Cancer is thou ht to result from "ama e to the enes controllin cell rowth. Some cancer is enetic( but this is not the best answer. ationa!e 2' Cancer is thou ht to result from "ama e to the enes controllin cell rowth. ationa!e 3' )iruses are associate" with only about *+, of all human cancers. ationa!e 4' Ci arette smokin an" secon"%han" smoke are carcino ens that can lea" to the "e$elopment of cancer( but this is not the best answer. "!o#a! ationa!e: Co$niti%e &e%e!: Applyin C!ient 'eed: -hysiolo ical .nte rity C!ient 'eed (u#: -hysiolo ical A"aptation 'ursin$/)nte$rated Concepts: /ursin -rocess' .mplementation &earnin$ *utcome: 01%* Question 2 Type: MCMA The nurse teaches a support roup about the causes of cancer for families of in"i$i"uals with cancer. The nurse e$aluates that learnin has occurre" when the clients make which statements? Note: Credit will be given only if all correct choices and no incorrect choices are selected. (tandard Te+t: Select all that apply.
A"ams, Pharmacology for Nurse: A Pathophysiologic Approach, 234 Copyri ht &5*2 by -earson 4"ucation( .nc.

1. "Some cancers ha$e a stron

enetic component."

2. "Cancer often results from an in6ury such as a bruise." 3. "Cancers ha$e a $ery stron en$ironmental component." 4. "Cancer can result from suppresse" an er an" ra e." ,. "Cancer can result from "ama e" tumor%suppressor enes." Correct Answer: *(0(+ ationa!e 1' Some cancers ha$e a stron enetic component.

ationa!e 2' There is no e$i"ence to support that in6uries such as bruises result in cancer. ationa!e 3' Cancers ha$e a $ery stron en$ironmental component. ationa!e 4' There is no e$i"ence to support that suppresse" an er an" ra e will result in cancer. ationa!e ,' Cancer can result from "ama e" tumor%suppressor enes. "!o#a! ationa!e: Co$niti%e &e%e!: Applyin C!ient 'eed: -hysiolo ical .nte rity C!ient 'eed (u#: -hysiolo ical A"aptation 'ursin$/)nte$rated Concepts: /ursin -rocess' 4$aluation &earnin$ *utcome: 01%& Question 3 Type: MCMA The client has recently been "ia nose" with cancer. The nurse "e$elops a plan to teach the client about the most effecti$e treatments for cancer. What treatment options will the nurse inclu"e in this teachin ? Note: Credit will be given only if all correct choices and no incorrect choices are selected. (tandard Te+t: Select all that apply. 1. Sur ery 2. Chemotherapy 3. /utrition therapy 4. Alternati$e me"icine
A"ams, Pharmacology for Nurse: A Pathophysiologic Approach, 234 Copyri ht &5*2 by -earson 4"ucation( .nc.

,. 7a"iation therapy Correct Answer: *(&(+ ationa!e 1' Sur ery continues to be a primary treatment for cancer. ationa!e 2' -harmacolo ical controls for cancer( or chemotherapy( is one of the stan"ar" effecti$e treatments for cancer. ationa!e 3' Support of nutrition is essential for the cancer client( but is( in itself( not a primary treatment. ationa!e 4' Alternati$e me"icine is not consi"ere" a $ery effecti$e treatment for cancer at this point. ationa!e ,' 7a"iation is one of the three primary treatments for cancer. "!o#a! ationa!e: Co$niti%e &e%e!: Applyin C!ient 'eed: -hysiolo ical .nte rity C!ient 'eed (u#: -harmacolo ical an" -arenteral Therapies 'ursin$/)nte$rated Concepts: /ursin -rocess' -lannin &earnin$ *utcome: 01%2 Question 4 Type: MCSA The nursin instructor teaches stu"ent nurses about chemotherapy for cancer. Which statement best explains why lun cancers are less sensiti$e to antineoplastic a ents than other types of cancers? 1. "8un cancer cells ha$e a $ery erratic cell cycle( an" this is why there isn#t much "ifference between the number of replicatin an" restin cells." 2. "8un cancer cells ha$e been rowin for a lon time before "etection( so they are less sensiti$e to antineoplastic a ents." 3. "8un cancer cells ha$e a low% rowth fraction( which means there isn#t much "ifference between the number of replicatin an" restin cells." 4. "8un cancer cells row in a hi h%oxy en en$ironment( so they are not $ery sensiti$e to antineoplastic a ents." Correct Answer: 0 ationa!e 1' 8un cancer cells "o not ha$e a $ery erratic cell cycle. ationa!e 2' 8un cancer cells may row for a lon time before "etection( but this is not the primary reason they are less susceptible to antineoplastic a ents.
A"ams, Pharmacology for Nurse: A Pathophysiologic Approach, 234 Copyri ht &5*2 by -earson 4"ucation( .nc.

ationa!e 3' 9rowth fraction is a ratio of the number of replicatin cells to the number of restin cells. Antineoplastic "ru s are much more toxic to tissues an" tumors with hi h% rowth fractions. :reast an" lun cancers ha$e low% rowth fractions. ationa!e 4' A hi h%oxy en en$ironment is not the reason why lun cancer cells are less sensiti$e to antineoplastic a ents. "!o#a! ationa!e: Co$niti%e &e%e!: Applyin C!ient 'eed: -hysiolo ical .nte rity C!ient 'eed (u#: -harmacolo ical an" -arenteral Therapies 'ursin$/)nte$rated Concepts: /ursin -rocess' .mplementation &earnin$ *utcome: 01%+ Question , Type: MCSA The client recei$es tamoxifen ;/ol$a"ex< for treatment of breast cancer. She asks the nurse why the me"icine works. What is the best response by the nurse? 1. "Tamoxifen ;/ol$a"ex< works by blockin estro en receptors on breast tissue." 2. "Tamoxifen ;/ol$a"ex< works by inhibitin the cellular mitosis of breast cancer." 3. "Tamoxifen ;/ol$a"ex< works by inhibitin the metabolism of breast cancer cells." 4. "Tamoxifen ;/ol$a"ex< works by bin"in to the =/A of breast cancer cells." Correct Answer: * ationa!e 1' :reast cancer is "epen"ent on estro en for rowth. Tamoxifen ;/ol$a"ex< acts by blockin estro en receptors! the tumor is "epri$e" of estro en. ationa!e 2' Tamoxifen "oes not inhibit the cellular mitosis of breast cancer. ationa!e 3' Tamoxifen "oes not inhibit the metabolism of breast cancer cells. ationa!e 4' Tamoxifen "oes not bin" to the =/A of breast cancer cells. "!o#a! ationa!e: Co$niti%e &e%e!: Applyin C!ient 'eed: -hysiolo ical .nte rity C!ient 'eed (u#: -harmacolo ical an" -arenteral Therapies 'ursin$/)nte$rated Concepts: /ursin -rocess' .mplementation &earnin$ *utcome: 01%>
A"ams, Pharmacology for Nurse: A Pathophysiologic Approach, 234 Copyri ht &5*2 by -earson 4"ucation( .nc.

Question Type: MCSA The nurse assesses se$eral clients for their potential risk for "e$elopin cancer. Which client "oes the nurse assess to be at hi hest risk for "e$elopin cancer? 1. The client who "rinks alcohol "aily an" eats re" meat at most meals 2. The client who is *5 poun"s o$erwei ht( but exercises re ularly 3. The client who usually applies sunscreen when arri$in at the beach 4. The client who fre?uently for ets self%breast exams( but has routine mammo rams Correct Answer: * ationa!e 1' Alcoholism an" consumin lar e amounts of re" meat are lifestyle factors that put this client at risk for "e$elopin cancer. ationa!e 2' :ein *5 poun"s o$erwei ht is not a bi risk( an" re ular exercise is protecti$e a ainst cancer. ationa!e 3' Application of sunscreen at the beach will help pre$ent skin cancer. ationa!e 4' A monthly self%breast exam is i"eal( but routine mammo rams will offset most of the risk from for ettin to "o some monthly exams. "!o#a! ationa!e: Co$niti%e &e%e!: Applyin C!ient 'eed: Health -romotion an" Maintenance C!ient 'eed (u#: 'ursin$/)nte$rated Concepts: /ursin -rocess' Assessment &earnin$ *utcome: 01%0 Question 7 Type: MCSA The client recei$es cyclophosphami"e ;Cytoxan< as treatment for cancer( an" is experiencin oral irritation as an a"$erse effect. What "oes the best plan by the nurse inclu"e as it relates to pro$i"in oral comfort? 1. Teach the client to a$oi" extreme temperatures of foo" selections. 2. Teach oo" oral hy iene( inclu"in the use of an antiseptic mouthwash. 3. A"minister me estrol ;Me ace 4S< to the client.
A"ams, Pharmacology for Nurse: A Pathophysiologic Approach, 234 Copyri ht &5*2 by -earson 4"ucation( .nc.

4. Teach the client to use a firm toothbrush for brushin the teeth. Correct Answer: * ationa!e 1' A$oi"in extreme temperatures of foo"s will help pre$ent further trauma an" "iscomfort to the mouth. ationa!e 2' Most mouthwashes contain alcohol( which will make the problem worse. ationa!e 3' Me estrol ;Me ace 4S< can be effecti$e for appetite stimulation in cancer clients( but will not help oral irritation. ationa!e 4' The client shoul" use a soft toothbrush. "!o#a! ationa!e: Co$niti%e &e%e!: Applyin C!ient 'eed: -hysiolo ical .nte rity C!ient 'eed (u#: -hysiolo ical A"aptation 'ursin$/)nte$rated Concepts: /ursin -rocess' -lannin &earnin$ *utcome: 01%** Question . Type: MCSA The female client has lost her thick strai ht hair "ue to treatment with cyclophosphami"e ;Cytoxan<. She is "istrau ht an" feels that no one will want to look at her. What will the best plan by the nurse inclu"e? 1. -lan to show the client photos of cancer sur$i$ors whose hair rew back better. 2. -lan to ha$e a cancer sur$i$or $isit the client an" "iscuss wearin a wi . 3. Tell the client that this is an opportunity to ha$e curly hair. 4. -lan to "iscuss the client#s feelin s about the effects of her hair loss. Correct Answer: 2 ationa!e 1' Showin the client photos will not help( as her hair may not row back better. ationa!e 2' Ha$in a cancer sur$i$or $isit to talk about wi s is not the best inter$ention at the present time. ationa!e 3' Hair often "oes row in "ifferently such as curly instea" of strai ht or a "ifferent color. Howe$er( this is not the best inter$ention at this time. ationa!e 4' The client nee"s to "iscuss an" explore the meanin of her hair loss to "eal with her feelin s! this is the most therapeutic plan.
A"ams, Pharmacology for Nurse: A Pathophysiologic Approach, 234 Copyri ht &5*2 by -earson 4"ucation( .nc.

"!o#a! ationa!e: Co$niti%e &e%e!: Analy@in C!ient 'eed: -hysiolo ical .nte rity C!ient 'eed (u#: -hysiolo ical A"aptation 'ursin$/)nte$rated Concepts: /ursin -rocess' -lannin &earnin$ *utcome: 01%** Question / Type: MCSA The client recei$es cisplatin ;-latinol< as therapy for cancer. Which assessment fin"in woul" prompt the nurse to contact the client#s physician imme"iately? 1. A temperature reater than *5*AB 2. An ele$ation in bloo" lucose 3. /ausea an" pro6ectile $omitin 4. A complaint of painful le cramps Correct Answer: * ationa!e 1' A temperature reater than *5*A B can in"icate an infection( which can be life threatenin because low W:Cs are an a"$erse effect of cisplatin. ationa!e 2' An ele$ation in bloo" lucose coul" be relate" to pancreatitis( which is not an a"$erse effect of cisplatin. ationa!e 3' /ausea an" $omitin are common si"e effects an" are not life threatenin . ationa!e 4' -ainful le cramps are not an a"$erse effect of cisplatin. "!o#a! ationa!e: Co$niti%e &e%e!: Applyin C!ient 'eed: -hysiolo ical .nte rity C!ient 'eed (u#: -harmacolo ical an" -arenteral Therapies 'ursin$/)nte$rated Concepts: /ursin -rocess' Assessment &earnin$ *utcome: 01%C Question 10 Type: MCSA The client recei$es cyclophosphami"e ;Cytoxan<. The nurse e$aluates the client#s laboratory work. Which laboratory fin"in woul" support cancelin the client#s next treatment with this "ru ?
A"ams, Pharmacology for Nurse: A Pathophysiologic Approach, 234 Copyri ht &5*2 by -earson 4"ucation( .nc.

1. Hemo lobin of *2 3"l 2. :loo" urea nitro en of *& m 3"l 3. W:C count of D(555 cells3mcl 4. -latelet count of D(5553mm Correct Answer: 2 ationa!e 1' A hemo lobin of *2 3"l is a normal le$el! there is no nee" to cancel the treatment. ationa!e 2' A bloo" urea nitro en of *& m 3"l is within a normal ran e! there is no nee" to cancel the treatment. ationa!e 3' A W:C of D(555 cells3mcl is within a normal ran e! there is no nee" to cancel the treatment. ationa!e 4' A normal platelet count is at least *+5(555. The client#s count is at a "an erous le$el( an" the client is at risk for hemorrha e( so this client shoul" not recei$e another treatment of cyclophosphami"e until numbers ha$e increase". "!o#a! ationa!e: Co$niti%e &e%e!: Analy@in C!ient 'eed: -hysiolo ical .nte rity C!ient 'eed (u#: -harmacolo ical an" -arenteral Therapies 'ursin$/)nte$rated Concepts: /ursin -rocess' 4$aluation &earnin$ *utcome: 01%> Question 11 Type: MCSA The client recei$es methotrexate ;7heumatrex<. The nurse assesses for si"e effects of this "ru . Which si"e effects are a primary concern for the nurse? 1. Hyper lycemia an" fati ue 2. /ausea an" $omitin 3. Hypertension an" sei@ures 4. Elcerati$e stomatitis an" "iarrhea Correct Answer: 2 ationa!e 1' Hyper lycemia is not an a"$erse effect of methotrexate. ationa!e 2' /ausea an" $omitin are expecte" a"$erse effects an" are not of primary concern.
A"ams, Pharmacology for Nurse: A Pathophysiologic Approach, 234 Copyri ht &5*2 by -earson 4"ucation( .nc.

ationa!e 3' Hypertension an" sei@ures are not a"$erse effects of this "ru . ationa!e 4' Elcerati$e stomatitis an" "iarrhea re?uire suspension of therapy because they may lea" to hemorrha ic enteritis an" "eath from intestinal perforation. "!o#a! ationa!e: Co$niti%e &e%e!: Applyin C!ient 'eed: -hysiolo ical .nte rity C!ient 'eed (u#: -harmacolo ical an" -arenteral Therapies 'ursin$/)nte$rated Concepts: /ursin -rocess' Assessment &earnin$ *utcome: 01%> Question 12 Type: MCSA The client experiences nausea an" $omitin soon after chemotherapy treatments. What is the best action by the nurse? 1. A"minister a sleepin me"ication "urin chemotherapy. 2. .ncrease flui" intake to flush the ki"neys prior to chemotherapy. 3. A"minister an antiemetic *F& hours before chemotherapy. 4. 7estrict foo" on the "ay the client recei$es chemotherapy. Correct Answer: 0 ationa!e 1' A sleepin me"ication will not pre$ent nausea an" $omitin . ationa!e 2' .ncreasin flui"s will not pre$ent nausea an" $omitin . ationa!e 3' -harmacolo ical inter$ention( such as a"ministerin an antiemetic( is usually necessary to control nausea an" $omitin . ationa!e 4' .t may help to withhol" foo" *F0 hours prior to chemotherapy( but the client can eat as "esire"! withhol"in foo" will not pre$ent nausea an" $omitin . "!o#a! ationa!e: Co$niti%e &e%e!: Applyin C!ient 'eed: -hysiolo ical .nte rity C!ient 'eed (u#: -harmacolo ical an" -arenteral Therapies 'ursin$/)nte$rated Concepts: /ursin -rocess' .mplementation &earnin$ *utcome: 01%**
A"ams, Pharmacology for Nurse: A Pathophysiologic Approach, 234 Copyri ht &5*2 by -earson 4"ucation( .nc.

Question 13 Type: MCSA The client recei$es se$eral chemotherapeutic a ents as treatments for cancer. The client asks the nurse why he nee"s so many "ru s. What is the best response by the nurse? 1. "Esin multiple "ru s means a shorter treatment time." 2. "Esin multiple "ru s "ecreases the inci"ence of si"e effects." 3. "Esin multiple "ru s will help kill more of the cancer." 4. "Esin multiple "ru s is more cost%effecti$e in treatin cancer." Correct Answer: 0 ationa!e 1' Esin multiple "ru s "oes not shorten the time re?uire" for treatment. ationa!e 2' Esin multiple "ru s "oes not "ecrease the inci"ence of si"e effects. ationa!e 3' Esin multiple "ru s is the oal of combination treatment because more of the cancer cells will be kille" with this approach. ationa!e 4' Esin multiple "ru s is not more cost%effecti$e. "!o#a! ationa!e: Co$niti%e &e%e!: Applyin C!ient 'eed: -hysiolo ical .nte rity C!ient 'eed (u#: -harmacolo ical an" -arenteral Therapies 'ursin$/)nte$rated Concepts: /ursin -rocess' .mplementation &earnin$ *utcome: 01%1 Question 14 Type: MCSA .n un"erstan"in the "ifference between normal cells an" cancer cells( the nurse knows that cancer is the result of 1. cell "i$ision occurrin extensi$ely in normal cells. 2. cell "i$ision occurrin $ia controlle" cell "i$ision. 3. suppressor enes stoppin cell rowth for cell "i$ision. 4. suppressor enes continuin cell rowth for cell "i$ision. Correct Answer: 0
A"ams, Pharmacology for Nurse: A Pathophysiologic Approach, 234 Copyri ht &5*2 by -earson 4"ucation( .nc.

ationa!e 1' 4xtensi$e cell "i$ision "oes occur in normal cells. ationa!e 2' Cell "i$ision "oes occur $ia controlle" cell "i$ision. ationa!e 3' Cancer is thou ht to result from "ama e to the suppressor enes controllin cell rowth. ationa!e 4' Suppressor enes for cell rowth must continue for cell "i$ision an" replication. "!o#a! ationa!e: Co$niti%e &e%e!: 7ememberin C!ient 'eed: -hysiolo ical .nte rity C!ient 'eed (u#: -hysiolo ical A"aptation 'ursin$/)nte$rated Concepts: /ursin -rocess' Assessment &earnin$ *utcome: 01%* Question 1, Type: MCSA .n un"erstan"in the rowth fraction as it pertains to the success of chemotherapy( the nurse knows that the rowth fraction is a ratio of 1. the number of replicatin cells to the number of acti$e cells. 2. the number of non%replicatin cells to the acti$e cells. 3. the number of replicatin cells to the number of restin cells. 4. The number of non%replicatin cells to the number of restin cells. Correct Answer: 0 ationa!e 1' This is not the ratio as it relates to the rowth fraction. ationa!e 2' This is not the ratio as it relates to the rowth fraction. ationa!e 3' The rowth fraction is a measure of the number of cells un"er oin mitosis in a tissue. .t is a ratio of the number of replicatin cells to the number of restin cells. ationa!e 4' This is not the ratio as it relates to the rowth fraction. "!o#a! ationa!e: Co$niti%e &e%e!: 7ememberin C!ient 'eed: -hysiolo ical .nte rity C!ient 'eed (u#: -hysiolo ical A"aptation 'ursin$/)nte$rated Concepts: /ursin -rocess' Assessment
A"ams, Pharmacology for Nurse: A Pathophysiologic Approach, 234 Copyri ht &5*2 by -earson 4"ucation( .nc.

&earnin$ *utcome: 01%+ Question 1Type: MCSA The most important nursin consi"eration for clients recei$in alkylatin a ents is 1. monitorin nausea an" $omitin . 2. monitorin nutritional intake. 3. monitorin skin inte rity. 4. monitorin C:C with "ifferential. Correct Answer: 2 ationa!e 1' /ausea an" $omitin are common "urin use of many chemotherapy "ru s an" are not particular to alkylatin a ents( an" this is not the most important nursin consi"eration. ationa!e 2' =ue to a"$erse effects such as nausea( $omitin ( an" anorexia( nutritional intake is "ecrease" in clients takin many kin"s of chemotherapeutic "ru s. This issue is not particular to alkylatin a ents an" is not the most important nursin consi"eration. ationa!e 3' .mpaire" skin inte rity is an issue with clients takin many forms of chemotherapy. .t is not particular to alkylatin a ents an" is not the most important nursin consi"eration. ationa!e 4' :loo" cells are particularly sensiti$e to alkylatin a ents. :one marrow suppression is the primary "ose%limitin toxicity of the "ru s in this class. .f the absolute neutrophil count ;A/C< obtaine" by rea"in C:C with "ifferential falls below +553mm( the risk for infection increases. "!o#a! ationa!e: Co$niti%e &e%e!: 7ememberin C!ient 'eed: -hysiolo ical .nte rity C!ient 'eed (u#: -harmacolo ical an" -arenteral Therapies 'ursin$/)nte$rated Concepts: /ursin -rocess' 4$aluation &earnin$ *utcome: 01%C Question 17 Type: MCSA The client is prescribe" tamoxifen for the treatment of breast cancer. The nurse shoul" a"$ise the client to monitor for which a"$erse effect? 1. Bati ue
A"ams, Pharmacology for Nurse: A Pathophysiologic Approach, 234 Copyri ht &5*2 by -earson 4"ucation( .nc.

2. Cou h 3. )a inal "ischar e 4. Si ns of "ehy"ration Correct Answer: 0 ationa!e 1' Bati ue may occur with many types of chemotherapy( but is not a particular a"$erse effect with tamoxifen. ationa!e 2' Cou h is not an expecte" a"$erse effect of tamoxifen. ationa!e 3' )a inal "ischar e is an expecte" a"$erse effect of tamoxifen an" shoul" be reporte" to the health care team. ationa!e 4' 7ather than "ehy"ration( the client shoul" be monitore" for water retention an" concentrate" urine. "!o#a! ationa!e: Co$niti%e &e%e!: Applyin C!ient 'eed: -hysiolo ical .nte rity C!ient 'eed (u#: -harmacolo ical an" -arenteral Therapies 'ursin$/)nte$rated Concepts: /ursin -rocess' Assessment &earnin$ *utcome: 01%> Question 1. Type: MCSA The main mechanism of action of alkylatin a ents is 1. they stimulate the bo"y#s immune system. 2. unknown. 3. they chan e the shape of the =/A "ouble helix an" pre$ent nucleic aci" from completin normal cell "i$ision. 4. they "isrupt metabolic pathways. Correct Answer: 0 ationa!e 1' This is representati$e of pharmacotherapy with biolo ic response mo"ifiers( immune therapies( an" miscellaneous antineoplastics. ationa!e 2' The mechanism of hormonal antineoplastic acti$ity is lar ely unknown. ationa!e 3' Alkylation chan es the shape of the =/A "ouble helix an" pre$ents the nucleic aci" from completin normal cell "i$ision.
A"ams, Pharmacology for Nurse: A Pathophysiologic Approach, 234 Copyri ht &5*2 by -earson 4"ucation( .nc.

ationa!e 4' This is representati$e of the antimetabolites. "!o#a! ationa!e: Co$niti%e &e%e!: 7ememberin C!ient 'eed: -hysiolo ical .nte rity C!ient 'eed (u#: -harmacolo ical an" -arenteral Therapies 'ursin$/)nte$rated Concepts: &earnin$ *utcome: 01%*5 Question 1/ Type: MCSA A client states( G. et so sick to my stomach after chemotherapy. Why canHt they 6ust put it "irectly into my tumor?I Which nursin response is in"icate"? 1. GThere is no technolo y a$ailable to "irectly place chemotherapy in a tumor.I 2. GThese are such stron me"ications that they woul" eat up your tissues.I 3. GThat type of therapy "oes exist( but it "oes not work for your particular type of cancer.I 4. G. know you et sick( but the nausea an" $omitin is not se$ere an" passes ?uickly.I Correct Answer: 0 ationa!e 1' Some antineoplastics are i$en locally or throu h "irect instillation into a tumor site. This treatment is not a$ailable for all tumors. ationa!e 2' Althou h this statement is somewhat accurate( it is not therapeutic an" is not the best answer to this ?uestion. ationa!e 3' This is a strai htforwar" an" accurate statement of fact. ationa!e 4' Many clients experience se$ere nausea an" $omitin that lasts se$eral hours up to "ays. "!o#a! ationa!e: Co$niti%e &e%e!: Applyin C!ient 'eed: -hysiolo ical .nte rity C!ient 'eed (u#: -harmacolo ical an" -arenteral Therapies 'ursin$/)nte$rated Concepts: /ursin -rocess' .mplementation &earnin$ *utcome: 8J KD Question 20 Type: MCSA
A"ams, Pharmacology for Nurse: A Pathophysiologic Approach, 234 Copyri ht &5*2 by -earson 4"ucation( .nc.

A nurse suspects that the .) line throu h which "oxorubicin ;A"riamycin< is infusin has infiltrate". The nurse has "iscontinue" the .) site. What a""itional action shoul" be taken? 1. /o special action is necessary. 2. A warm wet compress shoul" be place" on the site. 3. Wash the area thorou hly with soap an" water. 4. Apply ice packs to the area imme"iately. Correct Answer: 2 ationa!e 1' Special actions are in"icate". ationa!e 2' This is not the recommen"e" treatment. ationa!e 3' Washin the surface will not treat the extra$asation. ationa!e 4' .ce packs will help to re"uce the absorption of the "ru . "!o#a! ationa!e: Co$niti%e &e%e!: Applyin C!ient 'eed: -hysiolo ical .nte rity C!ient 'eed (u#: -harmacolo ical an" -arenteral Therapies 'ursin$/)nte$rated Concepts: /ursin -rocess' .mplementation &earnin$ *utcome: 8J K> Question 21 Type: MCMA A nurse suspects that the .) line infusin $incristine ;Jnco$in< has infiltrate". The nurse "iscontinue" the line. Which other actions are in"icate"? Note: Credit will be given only if all correct choices and no incorrect choices are selected. (tandard Te+t: Select all that apply. 1. Apply local ice packs. 2. .n6ect hyaluroni"ase per protocol. 3. -lace a tourni?uet on the clientHs arm abo$e the .) site. 4. -lace warm compresses on the site.
A"ams, Pharmacology for Nurse: A Pathophysiologic Approach, 234 Copyri ht &5*2 by -earson 4"ucation( .nc.

,. A"minister pre"nisone per protocol. Correct Answer: &(2 ationa!e 1' Col" compresses will si nificantly increase the toxicity of $inca alkaloi"s. ationa!e 2' Hyaluroni"ase is use" as treatment for $incristine extra$asation. ationa!e 3' There is no nee" to place a tourni?uet on the clientHs arm. ationa!e 4' Warm compresses are recommen"e" as treatment. ationa!e ,' -re"nisone is not i$en concurrently with $incristine "ue to increase" bone marrow toxicity. "!o#a! ationa!e: Co$niti%e &e%e!: Applyin C!ient 'eed: -hysiolo ical .nte rity C!ient 'eed (u#: -harmacolo ical an" -arenteral Therapies 'ursin$/)nte$rated Concepts: /ursin -rocess' .mplementation &earnin$ *utcome: Question 22 Type: MCMA A client is prescribe" methotrexate ;7heumatrex< for treatment of osteo enic sarcoma. The client says( GMy frien" took methotrexate( but she has ne$er ha" cancer.I How shoul" the nurse respon" to this statement? Note: Credit will be given only if all correct choices and no incorrect choices are selected. (tandard Te+t: Select all that apply. 1. G=oes your frien" ha$e rheumatoi" arthritis?I 2. GShe must ha$e ha" cancer an" not tol" you.I 3. GMethotrexate is use" to treat some autoimmune "isor"ers as well.I 4. GLou must ha$e misinterprete" what your frien" sai".I ,. GMethotrexate is use" to treat some forms of li$er "isease.I Correct Answer: *(0 ationa!e 1' Methotrexate has powerful immunosuppressant properties an" is use" to treat rheumatoi" arthritis( ulcerati$e colitis( lupus( an" psoriasis.
A"ams, Pharmacology for Nurse: A Pathophysiologic Approach, 234 Copyri ht &5*2 by -earson 4"ucation( .nc.

ationa!e 2' There are other reasons to take methotrexate. ationa!e 3' Methotrexate is a powerful immunosuppressant. ationa!e 4' .t is $ery possible that the frien" "i" not ha$e cancer an" was bein treate" with methotrexate. ationa!e ,' Methotrexate is hepatotoxic an" woul" not be use" to treat li$er "iseases. "!o#a! ationa!e: Co$niti%e &e%e!: Analy@in C!ient 'eed: -hysiolo ical .nte rity C!ient 'eed (u#: -harmacolo ical an" -arenteral Therapies 'ursin$/)nte$rated Concepts: /ursin -rocess' .mplementation &earnin$ *utcome: 8J K> Question 23 Type: MCMA A clientHs "osa e sche"ule inclu"es chemotherapy for each of + "ays an" then no chemotherapy for + "ays. The client says( GWhy "onHt they 6ust keep i$in me the chemo? . want to kill this cancer an" et on with my life.I How shoul" the nurse respon"? Note: Credit will be given only if all correct choices and no incorrect choices are selected. (tandard Te+t: Select all that apply. 1. GThis chemotherapy is so stron that you cannot physically stan" to take it for more than + "ays.I 2. GWe nee" to i$e your normal cells time to reco$er from the me"ication before you et more chemotherapy.I 3. GLou shoul" let the "octors worry about that.I 4. GWe nee" to let some of the cancer cells "e$elop into the sta e where the chemotherapy can kill them.I ,. GThe chemotherapy is not always imme"iately a$ailable( so pauses are taken to allow for more stock to arri$e.I Correct Answer: &(2 ationa!e 1' This is not a completely accurate statement an" is not therapeutic. The client may become concerne" that the chemotherapy will be fatal. ationa!e 2' The oal of chemotherapy is to "estroy mali nant cells with as little "ama e to normal cells as possible. .n some cases( a pause in chemotherapy treatment is necessary to allow this reco$ery. ationa!e 3' This is a "ismissi$e an" nontherapeutic statement.
A"ams, Pharmacology for Nurse: A Pathophysiologic Approach, 234 Copyri ht &5*2 by -earson 4"ucation( .nc.

ationa!e 4' Some chemotherapies are cell%cycle specific an" kill cells only in a specific win"ow of "e$elopment. -auses in chemotherapy are necessary to allow cells to mature into this win"ow. ationa!e ,' While recent "e$elopments ha$e in"icate" that the supply of some chemotherapy "ru s is not reliable( this is not a therapeutic statement. "!o#a! ationa!e: Co$niti%e &e%e!: Analy@in C!ient 'eed: -hysiolo ical .nte rity C!ient 'eed (u#: -harmacolo ical an" -arenteral Therapies 'ursin$/)nte$rated Concepts: /ursin -rocess' .mplementation &earnin$ *utcome: 8J K1 Question 24 Type: MCMA A client is "ia nose" with a small lipoma on his arm an" is bein "ischar e" from the clinic. The client says( G. ha$e a tumor( but . am not bein treate" with anythin . . "onHt un"erstan".I How shoul" the nurse respon"? Note: Credit will be given only if all correct choices and no incorrect choices are selected. (tandard Te+t: Select all that apply. 1. G. am suppose" to make an appointment for you to see the oncolo ist who will recommen" treatment.I 2. G8ipomas are beni n an" usually "o not re?uire treatment.I 3. G8ipomas row slowly an" are not cancerous.I 4. G8ipomas "o not metastasi@e an" are not cancer.I ,. GThe physician will consult with a sur eon an" will contact you later.I Correct Answer: &(0(2 ationa!e 1' There is no in"ication for seein an oncolo ist. ationa!e 2' A lipoma is a fatty tumor an" is beni n. They "o not re?uire treatment unless they are positione" where they are easily irritate" or in6ure". .f so( simple remo$al enerally suffices. ationa!e 3' 8ipomas are beni n an" row slowly. ationa!e 4' 8ipomas are beni n an" therefore "o not metastasi@e. ationa!e ,' There is no reason for a sur ical consultation.
A"ams, Pharmacology for Nurse: A Pathophysiologic Approach, 234 Copyri ht &5*2 by -earson 4"ucation( .nc.

"!o#a! ationa!e: Co$niti%e &e%e!: Analy@in C!ient 'eed: -sychosocial .nte rity C!ient 'eed (u#: 'ursin$/)nte$rated Concepts: /ursin -rocess' .mplementation &earnin$ *utcome: 8J K* Question 2, Type: MCMA A client with pancreatic cancer is recei$in chemotherapy e$en thou h pro nosis is rim. How "oes the nurse explain the rationale for this treatment? Note: Credit will be given only if all correct choices and no incorrect choices are selected. (tandard Te+t: Select all that apply. 1. G.t is a lon shot( but maybe the chemotherapy will cure him.I 2. GSometimes the chemotherapy can re"uce the si@e of the tumor.I 3. GWe 6ust hate to i$e up on him. He is such a nice man.I 4. GChemotherapy can sometimes re"uce the pain.I ,. GHopefully the chemotherapy will impro$e his ?uality of life.I Correct Answer: &(2(+ ationa!e 1' .f the client has a rim pro nosis relate" to pancreatic cancer( it is not ethical to i$e the family false hope. ationa!e 2' Chemotherapy is sometimes i$en to re"uce tumor si@e an" help to re"uce problems associate" with the pressure the tumor is exertin on a"6acent structures. ationa!e 3' Ese of the term G i$e up on himI is not therapeutic. .t may confuse the family when it comes time to "iscontinue the chemotherapy. ationa!e 4' -ain re"uction is a common reason for a"ministerin chemotherapy to a client with a poor pro nosis. ationa!e ,' The reason palliati$e chemotherapy is a"ministere" is to impro$e the clientHs ?uality of life. "!o#a! ationa!e: Co$niti%e &e%e!: Analy@in
A"ams, Pharmacology for Nurse: A Pathophysiologic Approach, 234 Copyri ht &5*2 by -earson 4"ucation( .nc.

C!ient 'eed: -hysiolo ical .nte rity C!ient 'eed (u#: -harmacolo ical an" -arenteral Therapies 'ursin$/)nte$rated Concepts: /ursin -rocess' .mplementation &earnin$ *utcome: 8J KC

A"ams, Pharmacology for Nurse: A Pathophysiologic Approach, 234 Copyri ht &5*2 by -earson 4"ucation( .nc.