Chapter 101: Anticancer Drugs I: Cytotoxic Agents

Chapter 101: Anticancer Drugs I: Cytotoxic Agents

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

1. The nurse would correctly identify the major dose-limiting toxicity of cyclophosphamide (Cytoxan) as

a.	cystitis.
b.	bone marrow suppression.
c.	stomatitis.
d.	pulmonary fibrosis.

 

 

ANS:   B

The major dose-limiting toxicity of cyclophosphamide is bone marrow suppression. Severe nausea, vomiting, and alopecia also are common, especially at high doses.

Cyclophosphamide can cause acute hemorrhagic cystitis, but this is not the major dose limiting effect.

Cyclophosphamide does not cause stomatitis or pulmonary fibrosis.

 

DIF:    Cognitive Level: Application             REF:    p. 1182 | p. 1186

TOP:    Nursing Process: Implementation

MSC:   NCLEX Client Needs Category: Physiological Integrity: Pharmacological and Parenteral Therapies

 

2. A patient on an oncology unit has been receiving ifosfamide (Ifex) for a few days. Prior to administration of the next dose, the nurse reviews the patient’s laboratory test results. Which finding would cause the nurse to hold the dose?

a.	Low levels of ketones in the urine
b.	Hematuria
c.	Blurred vision
d.	Low Hct and Hb

 

 

ANS:   B

The nurse should hold the dose for hematuria, because this may indicate hemorrhagic cystitis.

Ketones may reveal some other problem, but they are not associated with ifosfamide.

Blurred vision is a symptom of toxicity; however, the question specifically asks about a laboratory result.

Low Hct and Hb are expected for a patient undergoing chemotherapy.

 

DIF:    Cognitive Level: Analysis                  REF:    p. 1182 | p. 1186

TOP:    Nursing Process: Planning

MSC:   NCLEX Client Needs Category: Physiological Integrity: Pharmacological and Parenteral Therapies

 

3. The oncology nurse is caring for a patient receiving carmustine (BiCNU) for adenocarcinoma of the stomach. When should the nurse expect the leukocyte nadir?

a.	3 to 5 days
b.	7 to 10 days
c.	10 to 14 days
d.	4 to 6 weeks

 

 

ANS:   D

The nurse should expect the neutrophil nadir within 4 to 6 weeks.

These intervals are too short to allow the leukocyte nadir to develop.

 

DIF:    Cognitive Level: Application             REF:    p. 1186

TOP:    Nursing Process: Planning

MSC:   NCLEX Client Needs Category: Physiological Integrity: Pharmacological and Parenteral Therapies

 

4. The nurse provides education to the patient and family about fluorouracil (Adrucil). What statement by the patient most demonstrates the need for further teaching?

a.	“I may experience darkening skin in some areas of my body.”
b.	“I should report diarrhea.”
c.	“I shouldn’t anticipate blistering on my palms and soles.”
d.	“I probably will lose my hair.”

 

 

ANS:   C

The patient may experience blistering on the palms and soles; this statement indicates that further teaching is required.

The patient may experience darkening of the skin in some areas; no further teaching is required.

The medication should be discontinued as soon as mild reactions like stomatitis and diarrhea occur.

The patient likely will lose his hair; no further teaching is required.

 

DIF:    Cognitive Level: Application             REF:    p. 1189

TOP:    Nursing Process: Implementation

MSC:   NCLEX Client Needs Category: Physiological Integrity: Pharmacological and Parenteral Therapies