Lehne's Pharmacology for Nursing Care 9th Edition by Jacqueline Burchum
Lehne's Pharmacology for Nursing Care 9th Edition by Jacqueline Burchum
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Chapter 102: Anticancer Drugs I: Cytotoxic Agents
Complete Chapter Questions With Answers
Sample Questions Are Posted Below
MULTIPLE CHOICE
| a. | Cell-cycle phase–nonspecific drugs are less toxic. |
| b. | Cell-cycle phase–specific drugs do not harm “resting” cells. |
| c. | Cell-cycle phase–specific drugs should be given at specific intervals. |
| d. | Neither type is toxic to cells in the “resting” G0 phase. |
ANS: B
Cell-cycle phase–specific drugs do not harm “resting” cells, because these drugs are toxic only to cells that are active participants in the cell cycle. Cell-cycle phase–nonspecific drugs are not less toxic than cell-cycle phase–specific agents. Cell-cycle phase–specific drugs are usually given by prolonged infusion. Cell-cycle phase–nonspecific drugs are toxic to “resting” cells.
PTS: 1 DIF: Cognitive Level: Analysis REF: pp. 1220-1224
TOP: Nursing Process: Assessment
MSC: NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies
| a. | Elevated white blood cell count |
| b. | Low hemoglobin and hematocrit levels |
| c. | Low levels of ketones in the urine |
| d. | Microscopic hematuria |
ANS: D
The nurse should hold the dose for microscopic hematuria, because this may indicate hemorrhagic cystitis. An elevated white blood cell count is not an indication to hold the dose. Low hemoglobin and hematocrit levels are expected for a patient undergoing chemotherapy. Ketones may reveal some other problem, but they are not associated with ifosfamide.
PTS: 1 DIF: Cognitive Level: Application REF: p. 1225
TOP: Nursing Process: Evaluation
MSC: NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies
| a. | Change the IV site and notify the provider of the extravasation. |
| b. | Contact the provider to suggest using a different chemotherapeutic agent. |
| c. | Obtain an order for a topical anesthetic to minimize discomfort. |
| d. | Slow the rate of infusion to reduce the patient’s discomfort. |
ANS: A
Vincristine is a vesicant; extravasation of these agents can cause severe local injury that sometimes requires surgical debridement and skin grafting. The site should be changed, and the provider should be notified. Requesting a different drug is not indicated. Topical anesthetics will not prevent local tissue injury. Slowing the rate of infusion will not prevent local tissue injury.
PTS: 1 DIF: Cognitive Level: Application REF: p. 1223
TOP: Nursing Process: Diagnosis
MSC: NCLEX Client Needs Category: Physiologic Integrity: Reduction of Risk Potential
| a. | “Alkylating agents are toxic to tissues that have rapidly dividing cells.” |
| b. | “Bifunctional alkylating agents cannot form cross-links in DNA.” |
| c. | “Resistance to alkylating agents is rare.” |
| d. | “This drug needs to be given as a prolonged infusion.” |
ANS: A
Alkylating agents are toxic to rapidly dividing cells. Bifunctional agents form cross-links in cell DNA. Resistance to alkylating agents is common. These drugs may be given by bolus dosing.
PTS: 1 DIF: Cognitive Level: Application REF: pp. 1223-1225
TOP: Nursing Process: Implementation
MSC: NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies
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