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Text Mode – Text version of the exam 1. Chemotherapy dosing is usually based on the total body surface. What should the nurse do before administering chemotherapy? 2. The nurse is caring for of a client who is receiving a chemotherapy. Which of the following would be expected as a result of the massive cell destruction that occurred from the chemotherapy? 3. Mitomycin (Mutamycin) is prescribed to a client with colorectal cancer. All of which are the routes of administration, except? 4. The client with a testicular cancer is being treated with Etoposide (Etopophos). Which of the following side effect is specifically associated with this medication? 5. The clinic nurse provides instructions to a client receiving an antineoplastic medication. When implementing the plan, the nurse tells the client to? 6. The client with non-Hodgkin’s lymphoma is being managed with vincristine (Vincasar). Which of the following indicates a side effect specific to this medication? 7. A client with a sarcoma is receiving Bleomycin (Blenoxane). The nurse in charge for the client expect the physician to order which diagnostic procedure? 8. A male client with breast cancer is receiving Tamoxifen (Nolvadex). The nurse specifically monitors which laboratory value? 9. The client with an ovarian cancer is receiving Tamoxifen (Nolvadex). Which of the following indicates a side effect specific to this medication? 10. The client with acute myelocytic leukemia is being treated with Busulfan (Myleran). The nurse specifically monitors which laboratory value while the client is taking this medication? 11. The nurse is evaluating the medical history of a client who will be receiving Asparaginase (Elspar). The nurse contacts the health care provider if which of the following is noted in the history? 12. Megestrol acetate (Megace) is prescribed for a client with advanced breast cancer. The nurse reviews the client’s history and contacts the physician if which of the following is documented in the client’s history? 13. The cliet with non-hodgkins lymphoma is receiving Idarubucin (Idamycin). Which of the following would indicate to the nurse that the client is experiencing an adverse effect related to the medication? 14. The client is receiving Cisplatin (Platinol-AQ). Which of the following side effect is related to the medication? 15. The nurse is monitoring the laboratory results of a male client receiving antineoplastic medications. The nurse plans to initiate bleeding precautions if which laboratory is value is noted? 16. A client is receiving Methotrexate (Rheumatrex) for a series of chemotherapy. Which of the following medication should be readily available to avoid toxicity? 17. The nurse is providing teachings to a client receiving cyclophosphamide (Cytoxan). The nurse tells the client to which of the following? 18. The nurse is monitoring a patient receiving an Iv infusion of an antineoplastic medication. During the infusion, the patient complains of pain and redness at the insertion site. The nurse should take which actions? Select all that apply. 19. The nurse is caring for a client receiving chemotherapy when an anaphylactic reaction occurs from the medication. The nurse should take which actions? Select all that apply. 20. The nurse is caring for a client who is receiving Fluorouracil (Adrucil). Which of the following symptoms would necessitate the nurse to immediate discontinuation of the medication? 1. Answer: C. Weigh and measure the height of the patient on the day of administration. To assure that the client obtains optimal doses of chemotherapy, dosing is usually based on the total body surface (BSA), which requires an accurate current measurement of height and weight on the day of the administration. 2. Answer: D. Hyperuricemia. Increase level of uric acid (Hyperuricemia) in the body is common following the treatment for leukemias and lymphomas because chemotherapy results in massive cell destruction. 3. Answer: A. Oral. Mitomycin (Mutamycin) is an antitumor antibiotic used in the treatment of anal, bladder, breast, cervical, colorectal, head and neck, and non-small cell lung cancer. There is no pill form of this medication. 4. Answer: D. Orthostatic hypotension. While on etoposide infusion, blood pressure is monitored throughout and it should be administered slowly over 30-60 minutes to avoid hypotension. 5. Answer: D. To consult with health care providers before receiving immunization. Because antineoplastic medications lower the resistance of the body, clients must be informed not to received immunizations without a health care provider’s approval. 6. Answer: B. Numbness in the toes. A side effect specific to this medication is peripheral neuropathy. It can be manifested as numbness and tingling sensation in the finger and toes. 7. Answer: A. Pulmonary function studies (PFT’s). Bleomycin (Blenoxane) is an antitumor antibiotic that can cause interstitial pulmonary fibrosis. Pulmonary function tests and chest x-ray are done while on this treatment. 8. Answer: B. Triglyceride level. Tamoxifen (Nolvadex) is an antineoplastic medication that may increase cholesterol, triglyceride and calcium levels. Complete blood count, platelet count, serum calcium, cholesterol, and triglyceride level must be monitored periodically before the administration of this medication. 9. Answer: D. Constipation. Tamoxifen (Nolvadex) is an antineoplastic medication that may increase calcium levels. Signs of hypercalcemia includes include constipation, abdominal pain, hypotonicity of muscle, nausea and vomiting. 10. Answer: B. Uric acid level. Busulfan (Myleran) is an antineoplastic medication that can cause an increase uric acid level in the body. 11. Answer: B. Pancreatitis. One of the major toxicities associated with asparaginase therapy is pancreatitis. Pancreatic function test should be performed before and during the administration of the medication. 12. A. Pulmonary embolism. Megestrol acetate (Megace) is an antineoplastic agent that treats breast and endometrial cancer. This medication is contraindicated for patients with a history of thrombophlebitis and pulmonary embolism. 13. A. Dysrhythmia. Idarubicin (Idamycin) and Daunorubicin (Daunoxome) may cause cardiotoxicity (such as dysrhythmia, fatigue, shortness of breath), cardiomyopathy and ECG changes. 14. C. Tinnitus. Cisplatin (Platinol-AQ), an alkylating medication, may cause ototoxicity, tinnitus, hypokalemia, hypomagnesemia, hypocalcemia and nephrotoxicity. 15. B. Platelet count of 45,000 cells/mm3. The normal value for platelet is 150,000 to 450,000 cells/mm3. When platelet count is less than 50,000 cells/mm3, minor trauma can lead to episodes of prolonged bleeding; when less than 20,000 cells/mm3, spontaneous and uncontrolled bleeding can occur. 16. C. Leucovorin (Folinic acid). Large doses of Methotrexate (Rheumatrex) may lead to harmful effects in the body. Leucovorin is administered to prevent its toxicity. 17. B. Increase fluid intake to 2-3 liters per day. Cyclophosphamide can cause hemorrhagic cystitis. Encourage the client to increase their fluid intake to 2- 3 liters per day, unless contraindicated. 18. C. Notify the physician., D. Apply a heat or ice compress to the site., E. Administer an antidote as prescribed. Extravasation may occur during the infusion of chemotherapy. Signs of which are pain, redness and swelling on the insertion site. The infusion must stop and the physician is notified. The physician may order the administration of an antidote and a heat or cold compress is done. 19. A. Stop the medication., C. Administer Oxygen., D. Contact the physician. During an anaphylactic reaction, the medication is immediately stopped. The nurse assesses the respiratory status and monitors the client vital signs. The physician is contacted immediately. and an emergency medication is given such as epinephrine. 20. B. Ataxia. During the administration of Fluorouracil. Monitor for symptoms of dizziness, weakness, and ataxia which are signs of cerebral dysfunction that would immediately lead to the discontinuation of the medication.Practice Mode
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NCLEX Practice Exam for Pharmacology: Antineoplastic Medications
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