NCLEX Pharmacology Quiz 37 Antineoplastic Medications

1. The nurse is providing teachings to a client receiving cyclophosphamide (Cytoxan). The nurse tells the client to which of the following?

Eat foods rich in potassium.

Increase fluid intake to 2-3 liters per day.

Take the medication with food.

Eat foods rich in purine.

Cyclophosphamide can cause hemorrhagic cystitis. Encourage the client to increase their fluid intake to 2- 3 liters per day. unless contraindicated.Option A: This medication can cause hyperkalemia.Option C: The medication is taken without food.Option D: Client must follow a low purine diet to alkalinize the urine and lowers the uric acid level.

Explanation

Cyclophosphamide can cause hemorrhagic cystitis. Encourage the client to increase their fluid intake to 2- 3 liters per day. unless contraindicated.Option A: This medication can cause hyperkalemia.Option C: The medication is taken without food.Option D: Client must follow a low purine diet to alkalinize the urine and lowers the uric acid level.

2. 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?

White blood cell count of 6.000/mm3.

Platelet count of 45.000 cells/mm3

Clotting time of 8 minutes.

Hemoglobin count of 15g/dl.

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.Option A: Normal white blood cell count is 4.000 to 11.000/mm3.Option C: Normal clotting time is 8-15 minutes.Option D: Normal hgb is 13.5-17.5 g/dl.

Explanation

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.Option A: Normal white blood cell count is 4.000 to 11.000/mm3.Option C: Normal clotting time is 8-15 minutes.Option D: Normal hgb is 13.5-17.5 g/dl.

3. 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?

Diabetes Mellitus type II.

Pancreatitis.

Asthma.

Ischemic heart disease.

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.Options A. C. and D are not contraindicated with this medication.

Explanation

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.Options A. C. and D are not contraindicated with this medication.

4. 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?

Pulmonary embolism.

Gouty arthritis.

Bronchial asthma.

Ischemic heart disease.

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.Options B. C. and D are not contraindicated with this medication.

Explanation

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.Options B. C. and D are not contraindicated with this medication.

5. A client is receiving Methotrexate (Rheumatrex) for a series of chemotherapy. Which of the following medication should be readily available to avoid toxicity?

Mesna (Mesnex).

Vigabatrin (Sabril).

Leucovorin (Folinic acid).

Oseltamivir (Tamiflu).

Large doses of Methotrexate (Rheumatrex) may lead to harmful effects in the body. Leucovorin is administered to prevent its toxicity.Option A: Mesna is given with ifosfamide to decrease the potential of ifosfamide induced cystitis.Option B is an anticonvulsant.Option D: is an influenza antiviral medication.

Explanation

Large doses of Methotrexate (Rheumatrex) may lead to harmful effects in the body. Leucovorin is administered to prevent its toxicity.Option A: Mesna is given with ifosfamide to decrease the potential of ifosfamide induced cystitis.Option B is an anticonvulsant.Option D: is an influenza antiviral medication.

6. 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?

Palmar-plantar erythrodysesthesia.

Ataxia.

Constipation.

Insomnia.

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.Option A is characterized by skin rash. swelling. redness. pain and/or peeling of the skin on the palms of hands and soles of feet. Is usually a mild symptom that would only require reduction of the dosage.Option C: Diarrhea is a related sign. not constipation.Option D: is not a related symptom of this medication.

Explanation

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.Option A is characterized by skin rash. swelling. redness. pain and/or peeling of the skin on the palms of hands and soles of feet. Is usually a mild symptom that would only require reduction of the dosage.Option C: Diarrhea is a related sign. not constipation.Option D: is not a related symptom of this medication.

7. The client is receiving Cisplatin (Platinol-AQ). Which of the following side effect is related to the medication?

Depressed tendon reflexes.

Photosensitivity.

Tinnitus.

Ptosis.

Cisplatin (Platinol-AQ). an alkylating medication. may cause ototoxicity. tinnitus. hypokalemia. hypomagnesemia. hypocalcemia and nephrotoxicity.Option A is a sign of hypermagnesemia.Options B and D are side effects not related to this medication.

Explanation

Cisplatin (Platinol-AQ). an alkylating medication. may cause ototoxicity. tinnitus. hypokalemia. hypomagnesemia. hypocalcemia and nephrotoxicity.Option A is a sign of hypermagnesemia.Options B and D are side effects not related to this medication.

8. 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?

Dysrhythmia.

Weight loss.

Nausea and vomiting.

Peripheral neuropathy.

Idarubicin (Idamycin) and Daunorubicin (Daunoxome) may cause cardiotoxicity (such as dysrhythmia. fatigue. shortness of breath). cardiomyopathy and ECG changes.Option B: Weight gain not weight loss is a side effect.Option C is a usual side effect that can last for 2-3 days.Option D: is not a side effect related to this medication.

Explanation

Idarubicin (Idamycin) and Daunorubicin (Daunoxome) may cause cardiotoxicity (such as dysrhythmia. fatigue. shortness of breath). cardiomyopathy and ECG changes.Option B: Weight gain not weight loss is a side effect.Option C is a usual side effect that can last for 2-3 days.Option D: is not a side effect related to this medication.

9. 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.

Stop the medication.

Remove the IV line.

Administer Oxygen.

Administer epinephrine.

Positioned the client in a reverse Trendelenburg position.

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.Option B: The IV line is not removed because IV access is required to administer emergency IV medications.Option E: The client’s head is not lowered but elevated to improve ventilation.

Explanation

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.Option B: The IV line is not removed because IV access is required to administer emergency IV medications.Option E: The client’s head is not lowered but elevated to improve ventilation.

Submit

10. 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.

Reinsert the IV at a distal part of the same vein.

Increase the flow rate of the medication.

Notify the physician.

Apply a heat or ice compress to the site.

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.Options A and B: Reinsertion on the same vein and increasing the flow rate may cause further damage to the site.

Explanation

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.Options A and B: Reinsertion on the same vein and increasing the flow rate may cause further damage to the site.

Submit