Chemotherapy Competency Quiz 2

1. The pre-medication volume in the labeled syringe does not appear be contain the volume of drug expected. What is the correct action.

Say nothing and use the drug. Its close enough.

Ask the dispensing nurse to re-verify and re-dispense as indicated. If it is a recurring problem notify your supervisor.

Get a vial of the drug from the mixing room and adjust the dose yourself.

Refuse to use the drug at all. Tell the dispensing nurse you dont trust her/him.

The correct action in this situation is to ask the dispensing nurse to re-verify and re-dispense the medication as indicated. If this is a recurring problem, it is important to notify a supervisor. This is the appropriate course of action because it ensures that the correct medication dosage is administered and addresses any potential issues with the dispensing process. Refusing to use the drug or questioning the trustworthiness of the nurse are not productive solutions and may not address the underlying problem.

Explanation

The correct action in this situation is to ask the dispensing nurse to re-verify and re-dispense the medication as indicated. If this is a recurring problem, it is important to notify a supervisor. This is the appropriate course of action because it ensures that the correct medication dosage is administered and addresses any potential issues with the dispensing process. Refusing to use the drug or questioning the trustworthiness of the nurse are not productive solutions and may not address the underlying problem.

2. A patient receiving hospice care is refusing to take prescribed opiates and tells the nurse "pain is a part of life". The initial ste

Explore the meaning of pain with the patient

Refer the patient to the chaplain

Schedule a visit with a CanSurmount volunteer

Request an evaluation from the pain service.

It is useful to assess the meaning of the pain to the patient and family. Pain may be perceived as a punishment, and the nurse needs to help reframe this perception to provide comfort..

Ref ONCC

Explanation

It is useful to assess the meaning of the pain to the patient and family. Pain may be perceived as a punishment, and the nurse needs to help reframe this perception to provide comfort..

Ref ONCC

3. A patient receiving doxorubicin through a peripheral IV catheter reports burning at the site, but there is no notable swelling. The nurse's first action is to:

Stop the administration of the drug

Flush with 10 ml of 0.9% normal saline

Reposition the patient's arm

Continue the administration while observing the site.

Doxorubicin is a vesicant, meaning it can cause tissue damage. Pain and burning at the IV site is an immediate manifestation of extravasation. Administration of the drug should be stopped at the first sign of infiltration.

Ref ONCC
Ref: ONCC

Explanation

Doxorubicin is a vesicant, meaning it can cause tissue damage. Pain and burning at the IV site is an immediate manifestation of extravasation. Administration of the drug should be stopped at the first sign of infiltration.

Ref ONCC
Ref: ONCC

4. A patient is ordered opiates around the clock for pain control. Prior to initiating opioid therapy, the nurse anticipates an order for:

Bulk laxatives.

Suppositories

Stimulant laxatives.

Oral mineral oil

Opioids can delay gastric emptying, slow bowel motility, decrease peristalsis, and reduce secretions from the colonic mucosa. Constipation is the most common side effect of opioids and the only one for which individuals do not develop tolerance. Prevention, rather than treatment, op opioid side effects is important. Stimulant laxatives plus a stool softener is recommended when initiating opioid therapy.

Ref ONCC

Explanation

Opioids can delay gastric emptying, slow bowel motility, decrease peristalsis, and reduce secretions from the colonic mucosa. Constipation is the most common side effect of opioids and the only one for which individuals do not develop tolerance. Prevention, rather than treatment, op opioid side effects is important. Stimulant laxatives plus a stool softener is recommended when initiating opioid therapy.

Ref ONCC

5. A patient with small cell lung cancer has a four-pound weight gain, headache, and excessive thirst. These symptoms indicate:

Tumor lysis syndrome

Hemolytic uremic syndrome

Neoplastic cardiac tamponade

Syndrome of inappropriate antidiuretic hormong

Small cell lung cancer accounts for 80% of syndrome of inappropriate antidiuretic hormone syndrome (SIADH) cases. Signs and symptoms include thirst, weight gain, lethargy, headache, anorexia, muscle cramps, and weakness.

Explanation

Small cell lung cancer accounts for 80% of syndrome of inappropriate antidiuretic hormone syndrome (SIADH) cases. Signs and symptoms include thirst, weight gain, lethargy, headache, anorexia, muscle cramps, and weakness.

6. Which of the following medications can cause increased sedation when administered with opiods?

Chlorpromazine

Ibuprofen

Naloxone

Prednisone

Phenothiazines can potentiate the sedative effects of opiates. Nonsteroidal anti-inflammatory agents (NSAIDs) such as ibuprofen do not cause sedation. Naloxone antagonizes opioids, and prednisone can cause hyperexcitability and insomnia.

Ref ONCC

Explanation

Phenothiazines can potentiate the sedative effects of opiates. Nonsteroidal anti-inflammatory agents (NSAIDs) such as ibuprofen do not cause sedation. Naloxone antagonizes opioids, and prednisone can cause hyperexcitability and insomnia.

Ref ONCC

7. In addition to decreasing inflammation, corticosteroids:

Improve muscle tone

Stimulate weight loss

Stimulate the appetite.

Reduce anxiety.

Corticosteroids, such as dexamethasone and prednisone can stimulate the appetite. Additionally, this class of medications can create a sense of well-being, and may cause weight gain.

Explanation

Corticosteroids, such as dexamethasone and prednisone can stimulate the appetite. Additionally, this class of medications can create a sense of well-being, and may cause weight gain.

8. A patient newly diagnosed with cancer tells the nurse, "The doctor ordered all of these tests for clinical staging. What does that mean?" The nurse's best response is based on the knowledge that staging:

Predicts response treatment

Compares treatment results across populations.

Assesses the usual patterns of spread of specific cancers.

Evaluates the extent of local and potential metastatic disease.

The primary purpose for staging is to provide optimal treatment selection and planning for each individual patient. Staging systems include clinical, surgical, pathology, and biochemical determinants to define the extent of disease and direct treatment of the individual. Staging does not directly predict response to treatment, assess patterns of spread, nor compare results across a population.
Ref ONCC

Explanation

The primary purpose for staging is to provide optimal treatment selection and planning for each individual patient. Staging systems include clinical, surgical, pathology, and biochemical determinants to define the extent of disease and direct treatment of the individual. Staging does not directly predict response to treatment, assess patterns of spread, nor compare results across a population.
Ref ONCC

9. A patient in remission complains of dysthymic behaviors for the past several weeks. The nurse knows to assess for

Recurrence of disease

Cognitive learning

Bowel habits

Depression

Evidence suggests 25% of people with cancer have depression, and depressed people have poorer outcomes. Therefore, nurses need to assess for depression.

Ref ONCC

Explanation

Evidence suggests 25% of people with cancer have depression, and depressed people have poorer outcomes. Therefore, nurses need to assess for depression.

Ref ONCC

10. A 62 year old patient with CD33 positive acute myeloid leukemia in first relapse presents with a left ejection fraction of 40%. The nurse anticipates any order for

Gemtuzumab ozogamicin.

All-trans retinaic acid.

Cytarabine

Rituximab

Gemtuzumab ozogamicin (Mylotarg) is used for the treatment of relapsed CD33-positive acute myeloid leukemia in patients greater that or equal to 60 years of age, who would not be considered candidates for cytotoxic chemotherapy.

Ref ONCC

Explanation

Gemtuzumab ozogamicin (Mylotarg) is used for the treatment of relapsed CD33-positive acute myeloid leukemia in patients greater that or equal to 60 years of age, who would not be considered candidates for cytotoxic chemotherapy.

Ref ONCC