Ch 28 Drugs for Neoplasia

The nurse administers antiemetic drugs to a patient
receiving chemotherapy:
1. Only when vomiting occurs
2. Once the treatment regimen is completed
3. Just prior to treatment
4. Only if the patient requests to be medicated
3. Just prior to treatment

The patient with testicular cancer is receiving cisplatin
(Platinol) IV. The nurse plans to monitor for:
1. Irreversible heart failure
2. Bone marrow suppression
3. Cardiac toxicity
4. Peripheral neuropathy
2. Bone marrow suppression

Before a patient begins drug therapy with methotrexate, the nurse collects information regarding the use of other medications. What medication(s) would be of concern if the patient were to take it along with the methotrexate? (Select all that apply.)
1. Aspirin
2. Iron supplement
3. Acetaminophen
4. Nonsteroidal anti-inflammatory drugs (NSAIDs)
1. Aspirin
4. Nonsteroidal anti-inflammatory drugs (NSAIDs)

The patient with breast cancer has been receiving IV
doxorubicin (Adriamycin). The patient is now complaining of severe pain at the IV site. The nurse understands that the following most likely occurred:
1. An allergic reaction
2. Leaking at the IV site
3. Loss of neural reflexes
4. Development of a blood clot
2. Leaking at the IV site

A patient has started on tamoxifen as a treatment for cancer. The physician orders 20 mg, po, daily but it is only available in 10 mg tablets. How many tablets will the patient receive in a day? How many tablets in a week?
1. 1 tablet a day, 7 tablets a week
2. 2 tablets a day, 14 tablets a week
3. 2 tablets a day, 10 tablets a week
4. 4 tablets a day, 14 tablets a week
2. 2 tablets a day, 14 tablets a week

The patient on cyclosphosphamide (Cytoxan) is taught:
1. That alopecia is not irreversible
2. About signs and symptoms of neurotoxicity
3. About signs and symptoms of renal toxicity
4. That nausea, vomiting, and diarrhea frequently occur
4. That nausea, vomiting, and diarrhea frequently occur

The nurse monitors a patient taking methotrexate for
which adverse effect(s)? (Select all that apply.)
1. Cardiac dysthymias
2. Bruising
3. Decreased urinary output
4. Diarrhea
2. Bruising
4. Diarrhea

A patient is about to start his chemotherapy treatments. He will be taking rituximab (Rituxan), a type of monoclonal antibody. He asks the nurse how it works. The nurse tells him that this type of monoclonal antibody:
1. Changes the structure of cancer cell’s DNA, preventing them from replicating
2. Binds to surface proteins present on cancer cells and
shatters them
3. Blocks a specific step in cancer cell metabolism
4. Attaches to the DNA of cancer cells, inhibiting their growth
2. Binds to surface proteins present on cancer cells and
shatters them

The nurse informs a patient with a decreased white blood cell count that he should:
1. Use alcohol-based mouthwash for mouth sores
2. Increase liquid intake with meals
3. Avoid raw foods
4. Ask his physician about ordering megestrol (Megace)
3. Avoid raw foods

The patient on tamoxifen must be checked for:
1. Flu-like symptoms
2. Uterine cancer
3. Alopecia
4. Thrombocytopenia
2. Uterine cancer

True or False:
Malignant tumors are those that do not metastasize and rarely require drug treatment?
False

True or False:
Medications from different chemotherapeutic classes are rarely combined when patients receive surgery or radiation treatment?
False

True or False:
Resistance to antineoplastic drug is not a phenomenon observed with cancer cells?
False

True or False:
Specific dosing schedules have been found to increase the effectiveness of antineoplastic agents?
True

True or False:
Alkylating agents interfere with aspects of the nucleic acid metabolism of rapidly growing tumor cells?
True

True or False:
Some antibiotics have the ability to kill cancer cells?
True

True or False:
Plant extracts (natural products) are used for chemotherapy because they have relatively few adverse effects?
False

True or False:
Corticosteroids, estrogens, and androgens are commonly used in cancer chemotherapy?
True

True or False:
Biologic response modifiers differ from other chemotherapeutic agents in that they stimulate the patient’s own immune system to fight the cancer cells?
True

Fill in the blank:
Drug therapy of cancer is sometimes called ___________?
Chemotherapy

Fill in the blank:
A number of treatment strategies have been found to increase the effectiveness of anticancer drugs including: ____________ , ____________ , ___________ , and __________?
Surgery, radiation, multiple drugs, and special dosing schedule

Fill in the blank:
A novel delivery method in which drugs are enclosed in small sacs, or vesicles, of lipids is called ____________?
Liposome

Fill in the blank:
Bone marrow suppression is the most important adverse side effect of a class of antineoplastic drugs called __________?
Alkylating agents

Fill in the blank:
By blocking the synthesis of folic acid, a medication called __________ is able to inhibit replication in rapidly dividing cancer cells?
Methotrexate

Fill in the blank:
All antitumor antibiotics must be administered by the __________ route or through direct installation into a body cavity using a catheter?
Intravenous

Fill in the blank:
Plant extracts that have been isolated to kill cancer cells include the ___________ ____________ and ___________?
****vinca alkaloids, taxoids and topoisomerase inhibitors

Fill in the blank:
____________ help to limit the severe immunosuppressive effects of other anticancer drugs by stimulating the body’s immune system?
Biologic response inhibitiros

Matching:
______ Cyclophosphamide (Cytoxan)
A. Alkylating agent
B. Antimetabolite
C. Antitumor antibiotic
D. Hormones and hormone antagonist
E. Plant extract
F. Biologic response modifier or miscellaneous
A. Alkylating agent

Matching:
______ Fluorouracil (5-FU, Adrucil)
A. Alkylating agent
B. Antimetabolite
C. Antitumor antibiotic
D. Hormones and hormone antagonist
E. Plant extract
F. Biologic response modifier or miscellaneous
B. Antimetabolite

Matching:
______ Vincristine (Oncovin)
A. Alkylating agent
B. Antimetabolite
C. Antitumor antibiotic
D. Hormones and hormone antagonist
E. Plant extract
F. Biologic response modifier or miscellaneous
E. Plant extract

Matching:
______ Methotrexate (Rheumatrex, Trexall)
A. Alkylating agent
B. Antimetabolite
C. Antitumor antibiotic
D. Hormones and hormone antagonist
E. Plant extract
F. Biologic response modifier or miscellaneous
B. Antimetabolite

Matching:
______ Bleomycin (Blenoxane)
A. Alkylating agent
B. Antimetabolite
C. Antitumor antibiotic
D. Hormones and hormone antagonist
E. Plant extract
F. Biologic response modifier or miscellaneous
C. Antitumor antibiotic

Matching:
______ Medroxyprogesterone (Depo-Provera)
A. Alkylating agent
B. Antimetabolite
C. Antitumor antibiotic
D. Hormones and hormone antagonist
E. Plant extract
F. Biologic response modifier or miscellaneous
D. Hormones and hormone antagonist

Matching:
______ Etoposide (VePesid)
A. Alkylating agent
B. Antimetabolite
C. Antitumor antibiotic
D. Hormones and hormone antagonist
E. Plant extract
F. Biologic response modifier or miscellaneous
E. Plant extract

Matching:
______ Tamoxifen
A. Alkylating agent
B. Antimetabolite
C. Antitumor antibiotic
D. Hormones and hormone antagonist
E. Plant extract
F. Biologic response modifier or miscellaneous
D. Hormones and hormone antagonist

Matching:
______ Levamisole (Ergamisol)
A. Alkylating agent
B. Antimetabolite
C. Antitumor antibiotic
D. Hormones and hormone antagonist
E. Plant extract
F. Biologic response modifier or miscellaneous
F. Biologic response modifier or miscellaneous

Matching:
______ Streptozocin
A. Alkylating agent
B. Antimetabolite
C. Antitumor antibiotic
D. Hormones and hormone antagonist
E. Plant extract
F. Biologic response modifier or miscellaneous
A. Alkylating agent

Antimetabolites act by:
A. Changing the structure of deoxyribonucleic acid (DNA) in cancer cells
B. Disrupting critical cell pathways in cancer cells
C. Preventing cell division
D. Activating the body’s immune system
B. Disrupting critical cell pathways in cancer cells

Bruising is a common side effect of chemotherapy, caused by a deficiency of:
A. Platelets
B. Red blood cells
C. White blood cells
D. Normal bacterial flora
A. Platelets

The healthcare provider should teach patients that the probability of acquiring cancer may be reduced by adopting which of the following lifestyle changes?
A. Examining the skin for abnormal lesions or changes in moles
B. Exercising regularly and keeping body weight within normal guidelines
C. Examining the body monthly for abnormal lumps
D. All of the above
D. All of the above

Which of the following statements regarding tumors is INCORRECT?
A. Carcinomas are the most common type of neoplasm
B. Benign tumors are slow growing, do not metastasize, and rarely require drug treatment
C. Malignant tumors grow rapidly worse, become resistant to treatment, and normally result in death
D. The term neoplasm is often used interchangeably with carcinoma
D. The term neoplasm is often used interchangeably with carcinoma

Which of the following is NOT a treatment approach to remove cancer?
A. Surgery
B. Radiation therapy
C. Diet
D. Drug therapy
C. Diet

Which of the following approaches would eliminate the maximum number of cancer cells with the least toxicity?
A. Using multiple drugs in lower doses from different antineoplastic classes
B. Increasing the concentration of different antineoplastic drugs from the same class
C. Increasing the dose of one antineoplastic drug
D. Combining radiation therapy with chemotherapy treatment
A. Using multiple drugs in lower doses from different antineoplastic classes

Which of the following would the nurse NOT expect to observe during chemotherapy with antineoplastic drugs?
A. Alopecia
B. Nausea
C. Hypercholesterolemia
D. Leukopenia
C. Hypercholesterolemia

Which of the following acts by changing the shape of DNA and preventing it from functioning normally?
A. Cyclophosphamide (Cytoxan)
B. Methotrexate (Rheumatrex, Trexall)
C. Doxorubicin (Adriamycin)
D. Vincristine (Oncovin)
A. Cyclophosphamide (Cytoxan)

The primary drug therapy for AIDS-related Kaposi’s sarcoma is:
A. Mechlorethamine (Mustargen)
B. Floxuridine (FUDR)
C. Doxorubicin (Adriamycin)
D. Teniposide (Vumon)
C. Doxorubicin (Adriamycin)

A chemotherapeutic drug extended from the Pacific yew plant is:
A. Mercaptopurine (6-MP, Purinethol)
B. Paclitaxel (Taxol)
C. Vinblastine sulfate (Velban)
D. Flutamide (Eulexin)
B. Paclitaxel (Taxol)

The most serious limiting adverse effect of vincristine (Oncovin) is:
A. Flu-like symptoms
B. Hepatotoxicity
C. Neurotoxicity
D. Immunosuppression
C. Neurotoxicity

Which of the following is the only drug approved for preventing breast cancer?
A. Carboplatin (Paraplatin)
B. Pentostatin (Nipent)
C. Epirubicin (Ellence)
D. Tamoxifen
D. Tamoxifen

Epoietin alfa (Epogen, Procrit) is often administered to patients receiving chemotherapy in order to:
A. Increase the number of cancer cells killed
B. Limit the degree of anemia caused by antineoplastics
C. Increase the white blood cell count
D. Limit nausea and vomiting
B. Limit the degree of anemia caused by antineoplastics

Which of the following drugs would the nurse administer for palliation of advanced cancer?
A. Epirubicin (Ellence)
B. Dacarbazine (DTIC-Dome)
C. Ethinyl estradiol (Estinyl)
D. Chlorambucil (Leukeran)
C. Ethinyl estradiol (Estinyl)

Which of the following drugs would NOT be used for treatment of prostate cancer?
A. Vinorelbine (Navelbine)
B. Megestrol (Megace)
C. Bicalutamide (Casodex)
D. Leuprolide (Lupron)
A. Vinorelbine (Navelbine)

Which of the following drugs would the nurse administer for palliative treatment of malignant melanoma?
A. Teniposide (Vumon)
B. Idarubicin (Idamycin)
C. Dactinomycin (Actinomycin D, Cosmegan)
D. Hydroxyurea (Hydrea)
D. Hydroxyurea (Hydrea)

In a patient with cancer, the nurse would administer oprelvekin (Neumega) in order to:
A. Kill the maximum number of cancer cells
B. Protect normal cells from being killed by other chemotherapy agents
C. Stimulate red blood cell production
D. Stimulate platelet production
D. Stimulate platelet production

Which of the following drugs would most likely displace an antineoplastic drug from protein binding sites in the plasma, thus increasing its effect?
A. Nonsteroidal anti-inflammatory drugs (NSAIDs)
B. Sedative-hypnotics
C. Antidepressant
D. Calcium channel blockers
A. Nonsteroidal anti-inflammatory drugs (NSAIDs)

Heart failure is sometimes observed with antineoplastic drugs. The nurse should assess for which of the following symptoms in this patient?
A. Hypokalemia
B. Peripheral edema
C. Dehydration
D. Dysrhythmias
B. Peripheral edema

Glycoprotein IIb/IIIa inhibitors are used to treat:
A. Blood coagulation disorders
B. Depression
C. Tuberculosis
D. HIV/AIDS
A. Blood coagulation disorders

Valproic acid (Depakote) is useful in the pharmacotherapy of migraines, bipolar disorder, and:
A. Schizophrenia
B. Angina
C. Dysrhythmias
D. Seizures
D. Seizures

Indomethacin (Indocin) is a medication that prevents prostaglandin synthesis. It would most likely be used to treat:
A. Fungal infections
B. Pain and inflammation
C. Hypotension
D. Alzheimer’s disease
B. Pain and inflammation

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