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Drugs for Cancer Therapy

Understanding Pharmacology Essentials for Medication Safety

Nursing
21
Questions
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True/False
18
Choices
3
Essay
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Questions

Q1
Free

Which biological feature is specific to normal differentiated cells but not to cancer cells?

Multiple Choice
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A) Anaplasia
B) Hypertrophy
C) Aneuploidy
D) Loose adherence
Answer:
B) Hypertrophy

Explanation:
Some normal tissues increase in size by having individual cells get larger, a process called hypertrophy. Cancer cells are usually small and always grow by hyperplasia, not hypertrophy. The other features listed are characteristics that are associated with cancer cells and not normal differentiated cells.
Q2
Free

How is apoptosis related to cancer development?

Multiple Choice
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A) Cancer only occurs in cells capable of apoptosis.
B) Apoptosis increases the risk for DNA mutations.
C) The process of carcinogenesis suppresses or inhibits apoptosis.
D) Cancer cells with large amounts of apoptosis are more resistant to chemotherapy.
Answer:
C) The process of carcinogenesis suppresses or inhibits apoptosis.

Explanation:
Normal cells have a finite life span. When a normal cell reaches the end of this life span the cell responds to signals for programmed cell death (apoptosis). The purpose of apoptosis is to ensure each organ has an adequate number of cells at their functional peak. Most cancer cells have an enzyme that prevents apoptosis, allowing these cells to have an unlimited life span (are immortal).
Q3
Free

Which factor is the most common contributor to cancer development?

Multiple Choice
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A) Advancing age
B) Eating a high-fat diet
C) Having parents with cancer
D) Living in a geographic area with poor sanitation
Answer:
A) Advancing age

Explanation:
Advancing age is the most important risk factor for cancer. Exposure to carcinogens adds up over a lifetime, and immune protection decreases with age.
Q4

How does oncogene activation cause normal cells to transform into cancer cells?

Multiple Choice
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A) By inhibiting the ability of suppressor gene products to regulate apoptosis
B) By increasing the amount of cyclins present so that cells keep entering the cell cycle and dividing
C) By preventing the immune system from recognizing and eliminating cells that are no longer totally normal
D) By reducing the amount of glucose and other nutrients that reach normal cells, resulting in the starvation and death of normal cells
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Q5

Which health care worker is the most appropriate person to administer intravenous (IV) chemotherapy?

Multiple Choice
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A) Licensed practical/vocational nurse who has worked on an oncology unit for 10 years
B) Registered nurse who has completed menopause 5 years ago and can no longer get pregnant
C) Registered nurse who has completed an approved chemotherapy course
D) Pharmacist with 5 years experience in mixing chemotherapy
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Q6

A patient with breast cancer asks why her hair is falling out while receiving chemotherapy when the cancer is in her breast. What is the nurses best response?

Multiple Choice
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A) Breast cells and hair cells are similar. Any drug that affects one can be expected to affect the other.
B) The chemotherapy is interfering with your nutritional status. Eating more protein will help stop the hair loss.
C) It is possible that some cancer cells have escaped from your breast. Chemotherapy will kill cancer cells wherever they are.
D) Chemotherapy is delivered to all tissues and exerts the same damaging effects on some normal cells as well as on cancer cells.
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Q7

How do most chemotherapy drugs help rid the body of cancer cells?

Multiple Choice
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A) They interfere with cancer cell division.
B) They prevent cancer cells from receiving oxygen.
C) They enhance the immune systems ability to recognize and kill cancer cells.
D) They force cancer cells to undergo reverse transformation to become normal cells.
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Q8

A patient who is receiving intravenous (IV) chemotherapy asks why the nurse is wearing a mask, gloves, and gown when giving the drugs. What is the nurses best response?

Multiple Choice
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A) These drugs will reduce your immune response, and with these coverings I am protecting you from getting an infection from me.
B) Because your immunity is reduced by this therapy, I am preventing the spread of infection from you to me or any other patient here.
C) The drugs are powerful and I handle them every day. The clothing protects me from accidentally absorbing these strong drugs.
D) The hospital policy is for any nurse giving these drugs to wear gowns, gloves, and masks to prevent other people from getting cancer.
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Q9

When it is time for a patients third round of chemotherapy for colon cancer, the patients white blood cell count is low and the treatment is delayed. The patient is upset at this delay. What is the nurses best response?

Multiple Choice
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A) This extra time will give your hair a chance to grow back in.
B) This is for the best. You are too weak to receive chemotherapy now.
C) I will call the physician and request a prescription for something to calm your nerves.
D) Try not to worry. Your counts will probably be high enough next week and the chemotherapy will work just as well then.
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Q10

A patient who is to receive combination chemotherapy today has an absolute neutrophil count (ANC) of 6200 cells/mm3. What is the certified chemotherapy nurses best action?

Multiple Choice
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A) Administer the chemotherapy as prescribed.
B) Assess the patient for signs and symptoms of infection.
C) Hold the chemotherapy doses and notify the prescriber.
D) Explain to the patient that the treatment must be delayed until the ANC is acceptable.
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Q11

A patient arrives to receive a second round of combination chemotherapy. What is the most important patient assessment finding for the nurse to report to the prescriber?

Multiple Choice
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A) Height
B) Weight
C) Blood pressure
D) Pulse rate and rhythm
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Q12

Which drug does the nurse prepare to administer to a patient receiving combination chemotherapy who has a red blood cell (RBC) count of 120 million/mm3?

Multiple Choice
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A) Bleomycin (Blenoxane)
B) Oprelvekin (Neumega)
C) Epoetin alfa (Procrit)
D) Megestrol (Megace)
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Q13

A patient who is to receive a third round of combination chemotherapy today reports that mouth sores were present for 4 days within a week of receiving the last round of chemotherapy. What is the nurses best action?

Multiple Choice
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A) Hold todays dose of chemotherapy and notify the prescriber immediately.
B) Ask the patient whether sores were present after the first round of chemotherapy.
C) Reassure the patient that this is an expected chemotherapy side effect and no action is needed.
D) Administer the chemotherapy as prescribed and call the prescriber to determine whether preventive drugs are needed.
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Q14

A patient is receiving intravenous (IV) chemotherapy through a peripheral line. Which IV site assessment finding indicates to the nurse that the IV access needs to be discontinued?

Multiple Choice
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A) Bruising at the insertion site
B) Coolness of the skin below the site
C) Tissue swelling above and below the site
D) Wetness of the dressing over the access site
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Q15

Which chemotherapy problem, experienced by a patient after the first round of chemotherapy, does the nurse report to the prescriber to reduce the chemotherapy dose or delay the next treatment?

Multiple Choice
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A) Productive cough and fever
B) Loss of scalp and body hair
C) Moderate nausea and vomiting
D) Fatigue and increased sleep time
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Q16

A patient who has just been diagnosed with breast cancer asks why her treatment plan does not include the new drug Herceptin that she has read about. What is the nurses best response?

Multiple Choice
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A) Your immune system is too weak to tolerate Herceptin.
B) This drug is experimental and dangerous for you to take before trying other therapies.
C) Your breast cancer does not have the protein that this drug works on, so you would not benefit from this therapy.
D) You are young and can better tolerate the standard therapies for breast cancer that have been proven effective but have strong side effects.
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Q17

Which action is most important for the nurse to implement to prevent nausea and vomiting in a patient who is prescribed intravenous (IV) chemotherapy?

Multiple Choice
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A) Keep the patient NPO during the time chemotherapy is infusing.
B) Administer antiemetic drugs before administering chemotherapy.
C) Ensure that the chemotherapy is infused over a 4- to 6-hour period.
D) Assess the patients responses every hour during the infusion period.
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Q18

A male patient is prescribed estrogen as hormone treatment for cancer. Which assessment is most important for the nurse to perform for this patient?

Multiple Choice
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A) Ask whether there has been a change in the level of sexual activity.
B) Compare breast size after therapy to that from before therapy.
C) Check for swelling and hard, cordlike veins in the legs.
D) Measure the patients abdominal girth.
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Q19

[Multiple Response] Which complications or responses to chemotherapy have a greater impact among older adults who receive intravenous chemotherapy? (Select all that apply.)
a. Alopecia
b. Headache
c. Nausea and vomiting
d. Neutropenia
e. Peripheral neuropathy
f. Stomach and intestinal changes

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Q20

[Multiple Response] Which complications or responses to chemotherapy have a greater impact among older adults who receive intravenous chemotherapy? (Select all that apply.)
a. Alopecia
b. Headache
c. Nausea and vomiting
d. Neutropenia
e. Peripheral neuropathy
f. Stomach and intestinal changes

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Q21

A patient who has been prescribed combination chemotherapy today has a total white blood cell (WBC) count of 5 cells/mm3, a lymphocyte count of 2.2 cells/mm3, a segmented neutrophil count of 1.8 cells/mm3, a basophil count of 0.15 cells/mm3, an eosinophil count of 250 cells/mm3, and a band neutrophil count of 0.6 cells/mm3. What does the nurse calculate as the absolute neutrophil count (ANC)? _____ cells/mm3

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