The nurse is providing instruction to a client who will be receiving chemotherapy that selectively kills cancer cells without harming normal cells. Which type of chemotherapy is the nurse describing to the client?
Biologic therapy
Targeted therapy
✓
Neoadjuvant therapy
Adjuvant therapy
Correct Answer
Targeted therapy
Targeted therapy is administered to selectively kill cancer cells without harming healthy cells.
Question 2
The nurse is reviewing the medical record for a client receiving doxorubicin for breast cancer. The record shows that the client has received a lifetime total of 360 mg/m2 . Which action should the nurse take?
Notify the provider that the client needs a dose reduction
Call the pharmacy to ask that the cumulative dose be reduced
Continue with treatment and routine monitoring because this is within safe lifetime dose limits
✓
Notify the client that the next chemotherapy appointment will be delayed
Correct Answer
Continue with treatment and routine monitoring because this is within safe lifetime dose limits
The nurse should continue with the treatment because the client's lifetime total of doxorubicin is within the maximum lifetime limit of 550 mg/m2 .
Question 3
The nurse is checking the medication orders for a client receiving fluorouracil for the treatment of colon cancer. Which medication should the nurse anticipate will be ordered with fluorouracil?
Leucovorin
✓
Phenytoin
Diphenhydramine
Acetaminophen
Correct Answer
Leucovorin
Leucovorin is administered with fluorouracil to enhance the effectiveness of fluorouracil.
Question 4
Which statement made by a client indicates to the nurse that the client understands self-care during myelosuppressive chemotherapy?
"My sister will be caring for my cat while I am undergoing treatment."
✓
"I am going to increase my protein intake by eating venison my family prepared."
"I am excited about visiting my granddaughter's preschool class."
"I will include more salads in my diet."
Correct Answer
"My sister will be caring for my cat while I am undergoing treatment."
To avoid infection, the client with myelosuppression should avoid cat litter boxes.
Question 5
The nurse is caring for a client receiving pembrolizumab. What should the nurse should monitor the client for signs of?
Immune-mediated destruction
✓
Vitamin D deficiency
Severe neutropenia
Pernicious anemia
Correct Answer
Immune-mediated destruction
Pembrolizumab heightens T-lymphocyte activity, predisposing clients to the development of immunemediated conditions.
Question 6
Which finding should the nurse expect in a client with acute myelogenous leukemia who has developed tumor lysis syndrome?
Hypokalemia
Alkalosis
Hypocalcemia
✓
Hypophosphatemia
Correct Answer
Hypocalcemia
Tumor lysis syndrome occurs when cancer cells are destroyed, releasing cellular debris and electrolytes into the blood, resulting in hypocalcemia, hyperkalemia, hyperphosphatemia, and acidosis.
Question 7
Which information would the nurse give to a 67-year-old female client receiving tamoxifen to treat breast cancer?
This medication is administered intramuscularly.
Tamoxifen is taken for 5 years.
✓
Liver function tests need to be closely monitored.
Tamoxifen can cause muscle or joint pain.
Correct Answer
Tamoxifen is taken for 5 years.
Tamoxifen, an antiestrogen administered to treat breast cancers that are hormone-receptor positive, is taken for 5 years.
Question 8
A client diagnosed with breast cancer is scheduled to begin initial treatment with doxorubicin. Prior to administering the first dose of doxorubicin, the nurse notes that the client's left ventricular ejection fraction is 58%. Which action should the nurse take?
Hold the medication and call the prescriber
Notify the prescriber and request a reduced dose
Administer the medication, but at a reduced rate
Administer the medication as prescribed
✓
Correct Answer
Administer the medication as prescribed
Doxorubicin should not be administered to clients who have a left ventricular ejection fraction less than 55%. Since this client has an ejection fraction of 58%, the nurse would administer the medication as prescribed.
Question 9
The nurse is reviewing laboratory reports for a client receiving chemotherapy and notes an absolute neutrophil count of 1.4 cells/mcL. Which order should the nurse anticipate?
Packed red blood cells
Interferon A
Epoetin alfa
Filgrastim
✓
Correct Answer
Filgrastim
Because this client has a low absolute neutrophil count, the nurse anticipates an order for filgrastim to stimulate stem cell production of white blood cells.
Question 10
Which premedication order will the nurse anticipate being ordered to administer prior to administering rituximab?
Phenytoin and acetaminophen
Diphenhydramine and acetaminophen
✓
Aspirin and ondansetron
Corticosteroid
Correct Answer
Diphenhydramine and acetaminophen
Rituximab has a high risk for causing a sensitivity reaction, so the client must be premedicated with diphenhydramine and acetaminophen.