A nurse is preparing to administer Cyclophosphamide IV to a client who has Hodgkin's
disease. Which of the following medications should the nurse expect to administer
concurrently with the chemotherapy to prevent an adverse effect of Cyclophosphamide?
A. Uroprotectant agent, such as mesna
B. Opioid, such as morphine
C. Loop diuretic, such as furosemide
D. H1 receptor antagonist, such as diphenhydramine - CORRECT ANSWERS-A
(Mesna is a uroprotectant agent that can help prevent hemorrhagic cystitis when
administered IV with a nitrogen mustard chemotherapy medication)
A nurse is preparing to administer Leucovorin to a client who has cancer and is
receiving chemotherapy with Methotrexate. Which of the following responses should the
nurse use when the client asks why Leucovorin is being given?
A. "Leucovorin reduces the risk of a transfusion reaction from methotrexate."
B. "Leucovorin increases platelet production and prevents bleeding."
C. "Leucovorin potentiates the cytotoxic effects of methotrexate."
D. "Leucovorin protects healthy cells from methotrexate's toxic effect." - CORRECT
ANSWERS-D (Leucovorin, a folic acid derivative and an antagonist to methotrexate, is
given within 12 hr of high doses of methotrexate to protect healthy cells from the toxic
effects of methotrexate)
A nurse is teaching a client who has breast cancer about Tamoxifen. Which of the
following adverse effects of tamoxifen should the nurse discuss with the client?
A. Irregular heart beat
B. Abnormal uterine bleeding
C. Yellow sclera or dark-colored urine.
D. Difficulty swallowing - CORRECT ANSWERS-B (Vaginal discharge and bleeding are
adverse effects of tamoxifen. The client who takes tamoxifen is also at increased risk for
endometrial cancer, so any abnormal uterine bleeding should be carefully monitored
and evaluated)
A nurse is caring for a client who is being treated with Interferon alfa-2b for Malignant
Melanoma. For which of the following adverse effects should the nurse monitor? (Select
all that apply.)
A. Tinnitus
B. Muscle aches
C. Peripheral neuropathy
1|Page
,D. Bone loss
E. Depression - CORRECT ANSWERS-b, c, e
(B.muscle aches and other flu-like manifestations are common adverse effects of
interferon alfa-2b. Acetaminophen may be prescribed to relieve these manifestations.
C. Peripheral neuropathy, dizziness, and fatigue are CNS effects that can occur when
taking interferon alfa-2b. These should be reported to the provider, and the nurse
should teach the client to prevent injury from falls.
E. Depression and mental status changes
can occur with interferon alfa-2b treatment. The nurse should assess the client for
suicidal thoughts.)
A nurse is caring for a client who receives Rituximab to treat Non-hodgkin's Leukemia
and who asks the nurse how Rituximab works. Which of the following should the nurse
include?
A. Blocks hormone receptors
B. Increases immune response
C. Binds with specific antigens on tumor cells
D. Stops DNA replication during cell division - CORRECT ANSWERS-C (Rituximab is a
monoclonal antibody that binds to specific antigens on B-lymphocytes and then
destroying cancer cells.)
A nurse is implementing a plan of care for a client who has a wound infection. Which of
the following actions should the nurse perform first?
A. Administer antibiotic medication.
B. Obtain a wound specimen for culture.
C. Review WBC laboratory findings.
D. Apply a dressing to the wound - CORRECT ANSWERS-B (When using the urgent
vs. nonurgent approach to care, the nurse's priority action is to obtain a culture of the
wound before initiating antibiotic therapy)
A nurse is caring for a client who has a UTI and a history of recurrence of this type of
infection. The client asks why the provider has not yet prescribed an antibiotic. The
nurse should explain that the provider has to wait for the results of which of the following
laboratory tests to identify which antibiotic to prescribe?
A. Gram stain
B. Culture
C. Sensitivity
D. Specific gravity - CORRECT ANSWERS-C (A sensitivity test identifies the most
effective antibiotic to prescribe to treat a specific micro-organism.)
2|Page
, A nurse is preparing information for the unit's nurses about the effectiveness of
antimicrobial therapy for clients who have bacterial infections. Which of the following
host factors should the nurse include as conditions that affect antimicrobial
effectiveness? (Select all that apply.)
A. Meningitis
B. Pacemaker
C. Endocarditis
D. Pneumonia
E. Pyelonephriti - CORRECT ANSWERS-a, b, c
(A. Some clients who have meningitis have
difficulty responding to antimicrobial therapy because it is difficult for the medication to
cross the blood-brain barrier to reaching the infecting micro-organisms.
B. Some clients who have a pacemaker have difficulty responding to antimicrobial
therapy due to colonization of micro-organisms around the pacemaker and the inability
of phagocytic cells to destroy those micro-organisms.
C. Some clients who have endocarditis have
difficulty responding to antimicrobial therapy because the medication cannot penetrate
the vegetative thrombus that develops on the injured endocardium)
A nurse is caring for a group of clients who are receiving antimicrobial therapy. Which of
the following clients should the nurse plan to monitor for manifestations of antibiotic
toxicity?
A. An adolescent client who has a sinus infection
B. An older adult client who has prostatitis
C. A client who is postpartum and has mastitis
D. A middle adult client who has a urinary tract infection - CORRECT ANSWERS-B (An
older adult client who has prostatitis and is receiving antibiotics is at risk for toxicity due
to the age-related reduction in medication metabolism and excretion)
A charge nurse is teaching a group of nurses about the importance of prophylactic
antimicrobial therapy. Which of the following information should the charge nurse
include in the teaching? (Select all that apply.)
A. Administer prophylactic antimicrobial therapy to clients who report exposure to a
sexually transmitted infection.
B. Administer prophylactic antimicrobial therapy to clients who are having orthopedic
surgery.
C. Instruct clients who have a prosthetic heart valve about the need for prophylactic
antimicrobial therapy before dental work.
3|Page
disease. Which of the following medications should the nurse expect to administer
concurrently with the chemotherapy to prevent an adverse effect of Cyclophosphamide?
A. Uroprotectant agent, such as mesna
B. Opioid, such as morphine
C. Loop diuretic, such as furosemide
D. H1 receptor antagonist, such as diphenhydramine - CORRECT ANSWERS-A
(Mesna is a uroprotectant agent that can help prevent hemorrhagic cystitis when
administered IV with a nitrogen mustard chemotherapy medication)
A nurse is preparing to administer Leucovorin to a client who has cancer and is
receiving chemotherapy with Methotrexate. Which of the following responses should the
nurse use when the client asks why Leucovorin is being given?
A. "Leucovorin reduces the risk of a transfusion reaction from methotrexate."
B. "Leucovorin increases platelet production and prevents bleeding."
C. "Leucovorin potentiates the cytotoxic effects of methotrexate."
D. "Leucovorin protects healthy cells from methotrexate's toxic effect." - CORRECT
ANSWERS-D (Leucovorin, a folic acid derivative and an antagonist to methotrexate, is
given within 12 hr of high doses of methotrexate to protect healthy cells from the toxic
effects of methotrexate)
A nurse is teaching a client who has breast cancer about Tamoxifen. Which of the
following adverse effects of tamoxifen should the nurse discuss with the client?
A. Irregular heart beat
B. Abnormal uterine bleeding
C. Yellow sclera or dark-colored urine.
D. Difficulty swallowing - CORRECT ANSWERS-B (Vaginal discharge and bleeding are
adverse effects of tamoxifen. The client who takes tamoxifen is also at increased risk for
endometrial cancer, so any abnormal uterine bleeding should be carefully monitored
and evaluated)
A nurse is caring for a client who is being treated with Interferon alfa-2b for Malignant
Melanoma. For which of the following adverse effects should the nurse monitor? (Select
all that apply.)
A. Tinnitus
B. Muscle aches
C. Peripheral neuropathy
1|Page
,D. Bone loss
E. Depression - CORRECT ANSWERS-b, c, e
(B.muscle aches and other flu-like manifestations are common adverse effects of
interferon alfa-2b. Acetaminophen may be prescribed to relieve these manifestations.
C. Peripheral neuropathy, dizziness, and fatigue are CNS effects that can occur when
taking interferon alfa-2b. These should be reported to the provider, and the nurse
should teach the client to prevent injury from falls.
E. Depression and mental status changes
can occur with interferon alfa-2b treatment. The nurse should assess the client for
suicidal thoughts.)
A nurse is caring for a client who receives Rituximab to treat Non-hodgkin's Leukemia
and who asks the nurse how Rituximab works. Which of the following should the nurse
include?
A. Blocks hormone receptors
B. Increases immune response
C. Binds with specific antigens on tumor cells
D. Stops DNA replication during cell division - CORRECT ANSWERS-C (Rituximab is a
monoclonal antibody that binds to specific antigens on B-lymphocytes and then
destroying cancer cells.)
A nurse is implementing a plan of care for a client who has a wound infection. Which of
the following actions should the nurse perform first?
A. Administer antibiotic medication.
B. Obtain a wound specimen for culture.
C. Review WBC laboratory findings.
D. Apply a dressing to the wound - CORRECT ANSWERS-B (When using the urgent
vs. nonurgent approach to care, the nurse's priority action is to obtain a culture of the
wound before initiating antibiotic therapy)
A nurse is caring for a client who has a UTI and a history of recurrence of this type of
infection. The client asks why the provider has not yet prescribed an antibiotic. The
nurse should explain that the provider has to wait for the results of which of the following
laboratory tests to identify which antibiotic to prescribe?
A. Gram stain
B. Culture
C. Sensitivity
D. Specific gravity - CORRECT ANSWERS-C (A sensitivity test identifies the most
effective antibiotic to prescribe to treat a specific micro-organism.)
2|Page
, A nurse is preparing information for the unit's nurses about the effectiveness of
antimicrobial therapy for clients who have bacterial infections. Which of the following
host factors should the nurse include as conditions that affect antimicrobial
effectiveness? (Select all that apply.)
A. Meningitis
B. Pacemaker
C. Endocarditis
D. Pneumonia
E. Pyelonephriti - CORRECT ANSWERS-a, b, c
(A. Some clients who have meningitis have
difficulty responding to antimicrobial therapy because it is difficult for the medication to
cross the blood-brain barrier to reaching the infecting micro-organisms.
B. Some clients who have a pacemaker have difficulty responding to antimicrobial
therapy due to colonization of micro-organisms around the pacemaker and the inability
of phagocytic cells to destroy those micro-organisms.
C. Some clients who have endocarditis have
difficulty responding to antimicrobial therapy because the medication cannot penetrate
the vegetative thrombus that develops on the injured endocardium)
A nurse is caring for a group of clients who are receiving antimicrobial therapy. Which of
the following clients should the nurse plan to monitor for manifestations of antibiotic
toxicity?
A. An adolescent client who has a sinus infection
B. An older adult client who has prostatitis
C. A client who is postpartum and has mastitis
D. A middle adult client who has a urinary tract infection - CORRECT ANSWERS-B (An
older adult client who has prostatitis and is receiving antibiotics is at risk for toxicity due
to the age-related reduction in medication metabolism and excretion)
A charge nurse is teaching a group of nurses about the importance of prophylactic
antimicrobial therapy. Which of the following information should the charge nurse
include in the teaching? (Select all that apply.)
A. Administer prophylactic antimicrobial therapy to clients who report exposure to a
sexually transmitted infection.
B. Administer prophylactic antimicrobial therapy to clients who are having orthopedic
surgery.
C. Instruct clients who have a prosthetic heart valve about the need for prophylactic
antimicrobial therapy before dental work.
3|Page
