NURSING, Advanced Pharmacology.
• Question 1
1 out of 1 points
A patient will soon begin targeted therapy as a component of her treatment plan
for chronic leukemia. The nurse is conducting health education about this new
aspect of the patient's drug regimen and the patient has asked about the
potential side effects of treatment. How should the nurse best respond?
Response Targeted therapies are generally considered to be less toxic thantraditional
chemotherapy drugs.
Feedback:
However, adverse reactions to targeted therapies can occur such as
severe skin reactions, GI toxicities, skin reactions, and thrombosis.
• Question 2
1 out of 1 points
Mr. Singh is a 66-year-old man who is receiving chemotherapy for the
treatment of lung cancer that has metastasized to his liver. In an effort to prevent infection, Mr. Singh has been prescribed
filgrastim (Neupogen).
Which of the nurse's following assessment questions most directly addresses a common adverse effect of filgrastim?
Response Medullary bone pain is a consistently observed adverse effect that can be attributed to drug therapy
Feedback with filgrastim; it is mild to moderate in severity and is reported in 56% of patients
:
taking the drug. Shortness of breath, mucosal bleeding, and cool, clammy skin are not adverse effects
typical of filgrastim.
• Question 3
1 out of 1 points
An older adult woman has been diagnosed with acute lymphoblastic leukemia (ALL) and her care team has
identified potential benefits of imatinib. Which of the following characteristics of this patient's current health
status may preclude the use of imatinib?
Response Imatinib may be associated with edema. Patients should be weighed regularly and assessed for
Feedback
signs of fluid retention that could be severe. The risk of edema increases with higher doses of
:
,imatinib and age greater than 65 years. Previous strokes, orthopedic surgery, or well-controlled
diabetes may not contraindicate the use of imatinib.
• Question 4
1 out of 1 points
An oncology nurse is reviewing the pathophysiology of cancer and is discussing with a colleague the factors that contribute
to the success or
failure of a patient's chemotherapy. Which of the following cancerous cells is most susceptible to the effects of
chemotherapeutic drugs?
Response Cells that have a short generation time or rapid mitotic rate are most sensitive to antineoplastic
Feedback
agents. All cells (both cancerous and noncancerous) have a blood supply. A lack of contact
:
inhibition is characteristic of cancer, but this is not associated with susceptibility to
chemotherapeutic drugs.
• Question 5
1 out of 1 points
A nurse is caring for a patient with cancer who has been prescribed dronabinol (Marinol) to help reduce nausea and vomiting
from
chemotherapy. The nurse will inform the patient that he or she is taking an oral form of
Response
The major ingredient of Marinol is 9-tetrahydrocannabinol (THC), the active ingredient in
Feedback: marijuana.
• Question 6
1 out of 1 points
When planning care for a patient who is receiving filgrastim (Neupogen) for a nonmyeloid malignancy, the nurse should formulate
which of the following patient outcomes? (Select all that apply.)
Response
Desired outcomes for a patient receiving filgrastim include that febrile neutropenia will be
Feedbackavoided and infection and bone pain will not develop, or at least bone pain will not be
: unmanageable if it develops. Also, because this drug is administered subcutaneously every day during therapy,
management of their own administration would be a positive outcome for patients. A patient who is taking
oprelvekin would be at risk for fluid retention. Filgrastim is not associated with this adverse effect.
• Question 7
1 out of 1 points
A nurse has been assigned to a 55-year-old woman who has a malignant brain tumor. The patient is receiving her first dose
of carmustine. It will be critical for the nurse to observe for which of the following?
, Response Respiratory difficulty can indicate a hypersensitivity reaction or anaphylaxis. The nurse would report any
Feedback breathing difficulties immediately to the physician. If the patient does not eat or drink for more than 24
: hours, the physician should be notified. Nausea and vomiting are adverse effects of the drug therapy, and
an antiemetic regimen would be appropriate. Reddish urine is an adverse effect of doxorubicin, not
carmustine.
•
Question 8
1 out of 1 points
A patient has been scheduled to begin treatment with rituximab for non- Hodgkin's lymphoma. The nurse who will
administer this drug should understand that it targets
Response
Rituximab is a type of monoclonal antibody that binds specifically to the CD20 antigen found on
Feedback: the surface of normal and malignant B lymphocytes and causes cell lysis. The drug does not target the
complement system, plasma cell DNA, or the cell membrane of malignant cells.
• Question 9
1 out of 1 points
A patient with chronic heart failure has begun treatment with epoetin alfa, which she will receive in her own home from
a home health nurse. The nurse should teach the patient to supplement this treatment with a diet that is high in
Response
Patients receiving epoetin alfa should maintain adequate iron intake, which may aid in the
Feedback: effectiveness of epoetin alfa. Foods high in iron include green leafy vegetables, beans, and organ meats.
• Question 10
1 out of 1 points
A nurse is administering rituximab to a patient via the IV route. The nurse will set the IV pump at 50 mg/hour for the first
half hour of the initial infusion. If there are not apparent reactions after 30 minutes of the infusion, the nurse will
increase the dosage every 30 minutes by 50 mg/hour until the maximum infusion rate reaches which of the following?
Response Infusion-related effects occur in 80% of patients within 30 minutes to 2 hours after the first rituximab
Feedback infusion, but the severity of most reactions dissipates when the infusion rate is slowed or interrupted.
: Reactions may be related to dose, so it is advisable not to exceed the maximum infusion rate of 400
mg/hour.
•
Question 11
1 out of 1 points
Which of the following patients will be at the greatest risk for anemia and
would be the most likely candidate for epoetin alfa therapy?
Response
Older adults who have cancer and are receiving chemotherapy are especially vulnerable to the
Feedbackadverse effects of anemia as a result of chemotherapy and would therefore be the most likely
: candidates for epoetin alfa therapy. Young adults over age 18, pregnant women, and patients with a high white blood cell
count are not as vulnerable to anemia and would not require epoetin alfa therapy.
• Question 12
1 out of 1 points
, A patient receiving high-dose cisplatin therapy exhibits symptoms of
hypomagnesemia. Which of the following should the nurse suggest to help offset the magnesium losses from the cisplatin
therapy?
Response
Patients with hypomagnesemia, or low magnesium levels, should increase their dietary intake
Feedback of magnesium. Dark chocolate is high in magnesium and will help offset losses from the
:
cisplatin therapy. Calcium and magnesium compete to gain entrance into the intestines, so calcium-rich
foods should be limited.
Consumption of potassium-rich foods would have no effect on the patient's magnesium levels. The incidence
of hemorrhagic cystitis can be reduced by a vigorous hydration regimen of at least 2 to 3 liters of fluid a day,
but this would not help control symptoms of hypomagnesemia.
• Question 13
1 out of 1 points
A nurse has completed a medication reconciliation of a patient who has
been admitted following a motor vehicle accident. Among the many drugs that the patient has received in the previous year
is rituximab. The nurse would be justified in suspecting the patient may have received treatment for which of the following
diseases?
Response
Rituximab has historically been used to treat CD20-positive B-cell malignancies such as B-cell
Feedback: leukemias, chronic lymphocytic leukemia, non-Hodgkin's lymphoma, and some multiple myeloma. It is not
normally used to treat malignant melanoma, lung cancer, or kidney cancer.
• Question 14
1 out of 1 points
A nurse is assessing a patient who has chronic lymphoblastic myelogenous leukemia. The treatment plan includes
hydroxyurea (Hydrea). The nurse will assess the patient for which of the following?
Response
Hydroxyurea may be contraindicated in patients with low WBCs. The drug is not contraindicated
Feedback: with diabetes mellitus, hypertension, or hypoglycemia.
• Question 15
1 out of 1 points
Intravenous carmustine has been prescribed for a patient with cancer. The nurse should help relieve the discomfort of pain
and burning during the infusion by
Response
The nurse can relieve the discomfort of infusion by slowing the infusion, increasing the volume
Feedback: used for dilution, and increasing the total volume of the primary IV infusion. Giving 2 units of bleomycin before
administering carmustine would not help relieve discomfort.
• Question 16
1 out of 1 points
A female patient has follicular non-Hodgkin's lymphoma and is receiving thalidomide (Thalomid). It will be most important
for the nurse to monitor this patient for which of the following?
• Question 1
1 out of 1 points
A patient will soon begin targeted therapy as a component of her treatment plan
for chronic leukemia. The nurse is conducting health education about this new
aspect of the patient's drug regimen and the patient has asked about the
potential side effects of treatment. How should the nurse best respond?
Response Targeted therapies are generally considered to be less toxic thantraditional
chemotherapy drugs.
Feedback:
However, adverse reactions to targeted therapies can occur such as
severe skin reactions, GI toxicities, skin reactions, and thrombosis.
• Question 2
1 out of 1 points
Mr. Singh is a 66-year-old man who is receiving chemotherapy for the
treatment of lung cancer that has metastasized to his liver. In an effort to prevent infection, Mr. Singh has been prescribed
filgrastim (Neupogen).
Which of the nurse's following assessment questions most directly addresses a common adverse effect of filgrastim?
Response Medullary bone pain is a consistently observed adverse effect that can be attributed to drug therapy
Feedback with filgrastim; it is mild to moderate in severity and is reported in 56% of patients
:
taking the drug. Shortness of breath, mucosal bleeding, and cool, clammy skin are not adverse effects
typical of filgrastim.
• Question 3
1 out of 1 points
An older adult woman has been diagnosed with acute lymphoblastic leukemia (ALL) and her care team has
identified potential benefits of imatinib. Which of the following characteristics of this patient's current health
status may preclude the use of imatinib?
Response Imatinib may be associated with edema. Patients should be weighed regularly and assessed for
Feedback
signs of fluid retention that could be severe. The risk of edema increases with higher doses of
:
,imatinib and age greater than 65 years. Previous strokes, orthopedic surgery, or well-controlled
diabetes may not contraindicate the use of imatinib.
• Question 4
1 out of 1 points
An oncology nurse is reviewing the pathophysiology of cancer and is discussing with a colleague the factors that contribute
to the success or
failure of a patient's chemotherapy. Which of the following cancerous cells is most susceptible to the effects of
chemotherapeutic drugs?
Response Cells that have a short generation time or rapid mitotic rate are most sensitive to antineoplastic
Feedback
agents. All cells (both cancerous and noncancerous) have a blood supply. A lack of contact
:
inhibition is characteristic of cancer, but this is not associated with susceptibility to
chemotherapeutic drugs.
• Question 5
1 out of 1 points
A nurse is caring for a patient with cancer who has been prescribed dronabinol (Marinol) to help reduce nausea and vomiting
from
chemotherapy. The nurse will inform the patient that he or she is taking an oral form of
Response
The major ingredient of Marinol is 9-tetrahydrocannabinol (THC), the active ingredient in
Feedback: marijuana.
• Question 6
1 out of 1 points
When planning care for a patient who is receiving filgrastim (Neupogen) for a nonmyeloid malignancy, the nurse should formulate
which of the following patient outcomes? (Select all that apply.)
Response
Desired outcomes for a patient receiving filgrastim include that febrile neutropenia will be
Feedbackavoided and infection and bone pain will not develop, or at least bone pain will not be
: unmanageable if it develops. Also, because this drug is administered subcutaneously every day during therapy,
management of their own administration would be a positive outcome for patients. A patient who is taking
oprelvekin would be at risk for fluid retention. Filgrastim is not associated with this adverse effect.
• Question 7
1 out of 1 points
A nurse has been assigned to a 55-year-old woman who has a malignant brain tumor. The patient is receiving her first dose
of carmustine. It will be critical for the nurse to observe for which of the following?
, Response Respiratory difficulty can indicate a hypersensitivity reaction or anaphylaxis. The nurse would report any
Feedback breathing difficulties immediately to the physician. If the patient does not eat or drink for more than 24
: hours, the physician should be notified. Nausea and vomiting are adverse effects of the drug therapy, and
an antiemetic regimen would be appropriate. Reddish urine is an adverse effect of doxorubicin, not
carmustine.
•
Question 8
1 out of 1 points
A patient has been scheduled to begin treatment with rituximab for non- Hodgkin's lymphoma. The nurse who will
administer this drug should understand that it targets
Response
Rituximab is a type of monoclonal antibody that binds specifically to the CD20 antigen found on
Feedback: the surface of normal and malignant B lymphocytes and causes cell lysis. The drug does not target the
complement system, plasma cell DNA, or the cell membrane of malignant cells.
• Question 9
1 out of 1 points
A patient with chronic heart failure has begun treatment with epoetin alfa, which she will receive in her own home from
a home health nurse. The nurse should teach the patient to supplement this treatment with a diet that is high in
Response
Patients receiving epoetin alfa should maintain adequate iron intake, which may aid in the
Feedback: effectiveness of epoetin alfa. Foods high in iron include green leafy vegetables, beans, and organ meats.
• Question 10
1 out of 1 points
A nurse is administering rituximab to a patient via the IV route. The nurse will set the IV pump at 50 mg/hour for the first
half hour of the initial infusion. If there are not apparent reactions after 30 minutes of the infusion, the nurse will
increase the dosage every 30 minutes by 50 mg/hour until the maximum infusion rate reaches which of the following?
Response Infusion-related effects occur in 80% of patients within 30 minutes to 2 hours after the first rituximab
Feedback infusion, but the severity of most reactions dissipates when the infusion rate is slowed or interrupted.
: Reactions may be related to dose, so it is advisable not to exceed the maximum infusion rate of 400
mg/hour.
•
Question 11
1 out of 1 points
Which of the following patients will be at the greatest risk for anemia and
would be the most likely candidate for epoetin alfa therapy?
Response
Older adults who have cancer and are receiving chemotherapy are especially vulnerable to the
Feedbackadverse effects of anemia as a result of chemotherapy and would therefore be the most likely
: candidates for epoetin alfa therapy. Young adults over age 18, pregnant women, and patients with a high white blood cell
count are not as vulnerable to anemia and would not require epoetin alfa therapy.
• Question 12
1 out of 1 points
, A patient receiving high-dose cisplatin therapy exhibits symptoms of
hypomagnesemia. Which of the following should the nurse suggest to help offset the magnesium losses from the cisplatin
therapy?
Response
Patients with hypomagnesemia, or low magnesium levels, should increase their dietary intake
Feedback of magnesium. Dark chocolate is high in magnesium and will help offset losses from the
:
cisplatin therapy. Calcium and magnesium compete to gain entrance into the intestines, so calcium-rich
foods should be limited.
Consumption of potassium-rich foods would have no effect on the patient's magnesium levels. The incidence
of hemorrhagic cystitis can be reduced by a vigorous hydration regimen of at least 2 to 3 liters of fluid a day,
but this would not help control symptoms of hypomagnesemia.
• Question 13
1 out of 1 points
A nurse has completed a medication reconciliation of a patient who has
been admitted following a motor vehicle accident. Among the many drugs that the patient has received in the previous year
is rituximab. The nurse would be justified in suspecting the patient may have received treatment for which of the following
diseases?
Response
Rituximab has historically been used to treat CD20-positive B-cell malignancies such as B-cell
Feedback: leukemias, chronic lymphocytic leukemia, non-Hodgkin's lymphoma, and some multiple myeloma. It is not
normally used to treat malignant melanoma, lung cancer, or kidney cancer.
• Question 14
1 out of 1 points
A nurse is assessing a patient who has chronic lymphoblastic myelogenous leukemia. The treatment plan includes
hydroxyurea (Hydrea). The nurse will assess the patient for which of the following?
Response
Hydroxyurea may be contraindicated in patients with low WBCs. The drug is not contraindicated
Feedback: with diabetes mellitus, hypertension, or hypoglycemia.
• Question 15
1 out of 1 points
Intravenous carmustine has been prescribed for a patient with cancer. The nurse should help relieve the discomfort of pain
and burning during the infusion by
Response
The nurse can relieve the discomfort of infusion by slowing the infusion, increasing the volume
Feedback: used for dilution, and increasing the total volume of the primary IV infusion. Giving 2 units of bleomycin before
administering carmustine would not help relieve discomfort.
• Question 16
1 out of 1 points
A female patient has follicular non-Hodgkin's lymphoma and is receiving thalidomide (Thalomid). It will be most important
for the nurse to monitor this patient for which of the following?
