ATI PharmacologyProctoredexamTest Bank- comprehensiv
1. 1) A nurse is caring for a client with 3. Calcitonin (Miacalcin) Rationale:
hyperparathyroidism
andnotesthatthe client'sserum The normalserumcalciumlevelis 8.6to 10.0mg/dL.This clientis experiencing hypercalcemia.
Calcium
calciumlevelis 13 mg/dL.Whichmedicationshouldthe gluconateandcalciumchloridearemedications
usedforthe treatment of tetany, which occurs as a result of
nurseprepareto administeras prescribedto theclient? acute hypocalcemia. In hypercalcemia,
largedosesofvitaminD needtobeavoided.Calcitonin,athyroid
1. Calcium chloride hormone,decreasestheplasmacalciumlevelby inhibiting boneresorptionand lowering the serum calcium
2. Calciumgluconate concentration.
3. Calcitonin(Miacalcin)
4. Largedosesof vitaminD 4. Orange juice Rationale:
2. 2.)Oraliron supplements are
prescribedfor a 6-year-old Vitamin C increasestheabsorptionof iron by thebody.The mothershouldbe instructed
toadministerthe
child with iron deficiency anemia.
The nurseinstructs medicationwithacitrusfruitorajuicethatishighin vitaminC. Milkmayaffectabsorption
oftheiron.Waterwillnot
themother to administer the iron
with which best food assistinabsorption.Orangejuicecontainsa greateramountofvitaminC thanapplejuice.
item?
1. Milk
2. Water
3. Applejuice 1. Tinnitus Rationale:
4. Orangejuice Salicylic acid is absorbed readily throughthe skin, and systemic toxicity (salicylism)canresult.Symptomsinclude
tinnitus,dizziness,hyperpnea,andpsychological disturbances.
Constipationanddiarrheaarenotassociated
3. 3.) Salicylic acid is prescribedfor a client with a
withsalicylism.
diagnosisof psoriasis.The nursemonitorstheclient,
knowingthatwhichof thefollowingwouldindicatethe
presenceof systemictoxicityfromthismedication?
1. Tinnitus
2. Diarrhea
3. Constipation 4.At least30minutesbeforeexposure
tothesunRationale:
4. Decreasedrespirations Sunscreens
aremosteffective
whenappliedatleast30minutesbeforeexposure
tothe sun so that they can penetrate
the skin. All sunscreens should be reapplied after
swimming or sweating.
4. 4.) The camp nurse asks the children preparing
to swim
in thelakeif theyhave appliedsunscreen.The nurse
remindsthechildrenthatchemicalsunscreens
aremost
effective when applied:
1. Immediatelybeforeswimming
2. 15minutesbeforeexposure to
thesun
3. Immediately before
exposuretothesun 3. Informing theclientthatthis is normal Rationale:
4. At least30minutesbeforeexposureto the sun Mafenideacetateis
bacteriostaticforgram-negativeandgram
-positiveorganisms andisusedtotreatburnsto
reducebacteria
presentinavasculartissues.Theclient shouldbeinformedthatthemedication
willcauselocal
5. 5.) Mafenide acetate (Sulfamylon)prescribed
is forthe
discomfortandburningand thatthisis anormalreaction;thereforeoptions1,2,and4areincorrect
clientwitha burninjury.Whenapplyingthemedication,
theclientcomplainsof local discomfort
and burning.
Which of thefollowingis themost appropriate nursing
action?
1. Notifyingtheregisterednurse
2. Discontinuingthemedication
3. Informingtheclientthatthisis normal
4. Applyinga thinnerfilm thanprescribedto the burn
site
, 1. Hyperventilation
6.6.) The burn clientis receivingtreatments
of topicalmafenide
acetate(Sulfamylon)
tothe siteof injury.The nursemonitors Rationale:
theclient,knowingthatwhichofthefollowingindicatesthat a Mafenideacetate
isacarbonicanhydraseinhibitor
andcansuppressrenalexcretionof acid, thereby causing
acidosis.Clients receivingthis treatment should be
monitoredfor signs of an acid-base imbalance
systemic effect has occurred?
(hyperventilation). If this occurs, themedicationshouldbediscontinuedfor1to2days.Options3 and4 describe
1. Hyperventilation
2. Elevatedbloodpressure localratherthansystemiceffects.
An elevated
bloodpressure
maybeexpected
fromthepain that occurs with a
3. Local painattheburn site burn injury.
4. Localrashattheburnsite
7.7.)Isotretinoinis prescribed
for a clientwithsevere acne. Before 2. Triglyceridelevel
the administration of thismedication,
thenurseanticipates
that Rationale:
whichlaboratory test will be prescribed? Isotretinoincanelevatetriglyceridelevels.Bloodtriglyceridelevelsshouldbe measured
beforetreatment
andperiodicallythereafteruntil theeffecton thetriglycerides
hasbeenevaluated.
Options1,3,and4donotneed
1. Plateletcount
2. Triglyceridelevel tobemonitoredspecifically during this treatment.
3. Completeblood count
4. Whitebloodcell count
1. Vitamin A
8. 8.) A client with severe acne is seen in the clinic and the
Rationale:
health care provider (HCP)prescribesisotretinoin.
The
Isotretinoinis ametabolite
of vitamin Aand canproducegeneralizedintensificationisotretinoin
of toxicity.
nursereviewstheclient'smedicationrecordandwould
Because of the potential for increased toxicity, vitamin A supplementsshould be
contactthe(HCP) if theclientis takingwhichmedication?
discontinuedbeforeisotretinointherapy.Options
and2,4 are
3, notcontraindicatedwiththeuseofisotretinoin.
1. Vitamin A
2. Digoxin (Lanoxin)
3. Furosemide (Lasix)
4. Phenytoin(Dilantin)
9.9.) The nurse is applying a topical corticosteroid to a client
2. Axilla
with eczema. The nurse would monitor for the potential
Rationale:
for increased systemic absorption of the medication if the
Topicalcorticosteroids canbeabsorbedintothesystemiccirculation.Absorptionis higherfromregionswhere
medication were beingappliedtowhichof thefollowing
theskin is especiallypermeable(scalp,axilla,face,eyelids,neck,perineum,
genitalia),
andlowerfromregionsin
bodyareas?
whichpermeability is poor (back, palms, soles).
1. Back
2. Axilla
3. Solesof the feet
4. Palmsof the hands
10. 10.)The clinic nurseis performingan admissionassessment
1. Acne
ona client.The nursenotes that the client is taking azelaic
Rationale:
acid (Azelex). Because of the medication
prescription, the
Azelaicacidisatopicalmedicationusedtotreatmildtomoderate
acne.Theacid appearsto work by suppressing
nurse would suspect that the
client is being treated for:
thegrowthof Propionibacteriumacnesand decreasing
theproliferationofkeratinocytes.
Options2,3,and4
1. Acne
areincorrect.
2. Eczema
3. Hair loss
4. Herpessimplex
,11. 11.) Thehealth care provider has
prescribed silversulfadiazine 3. "The medicationwill permanentlystain my skin." Rationale:
(Silvadene)for theclientwitha partial- thicknessburn,which has Silver sulfadiazine(Silvadene)is an antibacterial thathas a broadspectrumofactivityagainstgram-
gram- negative bacteria. The nurse is reinforcing negativebacteria,
cultured positive for gram-positivebacteria,
and yeast.It is applieddirectlytothewoundtoassistin
informationtotheclientaboutthemedication.Whichstatement made healing.
It doesnot stain the
skin.
by the client indicates a lack of understanding about the
treatments?
1. "Themedicationis an antibacterial."
2. "Themedicationwill helphealtheburn."
3. "Themedicationwillpermanently
stainmyskin."
4. "Themedicationshouldbeapplieddirectlytothewound."
1. Notifytheregisterednurse.
12.12.)A nurseis caringfora clientwhois receivingan intravenous (IV)
Rationale:
infusion of an antineoplastic
medication.
Duringtheinfusion,
the
When antineoplastic medications (Chemotheraputic Agents)administeredvia
are IV,
clientcomplainsof painattheinsertionsite.During an inspectionof
greatcaremust
betakentopreventthe
medicationfromescapingintothetissuessurrounding
theinjection
thesite,thenursenotesrednessand swellingand that the rate of
site,because
pain,tissuedamage, and necrosis can result. The nurse monitors for signs of
infusion of the medication has slowed. The nurse should take which
extravasation, such as redness or swelling at the insertion sitedecreasedinfusion
and a rate.If
appropriateaction?
extravasationoccurs,theregisterednurseneeds
tobenotified;heor shewill thencontactthehealthcare
1. Notifytheregisterednurse.
provider.
2. Administerpainmedicationtoreduce thediscomfort.
3. Applyiceandmaintaintheinfusionrate,asprescribed.
4. Elevatetheextremityof theIV site,andslowthe infusion.
13.13.)Theclientwithsquamous
cellcarcinomaofthelarynxis receiving
bleomycinintravenously.The nursecaringfor theclientanticipates
thatwhich diagnostic study will be prescribed?
1. Echocardiography
4. Pulmonary function studies
2. Electrocardiography
Rationale:
3. Cervicalradiography Bleomycinisanantineoplasticmedication
(Chemotheraputic
Agents)thatcan causeinterstitial
4. Pulmonaryfunctionstudies pneumonitis, which can progress to pulmonary fibrosis.
Pulmonaryfunctionstudiesalongwith
hematological,hepatic,andrenal functiontestsneedto be monitored.The nurseneedsto monitor
lung soundsfordyspneaandcrackles,whichindicatepulmonarytoxicity.The medicationneedstobe
14.14.)Theclientwithacutemyelocytic
leukemiais beingtreatedwith discontinuedimmediatelyif pulmonarytoxicity occurs. Options 1, 2, and 3 are unrelated to the
busulfan(Myleran).Which laboratoryvaluewouldthenurse specific use of thismedication.
specificallymonitorduringtreatmentwiththismedication? 2. Uric acidlevel
1. Clottingtime Rationale:
2. Uric acid level Busulfan (Myleran) can cause an increase in the uric acid level.
3. Potassiumlevel Hyperuricemiacanproduceuricacidnephropathy,
renalstones,
andacuterenal failure. Options 1, 3,
4. Blood glucoselevel and 4 are not specifically related to this
medication.
, 15.15.)The clientwithsmallcell lung canceris beingtreatedwith 4. Orthostatic hypotension
Rationale:
etoposide(VePesid).The nursewhois assistingin caringfor A sideeffectspecific
toetoposide
isorthostatic
hypotension.
Theclient'sbloodpressureismonitoredduringthe
infusion.Hair lossoccurswithnearlyalltheantineoplastic
medications.
Chestpainandpulmonaryfibrosisare
theclientduring its administration understands that which
side
unrelated
tothis medication.
effectis specificallyassociatedwiththis medication?
1. Alopecia
2. Chestpain
3. Pulmonaryfibrosis
4. Orthostatichypotension
3. Consult with health careproviders (HCPs) beforereceiving immunizations Rationale:
16. 16.) The clinic nurse is reviewing a teaching plan
for the client
Because
antineoplastic
medications lower
theresistance
ofthebody,clients must
beinformednotto
receiving an antineoplastic medication.
Whenimplementing
receiveimmunizations
withoutaHCP's approval.Clientsalso needtoavoidcontactwithindividualswho
theplan,the nurse tells theclient:
haverecentlyreceiveda livevirus vaccine. Clients need to avoid aspirin and aspirin
-containing products to
1. To takeaspirin(acetylsalicylic
acid)asneeded for
minimize the risk of bleeding, and they need to avoid alcohol to minimize the risk of toxicity and side
headache
effects.
2. Drink beverages containing alcohol
moderate
in
amounts each evening
3. Consult with health care providers (HCPs)
before
receiving immunizations
4. That it is not necessaryto consult HCPs before
receivinga flu vaccineat thelocal health fair
4. Numbnessandtinglingin thefingersandtoesRationale:
17.17.)The clientwithovariancanceris being treated
with A sideeffectspecificto vincristineis peripheralneuropathy,whichoccursin almosteveryclient.
vincristine(Oncovin).The nursemonitorstheclient, Peripheralneuropathy
canbemanifested
asnumbnessand tinglingin thefingersandtoes.Depressionofthe
knowingthatwhichofthe following
indicatesa sideeffect Achillestendonreflexmaybethefirstclinicalsignindicatingperipheralneuropathy.Constipationrather
specifictothismedication? thandiarrhea is mostlikely to occur with this medication, although diarrhea may occur
occasionally.Hair loss
1. Diarrhea occurswithnearlyall theantineoplasticmedications.
2. Hair loss Chestpain is unrelatedto this medication.
3. Chestpain
4. Numbnessandtinglingin thefingersand toes 1. Pancreatitis
18.18.)The nurseis reviewing
thehistoryandphysicalexamination Rationale:
of a clientwhowill be receivingasparaginase(Elspar), an Asparaginase(Elspar) is contraindicatedif hypersensitivityexists,in pancreatitis,or if theclienthasa historyof
antineoplastic
agent.Thenurseconsultswiththe registered pancreatitis.The medicationimpairspancreaticfunctionandpancreatic
functiontestsshouldbeperformed
nurse regarding theadministration of the medication if whichbeforetherapy
of beginsandwhenaweekormorehaselapsedbetween administrationofthedoses.The client
thefollowingis documented
in theclient'shistory? needsto bemonitoredfor signsof pancreatitis,whichincludenausea,vomiting,andabdominalpain.
1. Pancreatitis Theconditionsnotedinoptions2,3,and4arenotcontraindicated with this
medication.
2. Diabetesmellitus
3. Myocardialinfarction
4. Chronic obstructivepulmonarydisease
1. 1) A nurse is caring for a client with 3. Calcitonin (Miacalcin) Rationale:
hyperparathyroidism
andnotesthatthe client'sserum The normalserumcalciumlevelis 8.6to 10.0mg/dL.This clientis experiencing hypercalcemia.
Calcium
calciumlevelis 13 mg/dL.Whichmedicationshouldthe gluconateandcalciumchloridearemedications
usedforthe treatment of tetany, which occurs as a result of
nurseprepareto administeras prescribedto theclient? acute hypocalcemia. In hypercalcemia,
largedosesofvitaminD needtobeavoided.Calcitonin,athyroid
1. Calcium chloride hormone,decreasestheplasmacalciumlevelby inhibiting boneresorptionand lowering the serum calcium
2. Calciumgluconate concentration.
3. Calcitonin(Miacalcin)
4. Largedosesof vitaminD 4. Orange juice Rationale:
2. 2.)Oraliron supplements are
prescribedfor a 6-year-old Vitamin C increasestheabsorptionof iron by thebody.The mothershouldbe instructed
toadministerthe
child with iron deficiency anemia.
The nurseinstructs medicationwithacitrusfruitorajuicethatishighin vitaminC. Milkmayaffectabsorption
oftheiron.Waterwillnot
themother to administer the iron
with which best food assistinabsorption.Orangejuicecontainsa greateramountofvitaminC thanapplejuice.
item?
1. Milk
2. Water
3. Applejuice 1. Tinnitus Rationale:
4. Orangejuice Salicylic acid is absorbed readily throughthe skin, and systemic toxicity (salicylism)canresult.Symptomsinclude
tinnitus,dizziness,hyperpnea,andpsychological disturbances.
Constipationanddiarrheaarenotassociated
3. 3.) Salicylic acid is prescribedfor a client with a
withsalicylism.
diagnosisof psoriasis.The nursemonitorstheclient,
knowingthatwhichof thefollowingwouldindicatethe
presenceof systemictoxicityfromthismedication?
1. Tinnitus
2. Diarrhea
3. Constipation 4.At least30minutesbeforeexposure
tothesunRationale:
4. Decreasedrespirations Sunscreens
aremosteffective
whenappliedatleast30minutesbeforeexposure
tothe sun so that they can penetrate
the skin. All sunscreens should be reapplied after
swimming or sweating.
4. 4.) The camp nurse asks the children preparing
to swim
in thelakeif theyhave appliedsunscreen.The nurse
remindsthechildrenthatchemicalsunscreens
aremost
effective when applied:
1. Immediatelybeforeswimming
2. 15minutesbeforeexposure to
thesun
3. Immediately before
exposuretothesun 3. Informing theclientthatthis is normal Rationale:
4. At least30minutesbeforeexposureto the sun Mafenideacetateis
bacteriostaticforgram-negativeandgram
-positiveorganisms andisusedtotreatburnsto
reducebacteria
presentinavasculartissues.Theclient shouldbeinformedthatthemedication
willcauselocal
5. 5.) Mafenide acetate (Sulfamylon)prescribed
is forthe
discomfortandburningand thatthisis anormalreaction;thereforeoptions1,2,and4areincorrect
clientwitha burninjury.Whenapplyingthemedication,
theclientcomplainsof local discomfort
and burning.
Which of thefollowingis themost appropriate nursing
action?
1. Notifyingtheregisterednurse
2. Discontinuingthemedication
3. Informingtheclientthatthisis normal
4. Applyinga thinnerfilm thanprescribedto the burn
site
, 1. Hyperventilation
6.6.) The burn clientis receivingtreatments
of topicalmafenide
acetate(Sulfamylon)
tothe siteof injury.The nursemonitors Rationale:
theclient,knowingthatwhichofthefollowingindicatesthat a Mafenideacetate
isacarbonicanhydraseinhibitor
andcansuppressrenalexcretionof acid, thereby causing
acidosis.Clients receivingthis treatment should be
monitoredfor signs of an acid-base imbalance
systemic effect has occurred?
(hyperventilation). If this occurs, themedicationshouldbediscontinuedfor1to2days.Options3 and4 describe
1. Hyperventilation
2. Elevatedbloodpressure localratherthansystemiceffects.
An elevated
bloodpressure
maybeexpected
fromthepain that occurs with a
3. Local painattheburn site burn injury.
4. Localrashattheburnsite
7.7.)Isotretinoinis prescribed
for a clientwithsevere acne. Before 2. Triglyceridelevel
the administration of thismedication,
thenurseanticipates
that Rationale:
whichlaboratory test will be prescribed? Isotretinoincanelevatetriglyceridelevels.Bloodtriglyceridelevelsshouldbe measured
beforetreatment
andperiodicallythereafteruntil theeffecton thetriglycerides
hasbeenevaluated.
Options1,3,and4donotneed
1. Plateletcount
2. Triglyceridelevel tobemonitoredspecifically during this treatment.
3. Completeblood count
4. Whitebloodcell count
1. Vitamin A
8. 8.) A client with severe acne is seen in the clinic and the
Rationale:
health care provider (HCP)prescribesisotretinoin.
The
Isotretinoinis ametabolite
of vitamin Aand canproducegeneralizedintensificationisotretinoin
of toxicity.
nursereviewstheclient'smedicationrecordandwould
Because of the potential for increased toxicity, vitamin A supplementsshould be
contactthe(HCP) if theclientis takingwhichmedication?
discontinuedbeforeisotretinointherapy.Options
and2,4 are
3, notcontraindicatedwiththeuseofisotretinoin.
1. Vitamin A
2. Digoxin (Lanoxin)
3. Furosemide (Lasix)
4. Phenytoin(Dilantin)
9.9.) The nurse is applying a topical corticosteroid to a client
2. Axilla
with eczema. The nurse would monitor for the potential
Rationale:
for increased systemic absorption of the medication if the
Topicalcorticosteroids canbeabsorbedintothesystemiccirculation.Absorptionis higherfromregionswhere
medication were beingappliedtowhichof thefollowing
theskin is especiallypermeable(scalp,axilla,face,eyelids,neck,perineum,
genitalia),
andlowerfromregionsin
bodyareas?
whichpermeability is poor (back, palms, soles).
1. Back
2. Axilla
3. Solesof the feet
4. Palmsof the hands
10. 10.)The clinic nurseis performingan admissionassessment
1. Acne
ona client.The nursenotes that the client is taking azelaic
Rationale:
acid (Azelex). Because of the medication
prescription, the
Azelaicacidisatopicalmedicationusedtotreatmildtomoderate
acne.Theacid appearsto work by suppressing
nurse would suspect that the
client is being treated for:
thegrowthof Propionibacteriumacnesand decreasing
theproliferationofkeratinocytes.
Options2,3,and4
1. Acne
areincorrect.
2. Eczema
3. Hair loss
4. Herpessimplex
,11. 11.) Thehealth care provider has
prescribed silversulfadiazine 3. "The medicationwill permanentlystain my skin." Rationale:
(Silvadene)for theclientwitha partial- thicknessburn,which has Silver sulfadiazine(Silvadene)is an antibacterial thathas a broadspectrumofactivityagainstgram-
gram- negative bacteria. The nurse is reinforcing negativebacteria,
cultured positive for gram-positivebacteria,
and yeast.It is applieddirectlytothewoundtoassistin
informationtotheclientaboutthemedication.Whichstatement made healing.
It doesnot stain the
skin.
by the client indicates a lack of understanding about the
treatments?
1. "Themedicationis an antibacterial."
2. "Themedicationwill helphealtheburn."
3. "Themedicationwillpermanently
stainmyskin."
4. "Themedicationshouldbeapplieddirectlytothewound."
1. Notifytheregisterednurse.
12.12.)A nurseis caringfora clientwhois receivingan intravenous (IV)
Rationale:
infusion of an antineoplastic
medication.
Duringtheinfusion,
the
When antineoplastic medications (Chemotheraputic Agents)administeredvia
are IV,
clientcomplainsof painattheinsertionsite.During an inspectionof
greatcaremust
betakentopreventthe
medicationfromescapingintothetissuessurrounding
theinjection
thesite,thenursenotesrednessand swellingand that the rate of
site,because
pain,tissuedamage, and necrosis can result. The nurse monitors for signs of
infusion of the medication has slowed. The nurse should take which
extravasation, such as redness or swelling at the insertion sitedecreasedinfusion
and a rate.If
appropriateaction?
extravasationoccurs,theregisterednurseneeds
tobenotified;heor shewill thencontactthehealthcare
1. Notifytheregisterednurse.
provider.
2. Administerpainmedicationtoreduce thediscomfort.
3. Applyiceandmaintaintheinfusionrate,asprescribed.
4. Elevatetheextremityof theIV site,andslowthe infusion.
13.13.)Theclientwithsquamous
cellcarcinomaofthelarynxis receiving
bleomycinintravenously.The nursecaringfor theclientanticipates
thatwhich diagnostic study will be prescribed?
1. Echocardiography
4. Pulmonary function studies
2. Electrocardiography
Rationale:
3. Cervicalradiography Bleomycinisanantineoplasticmedication
(Chemotheraputic
Agents)thatcan causeinterstitial
4. Pulmonaryfunctionstudies pneumonitis, which can progress to pulmonary fibrosis.
Pulmonaryfunctionstudiesalongwith
hematological,hepatic,andrenal functiontestsneedto be monitored.The nurseneedsto monitor
lung soundsfordyspneaandcrackles,whichindicatepulmonarytoxicity.The medicationneedstobe
14.14.)Theclientwithacutemyelocytic
leukemiais beingtreatedwith discontinuedimmediatelyif pulmonarytoxicity occurs. Options 1, 2, and 3 are unrelated to the
busulfan(Myleran).Which laboratoryvaluewouldthenurse specific use of thismedication.
specificallymonitorduringtreatmentwiththismedication? 2. Uric acidlevel
1. Clottingtime Rationale:
2. Uric acid level Busulfan (Myleran) can cause an increase in the uric acid level.
3. Potassiumlevel Hyperuricemiacanproduceuricacidnephropathy,
renalstones,
andacuterenal failure. Options 1, 3,
4. Blood glucoselevel and 4 are not specifically related to this
medication.
, 15.15.)The clientwithsmallcell lung canceris beingtreatedwith 4. Orthostatic hypotension
Rationale:
etoposide(VePesid).The nursewhois assistingin caringfor A sideeffectspecific
toetoposide
isorthostatic
hypotension.
Theclient'sbloodpressureismonitoredduringthe
infusion.Hair lossoccurswithnearlyalltheantineoplastic
medications.
Chestpainandpulmonaryfibrosisare
theclientduring its administration understands that which
side
unrelated
tothis medication.
effectis specificallyassociatedwiththis medication?
1. Alopecia
2. Chestpain
3. Pulmonaryfibrosis
4. Orthostatichypotension
3. Consult with health careproviders (HCPs) beforereceiving immunizations Rationale:
16. 16.) The clinic nurse is reviewing a teaching plan
for the client
Because
antineoplastic
medications lower
theresistance
ofthebody,clients must
beinformednotto
receiving an antineoplastic medication.
Whenimplementing
receiveimmunizations
withoutaHCP's approval.Clientsalso needtoavoidcontactwithindividualswho
theplan,the nurse tells theclient:
haverecentlyreceiveda livevirus vaccine. Clients need to avoid aspirin and aspirin
-containing products to
1. To takeaspirin(acetylsalicylic
acid)asneeded for
minimize the risk of bleeding, and they need to avoid alcohol to minimize the risk of toxicity and side
headache
effects.
2. Drink beverages containing alcohol
moderate
in
amounts each evening
3. Consult with health care providers (HCPs)
before
receiving immunizations
4. That it is not necessaryto consult HCPs before
receivinga flu vaccineat thelocal health fair
4. Numbnessandtinglingin thefingersandtoesRationale:
17.17.)The clientwithovariancanceris being treated
with A sideeffectspecificto vincristineis peripheralneuropathy,whichoccursin almosteveryclient.
vincristine(Oncovin).The nursemonitorstheclient, Peripheralneuropathy
canbemanifested
asnumbnessand tinglingin thefingersandtoes.Depressionofthe
knowingthatwhichofthe following
indicatesa sideeffect Achillestendonreflexmaybethefirstclinicalsignindicatingperipheralneuropathy.Constipationrather
specifictothismedication? thandiarrhea is mostlikely to occur with this medication, although diarrhea may occur
occasionally.Hair loss
1. Diarrhea occurswithnearlyall theantineoplasticmedications.
2. Hair loss Chestpain is unrelatedto this medication.
3. Chestpain
4. Numbnessandtinglingin thefingersand toes 1. Pancreatitis
18.18.)The nurseis reviewing
thehistoryandphysicalexamination Rationale:
of a clientwhowill be receivingasparaginase(Elspar), an Asparaginase(Elspar) is contraindicatedif hypersensitivityexists,in pancreatitis,or if theclienthasa historyof
antineoplastic
agent.Thenurseconsultswiththe registered pancreatitis.The medicationimpairspancreaticfunctionandpancreatic
functiontestsshouldbeperformed
nurse regarding theadministration of the medication if whichbeforetherapy
of beginsandwhenaweekormorehaselapsedbetween administrationofthedoses.The client
thefollowingis documented
in theclient'shistory? needsto bemonitoredfor signsof pancreatitis,whichincludenausea,vomiting,andabdominalpain.
1. Pancreatitis Theconditionsnotedinoptions2,3,and4arenotcontraindicated with this
medication.
2. Diabetesmellitus
3. Myocardialinfarction
4. Chronic obstructivepulmonarydisease
