Course NURS-6521N-32,Advanced Pharmacology.2016 Winter Qtr 11/28-02/19-PT27 Test

Course NURS-6521N-32,Advanced Pharmacology.2016 Winter Qtr 11/28-02/19-PT27 Test 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? 1 out of 1 points Response Feedback: Targeted therapies are generally considered to be less toxic than traditional chemotherapy drugs. However, adverse reactions to targeted therapies can occur such as severe skin reactions, GI toxicities, skin reactions, and thrombosis. • Question 2 Mr. Singh is a 66-year-old man who is receiving chemotherapy for the 1 out of 1 points 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 Feedback : Medullary bone pain is a consistently observed adverse effect that can be attributed to drug therapy 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 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? 1 out of 1 points Response Feedback : Imatinib may be associated with edema. Patients should be weighed regularly and assessed for 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 An oncology nurse is reviewing the pathophysiology of cancer and is discussing with a colleague the factors that contribute to the success or 1 out of 1 points failure of a patient's chemotherapy. Which of the following cancerous cells is most susceptible to the effects of chemotherapeutic drugs? Response Feedback : Cells that have a short generation time or rapid mitotic rate are most sensitive to antineoplastic 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 A nurse is caring for a patient with cancer who has been prescribed dronabinol (Marinol) to help reduce nausea and vomiting from 1 out of 1 points chemotherapy. The nurse will inform the patient that he or she is taking an oral form of Response Feedback: The major ingredient of Marinol is 9-tetrahydrocannabinol (THC), the active ingredient in 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 Feedback : Desired outcomes for a patient receiving filgrastim include that febrile neutropenia will be avoided 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 Feedback : Respiratory difficulty can indicate a hypersensitivity reaction or anaphylaxis. The nurse would report any 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 Feedback: Rituximab is a type of monoclonal antibody that binds specifically to the CD20 antigen found on 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 Feedback: Patients receiving epoetin alfa should maintain adequate iron intake, which may aid in the 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 Feedback : Infusion-related effects occur in 80% of patients within 30 minutes to 2 hours after the first rituximab 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 Feedback : Older adults who have cancer and are receiving chemotherapy are especially vulnerable to the adverse 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 A patient receiving high-dose cisplatin therapy exhibits symptoms of 1 out of 1 points hypomagnesemia. Which of the following should the nurse suggest to help offset the magnesium losses from the cisplatin therapy? Response Feedback : Patients with hypomagnesemia, or low magnesium levels, should increase their dietary intake 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.