Ch44 Pharm

Mosby items and derived items 2010, 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.
Clayton: Basic Pharmacology for Nurses, 15

th
Edition

Chapter 44: Drugs Used for Cancer Treatment

Test Bank

MULTIPLE CHOICE

1. The nurse is educating a patient with cancer about combination chemotherapy. Which is
an accurate statement?
A. Combination chemotherapy is the administration of an antineoplastic drug that
will be toxic during a specific phase of cellular growth.
B. Combination chemotherapy is the administration of an antineoplastic drug that is
active throughout the cell cycle.
C. Combination chemotherapy is the administration of antineoplastic drugs that
change the way the body responds to cancer or strengthens the immune system.
D. Combination chemotherapy is the administration of antineoplastic drugs, which
results in cell death during different phases of the cell cycle.

ANS: D

Feedback
A
This is a single drug regimen, not a combination.
B
C
D
Use of combination drug therapy is superior in therapeutic effect to the use of
single-agent chemotherapy.

DIF: Cognitive Level: Comprehension REF: 697
TOP: Nursing Process Step: Implementation
MSC: NCLEX Client Needs Category: Physiological Integrity

2. The cell cyclespecific agent vincristine sulphate (Oncovin) acts in which phase of the
cells life cycle?
A. S phase
B. Mitotic phase
C. Phase G
1

D. Phase G
0

ANS: B

Feedback
A
The S phase is the stage of active synthesis of two sets of DNA.
B
Vinca alkaloids block the formation of the mitotic spindle during mitosis, thus
inhibiting cell division.
C
Phase G
1
is considered a presynthetic phase in which the cell prepares for DNA
synthesis by manufacturing necessary enzymes.
Test Bank

44-2
D
G
0
is the largest variable in the cell cycle and, during this resting phase, the cell
is not actively replicating.

DIF: Cognitive Level: Knowledge REF: 705

3. What is the importance of correlating the dosage schedule with cell cyclespecific drug
therapy?
A. Ongoing proliferation of neoplastic tissue
B. The known cellular kinetics of the neoplasm
C. The hormonal requirements of the patient
D. The bodys response in strengthening the immune system

ANS: B

Feedback
A
The object of chemotherapy is to stop the proliferation of neoplastic tissue.
B
Cell cyclespecific agent scheduling should be correlated with the known
cellular kinetics of the particular type of neoplasm being treated. This type of
drug is schedule-dependent and selectively toxic when the cell is in a specific
phase of growth.
C
Hormones are only used in specific types of cancer and are not related to cell
cycle specificity.
D
Immunomodulators are used to enhance the bodys response in strengthening the
immune system.


4. When are cancer cells most sensitive to chemotherapy?
A. Resting phases
B. Rapid division
C. Remission intervals
D. Slow replication

ANS: B

Feedback
A
Cancer cells are not sensitive to chemotherapy during resting phases.
B
The cancer cells are the most sensitive to chemotherapy when the cells are
dividing rapidly.
C
Cancer cells are not sensitive to chemotherapy during remission intervals.
D
Cancer cells are not sensitive to chemotherapy during slow replication.

Test Bank

44-3

5. What is the advantage of combination therapy using cell cyclespecific and cell cycle
nonspecific agents?
A. Decreased expense and time needed for administration
B. Decreased toxicity to patients and the nurses who administer the drug
C. Increased cell death in various cycles and decreased toxicity
D. Increased rate of treatment success

ANS: D

Feedback
A
Combination therapy is not more economical or faster.
B
Combination therapy is not less toxic because it exposes patients and nurses to
additional medications.
C
The use of combination drug therapy allows for cell death during different
phases of the cell cycle, but the agents often have toxic effects on different
organs at different time intervals after administration.
D
Combination therapy is far superior to the use of single-agent therapy. The use
of a cell cyclespecific and cell cyclenonspecific agent together facilitates cell
death during different phases of the cell cycle.

TOP: Nursing Process Step: Evaluation

6. Why is a patient with prostate cancer prescribed an estrogen?
A. To achieve hormonal balance
B. To decrease the rate of production for malignant cells
C. To soften prostatic tissue
D. To suppress prostate gland function

ANS: B

Feedback
A
Estrogen is not given for hormonal balance.
B
Estrogen therapy is used during the treatment of prostate cancer to decrease the
rate of production of malignant cells. The use of female hormones decreases the
amount of male hormones available for use by the cancer cells.
C
Estrogen does not soften prostatic tissue.
D
Estrogen does not suppress prostate gland function.


Test Bank

44-4
7. Which assessment by the nurse would be a sign of neurotoxicity related to
chemotherapy?
A. Paresthesia
B. Euphoria
C. Nausea
D. Hallucinations

ANS: A

Feedback
A
Signs and symptoms of neurotoxicity include numbness and tingling in
extremities, confusion, changes in gait, and motor weakness.
B
Euphoria is not a sign of neurotoxicity related to chemotherapy.
C
Nausea is not a sign of neurotoxicity related to chemotherapy.
D
Hallucinations are not a sign of neurotoxicity related to chemotherapy.


8. Which symptom is the patient who is receiving bleomycin (Blenoxane) therapy most
likely to exhibit?
A. Increased respiratory rate and cough
B. Weight gain and peripheral edema
C. Numbness and tingling of hands and feet
D. Lethargy and orthostatic hypotension

ANS: A

Feedback
A
Compromised respiratory function may occur in patients receiving bleomycin
therapy. Increased respiratory rate and cough can be signs that further problems
are developing, such as heart failure.
B
Bleomycin does not cause weight gain and peripheral edema.
C
Bleomycin does not produce numbness and tingling of hands and feet.
D
Bleomycin does not produce lethargy and orthostatic hypotension.

TOP: Nursing Process Step: Assessment

9. What is the purpose of administering filgrastim (Neupogen) to a patient who is post
bowel resection secondary to cancer?
A. Decrease the gastrointestinal toxicity secondary to chemotherapeutic agents
B. Suppress the immune response
C. Work as an antiemetic and stimulate his appetite
D. Increase the white blood cell counts
Test Bank

44-5

ANS: D

Feedback
A
Filgrastim does not affect GI toxicity.
B
Filgrastim does not suppress immune response; it works to enhance it.
C
Filgrastim does not affect appetite or nausea.
D
Filgrastim works to stimulate white blood cell production and decrease the
incidence of infection. Filgrastim is a colony-stimulating factor, which
stimulates white blood cell proliferation and maturation. It is particularly helpful
for patients prone to neutropenia secondary to cancer therapy.

DIF: Cognitive Level: Application REF: 700
MSC: NCLEX Client Needs Category: Health Promotion and Maintenance

10. What is the intended outcome of the chemoprotective drug amifostine (Ethyol)?
A. Decreased nausea and vomiting
B. Increased effectiveness of the chemotherapy
C. Maintenance of body weight
D. Decreased renal toxicity

ANS: D

Feedback
A
Chemoprotective drugs do not decrease nausea and vomiting.
B
Chemoprotective drugs do not enhance the effectiveness of chemotherapy
treatment.
C
Chemoprotective drugs do not help prevent weight loss.
D
Amifostine is used to reduce the cumulative renal toxicity associated with the
repeated administration of cisplatin in patients with advanced ovarian cancer.


11. Why are bone marrow stimulants used in the treatment of cancer?
A. To increase uptake of the chemotherapy from the interior of the bones
B. To strengthen bones weakened by pathologic processes
C. To enhance the patients immune system during treatment
D. To protect the bone marrow from destructive actions from the cancer treatment

ANS: C

Feedback
A
Bone marrow stimulants do not increase uptake of drugs.
B
Bone marrow stimulants do not strengthen bones.
Test Bank

44-6
C
Bone marrow stimulants trigger the recovery of bone marrow cells several days
earlier than would be the natural course of recovery. The major benefit to this
earlier recovery is that patients immune systems are able to respond to and stop
infections from being so pathologic, and patients can be released from the
isolation room several days earlier.
D
Bone marrow stimulants do not protect the bone marrow from destructive effects
of chemotherapy or radiation.


12. The nurse is providing education about chemotherapy to a patient who is being
discharged. Which statement by the patient indicates a need for further teaching?
A. I will shave with an electric razor.
B. I will take aspirin for a headache.
C. I will wash my laundry separate from other family members.
D. I will flush the toilet twice after using.

ANS: B

Feedback
A
Shaving with an electric razor is preferable for a patient undergoing
chemotherapy because of the decreased risk of bleeding.
B
Patients should not take any aspirin or aspirin-containing products.
C
The clothing of the chemotherapy patient should be washed separately from
other household linens.
D
Because most chemotherapeutic agents are excreted in the urine and feces, it is
best to flush the toilet two or three times.


MULTIPLE RESPONSE

1. Which are major chemotherapeutic agents? (Select all that apply.)
A. Alkylating agents
B. Antineoplastic antibiotics
C. Hormones
D. Antimetabolites
E. Antinuclear antibodies
F. Chelating agents

ANS: A, B, C, D

Feedback
Test Bank

44-7
Correct
Alkylating agents are considered major chemotherapeutic agents.
Antineoplastic antibiotics are considered major chemotherapeutic agents.
Hormones are considered major chemotherapeutic agents.
Antimetabolites are considered major chemotherapeutic agents.
Incorrect
Antinuclear antibodies are antibodies produced by the immune system that
attack the body's own tissues instead of foreign toxins. They are frequently
present in people with systemic lupus erythematosus and, less commonly,
in other diseases.
Chelating agents are used to detoxify a patient from heavy metal
poisoning.

DIF: Cognitive Level: Comprehension REF: 690-696

2. Which nursing considerations are taken into account prior to the administration of
cisplatin IV? (Select all that apply.)
A. Review of laboratory data for presence of myelosuppression and hepatic and renal
parameters
B. Administration of IV hydration as prescribed
C. Administration of epoetin alpha (Epogen)
D. Administration of prechemotherapy mesna (Mesnex)
E. Assessment for dermatologic conditions

ANS: A, B, D

Feedback
Correct
Premedication nursing considerations regarding cisplatin, an alkylating
agent, include checking laboratory reports for baseline data reflecting
hepatic and renal function and baseline hematologic studies that reflect the
degree of myelosuppression present before initiating chemotherapy.
agent, include assessing patient hydration and the health care providers
orders for oral and IV hydration instructions before drug therapy.
agent, include administering prechemotherapy drugs including mesna,
ondansetron, and antianxiety drugs.
Incorrect
Epogen is given to treat anemia associated with chemotherapy; it is not
given before administration of chemotherapy.
Dermatologic assessment is not necessary before administering cisplatin.


3. Which signs and symptoms assessed by the nurse are indicative of thrombocytopenia?
(Select all that apply.)
Test Bank

44-8
A. Pinpoint red rash
B. Casts in urine
C. Brown, fatty stools
D. Increase in menstrual flow
E. Coffee ground emesis

ANS: A, D, E

Feedback
Correct
Pinpoint red rash indicates thrombocytopenia, which causes an increased
tendency to bleed.
An increase in menstrual flow indicates thrombocytopenia, which causes
an increased tendency to bleed.
Coffee ground emesis indicates thrombocytopenia, which causes an
increased tendency to bleed.
Incorrect
Thrombocytopenia may cause hematuria.
Thrombocytopenia may cause dark, tarry stools.

TOP: Nursing Process Step: Assessment
MSC: NCLEX Client Needs Category: Health Promotion and Maintenance

4. Which are treatments that may be used alone or in combination for the treatment of
cancer? (Select all that apply.)
A. Surgery
B. Radiation
C. Chemotherapy
D. Immunotherapy
E. Phlebotomy

ANS: A, B, C, D

Feedback
Correct
Treatment of cancer often requires surgery.
Treatment of cancer often requires radiation.
Treatment of cancer often requires chemotherapy.
Treatment of cancer often requires immunotherapy.
Incorrect
Phlebotomy does not treat cancer cells.


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Mosby items and derived items 2010, 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.

Clayton: Basic Pharmacology for Nurses, 15

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