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Antineoplastic Medications NCLEX Practice Quiz (20 items)

By Paul Martin, RN - August 22, 2016

Neonatal Nurse Designed

The Innovative babyLance™ Offers a Family of
Sizes, Precision Targeting & Safety Features

Clinical Innovations OPEN

This 20-item NCLEX style exam will test your knowledge on antineoplastic medications.

You gain strength, courage, and confidence by every experience in which you really stop to look fear in the face.
You must do the thing which you think you cannot do.
– Eleanor Roosevelt

Topics

Neonatal Nurse Designed

The Innovative babyLance™ Offers a Family of Sizes, Precision Targeting OPEN
& Safety Features

Topics or concepts included in this exam are:

Antineoplastic Medications

Guidelines
To make the most out of this quiz, follow the guidelines below:

Read each question carefully and choose the best answer.

You are given one minute per question. Spend your time wisely!
Answers and rationales (if any) are given below. Be sure to read them.
If you need more clarifications, please direct them to the comments section.

Questions

⋆ EXAM MODE ! PRACTICE MODE " TEXT MODE

In Exam Mode: All questions are shown but the results, answers, and rationales (if any) will only be given after youʼve finished the quiz.

Antineoplastic Medications NCLEX Practice Quiz (20 items)

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Congratulations - you have completed Antineoplastic Medications NCLEX Practice Quiz (20 items). You scored 20 out of 20. Your
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Your answers are highlighted below.

Question 1 CORRECT

Chemotherapy dosing is usually based on the total body surface. What should the nurse do before administering
chemotherapy?

Get the body mass index (BMI).

Ask the client about intake and output.

Weigh and measure the height of the patient on the day of administration.

Ask the client for the height and weight.

Question 1 Explanation:

To assure that the client obtains optimal doses of chemotherapy, dosing is usually based on the total body surface
(BSA), which requires an accurate current measurement of height and weight on the day of the administration. Options A
and B will not provide the information needed. Option D will lead to inaccurate value in determining the true body total
surface.

Question 2 CORRECT

The nurse is caring for of a client who is receiving a chemotherapy. Which of the following would be expected as a result of
the massive cell destruction that occurred from the chemotherapy?

Leukopenia.

Anemia.

Thrombocytopenia.

Hyperuricemia.

Question 2 Explanation:

Increase level of uric acid (Hyperuricemia) in the body is common following the treatment for leukemias and lymphomas
because chemotherapy results in massive cell destruction. Options A, B, and C are usually noted, but an increase uric
acid level is specifically related to massive cell destruction.

Question 3 CORRECT

Mitomycin (Mutamycin) is prescribed to a client with colorectal cancer. All of which are the routes of administration, except?

Oral.

Intravenous.

Intravesical.

Intraarterial.

Question 3 Explanation:

Mitomycin (Mutamycin) is an antitumor antibiotic used in the treatment of anal, bladder, breast, cervical, colorectal, head
and neck, and non-small cell lung cancer. There is no pill form of this medication. Options B, C, and D are the routes of
medication.

Question 4 CORRECT

The client with a testicular cancer is being treated with Etoposide (Etopophos). Which of the following side effect is
specifically associated with this medication?

Chest pain.

Edema.

Alopecia.

Orthostatic hypotension.

Question 4 Explanation:

While on etoposide infusion, blood pressure is monitored throughout and it should be administered slowly over 30-60
minutes to avoid hypotension. Options A and B are not related to this medication. Option C: Alopecia happens nearly with
all the neoplastic medications.

Question 5 CORRECT

The clinic nurse provides instructions to a client receiving an antineoplastic medication. When implementing the plan, the
nurse tells the client to?

To drink beverages containing alcohol in moderate amount during the evening.

To eat high fiber rich foods.

To take acetylsalicylic acid as needed for headache.

To consult with health care providers before receiving immunization.

Question 5 Explanation:

Because antineoplastic medications lower the resistance of the body, clients must be informed not to received
immunizations without a health care provider's approval. Option A: Clients need to avoid alcohol to minimize the risk of
toxicity. Option B: Diarrhea as one of the common signs of antineoplastic medication needs to avoid spicy and high-fiber
foods which can increase peristalsis. Option C: Clients need to avoid aspirin to minimize the risk of bleeding.

Question 6 CORRECT

The client with non-Hodgkin's lymphoma is being managed with vincristine (Vincasar). Which of the following indicates a side
effect specific to this medication?

Alopecia.

Numbness in the toes.

Chest heaviness.

Weight gain.

Question 6 Explanation:

A side effect specific to this medication is peripheral neuropathy. It can be manifested as numbness and tingling
sensation in the finger and toes. Option A: Alopecia occurs nearly with all the neoplastic medications. Options C and D
are not related to this medication.

Question 7 CORRECT

A client with a sarcoma is receiving Bleomycin (Blenoxane). The nurse in charge with the client expect the physician to order
which diagnostic procedure?

Pulmonary function studies (PFT's).

Stress test.

Cranial x-ray.

Electrocardiogram (ECG).

Question 7 Explanation:

Bleomycin (Blenoxane) is an antitumor antibiotic that can cause interstitial pulmonary fibrosis. Pulmonary function tests
and chest x-ray are done while on this treatment. Options B, C, and D are not related to the specific use of this
medication.

Question 8 CORRECT

A male client with breast cancer is receiving Tamoxifen (Nolvadex). The nurse specifically monitors which laboratory value?

Activated partial thromboplastin time.

Triglyceride level.

Fasting blood sugar.

Serum sodium and potassium.

Question 8 Explanation:

Tamoxifen (Nolvadex) is an antineoplastic medication that may increase cholesterol, triglyceride and calcium levels.
Complete blood count, platelet count, serum calcium, cholesterol, and triglyceride level must be monitored periodically
before the administration of this medication.

Question 9 CORRECT

The client with an ovarian cancer is receiving Tamoxifen (Nolvadex). Which of the following indicates a side effect specific to
this medication?

Weak and brittle nails.

Facial twitching.

Convulsions.

Constipation.

Question 9 Explanation:

Tamoxifen (Nolvadex) is an antineoplastic medication that may increase calcium levels. Signs of hypercalcemia includes
include constipation, abdominal pain,hypotonicity of muscle, nausea and vomiting etc. Options A, B, and C are signs of
hypocalcemia.

Question 10 CORRECT

The client with acute myelocytic leukemia is being treated with Busulfan (Myleran). The nurse specifically monitors which
laboratory value while the client is taking this medication?

Serum calcium.

Uric acid level.

Prothrombin time.

Platelet count.

Question 10 Explanation:

Busulfan (Myleran) is an antineoplastic medication that can cause an increase uric acid level in the body. Options A, C,
and D are not related to this medication.

Question 11 CORRECT

The nurse is evaluating the medical history of a client who will be receiving Asparaginase (Elspar). The nurse contacts the
health care provider if which of the following is noted in the history?

Diabetes Mellitus type II.

Pancreatitis.

Asthma.

Ischemic heart disease.

Question 11 Explanation:

One of the major toxicities associated with asparaginase therapy is pancreatitis. Pancreatic function test should be
performed before and during the administration of the medication. Options A, C, and D are not contraindicated with this
medication.

Question 12 CORRECT

Megestrol acetate (Megace) is prescribed for a client with advanced breast cancer. The nurse reviews the client's history and
contacts the physician if which of the following is documented in the client's history?

Pulmonary embolism.

Gouty arthritis.

Bronchial asthma.

Ischemic heart disease.

Question 12 Explanation:

Megestrol acetate (Megace) is an antineoplastic agent that treats breast and endometrial cancer. This medication is
contraindicated for patients with a history of thrombophlebitis and pulmonary embolism. Options B, C, and D are not
contraindicated with this medication.

Question 13 CORRECT

The client with non-hodgkins lymphoma is receiving Idarubucin (Idamycin). Which of the following would indicate to the nurse
that the client is experiencing an adverse effect related to the medication?

Dysrhythmia.

Weight loss.

Nausea and vomiting.

Peripheral neuropathy.

Question 13 Explanation:

Idarubicin (Idamycin) and Daunorubicin (Daunoxome) may cause cardiotoxicity (such as dysrhythmia, fatigue, shortness
of breath), cardiomyopathy and ECG changes. Option B: Weight gain not weight loss is a side effect. Option C: is a usual
side effect that can last for 2-3 days. Option D: is not a side effect related to this medication.

Question 14 CORRECT

The client is receiving Cisplatin (Platinol-AQ). Which of the following side effect is related to the medication?

Depressed tendon reflexes.

Photosensitivity.

Tinnitus.

Ptosis.

Question 14 Explanation:

Cisplatin (Platinol-AQ), an alkylating medication, may cause ototoxicity, tinnitus, hypokalemia, hypomagnesemia,
hypocalcemia and nephrotoxicity. Option A: is a sign of hypermagnesemia. Options B and D are side effects not related
to this medication.

Question 15 CORRECT

The nurse is monitoring the laboratory results of a male client receiving antineoplastic medications. The nurse plans to initiate
bleeding precautions if which laboratory is value is noted?

White blood cell count of 6,000/mm3.

Platelet count of 45,000 cells/mm3.

Clotting time of 8 minutes.

Hemoglobin count of 15g/dl.

Question 15 Explanation:

The normal value for platelet is 150,000 to 450,000 cells/mm3. When platelet count is less than 50,000 cells/mm3, minor
trauma can lead to episodes of prolonged bleeding; when less than 20,000 cells/mm3, spontaneous and uncontrolled
bleeding can occur. Option A: Normal white blood cell count is 4,000 to 11,000/mm3. Option C: Normal clotting time is 8-
15 minutes. Option D: Normal hgb is 13.5-17.5 g/dl.

Question 16 CORRECT

A client is receiving Methotrexate (Rheumatrex) for a series of chemotherapy. Which of the following medication should be
readily available to avoid toxicity?

Mesna (Mesnex).

Vigabatrin (Sabril).

Leucovorin (Folinic acid).

Oseltamivir (Tamiflu).

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Question 16 Explanation:

Large doses of Methotrexate (Rheumatrex) may lead to harmful effects in the body. Leucovorin is administered to
prevent toxicity. Option A: Mesna is given with ifosfamide to decrease the potential of ifosfamide induced cystitis. Option
B: is an anticonvulsant. Option D: is an antiviral influenza medication.

Question 17 CORRECT

The nurse is providing teachings to a client receiving cyclophosphamide (Cytoxan). The nurse tells the client to which of the
following?

Eat foods rich in potassium.

Increase fluid intake to 2-3 liters per day.

Take the medication with food.

Eat foods rich in purine.

Question 17 Explanation:

Cyclophosphamide can cause hemorrhagic cystitis. Encourage the client to increase their fluid intake to 2- 3 liters per
day, unless contraindicated. Option A: This medication can cause hyperkalemia. Option C: The medication is taken
without food. Option D: Client must follow a low purine diet to alkalinize the urine and lowers the uric acid level.

Question 18 CORRECT

The nurse is monitoring a patient receiving an IV infusion of an antineoplastic medication. During the infusion, the patient
complains of pain and redness at the insertion site. The nurse should take which actions? Select all that apply.

Reinsert the IV at a distal part of the same vein.

Increase the flow rate of the medication.

Notify the physician.

Apply a heat or ice compress to the site.

Administer an antidote as prescribed.

Question 18 Explanation:

Extravasation may occur during the infusion of chemotherapy. Signs of which are pain, redness and swelling on the
insertion site. The infusion must stop and the physician is notified. The physician may order the administration of an
antidote and a heat or cold compress is done. Options A and B: Reinsertion on the same vein and increasing the flow rate
may cause further damage to the site.

Question 19 CORRECT

The nurse is caring for a client receiving chemotherapy when an anaphylactic reaction occurs from the medication. The nurse
should take which actions? Select all that apply.

Stop the medication.

Remove the IV line.

Administer Oxygen.

Administer epinephrine.

Position the client in a reverse Trendelenburg position.

Question 19 Explanation:

During an anaphylactic reaction, the medication is immediately stopped. The nurse assesses and monitors the client vital
signs. Emergency medications such as epinephrine is administered and the physician is contacted immediately. Option
B: The IV line is not removed because IV access is required to administer emergency IV medications. Option E: The
client's head is not lowered but elevated to improve ventilation.

Question 20 CORRECT

The nurse is caring for a client who is receiving Fluorouracil (Adrucil). Which of the following symptoms would necessitate the
nurse to immediate discontinuation of the medication?

Palmar-plantar erythrodysesthesia.

Ataxia.

Constipation.

Insomnia.

Question 20 Explanation:

During the administration of Fluorouracil. Monitor for symptoms of dizziness, weakness, and ataxia which are signs of
cerebral dysfunction that would immediately lead to the discontinuation of the medication. Option A: is characterized by
skin rash, swelling, redness, pain and/or peeling of the skin on the palms of hands and soles of feet. Usually a mild
symptom that would only require reduction of the dosage. Option C: Diarrhea is a related sign not constipation. Option D:
is not a related symptom of this medication.

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