Chapter 50: Traditional Chemotherapy Introductory Clinical Pharmacology 12th Edition by Susan M Ford

Introductory Clinical Pharmacology 12th Edition by Susan M Ford 1. A nurse is presenting information at a health fair concerning cancer. When questioned about the use of green tea, the nurse would point out which potential effect of green tea? a. Dental caries b. Damage to heart c. Insomnia d. Damage to liver Answer: C Rationale: The nurse should inform the client that green tea can cause insomnia, nervousness, restlessness, and GI upset because it contains caffeine. Green tea is known to improve dental health and maintain health of the heart and liver. Question format: Multiple Choice Chapter: 50 Learning Objective: 2 Cognitive Level: Apply Client Needs: Health Promotion and Maintenance Integrated Process: Teaching/Learning Reference: p. 681, Herbal Considerations 2. A nursing instructor is conducting a class discussion on the actions of vincristine. The instructor determines the class is successful when the students correctly choose which action? a. Interfere with amino acid production in the S phase b. Stop cells during the S and G2 phases c. Inhibit DNA synthesis during the S phase d. Prevent cell division during the S and G2 phases Answer: A Rationale: Vinca alkaloids, such as vincristine, interfere with amino acid production in the S phase. Podophyllotoxins stop the cells and prevent cell division during the S and G2 phases. Camptothecin analog drugs inhibit DNA synthesis during the S phase. Question format: Multiple Choice Chapter: 50 Learning Objective: 2 Cognitive Level: Understand Client Needs: Physiological Integrity: Pharmacological Therapies Integrated Process: Clinical Problem-solving Process (Nursing Process) Reference: p. 682, Plant Alkaloids 3. A nurse is preparing to administer etoposide to a client. Which assessment finding that could influence dosing should the nurse prioritize in the preadministration assessment? a. The emotional response b. Complete blood count c. Fluid intake and output d. Understanding of therapy Answer: B Rationale: The nurse should perform a complete blood count to provide baseline data for future reference due to the potential bone marrow suppression that can occur with etoposide. Emotional response to the disease, client understanding of therapy, and fluid intake and output are preadministration assessments not pertaining to the depressing effect of the bone marrow. Question format: Multiple Choice Chapter: 50 Learning Objective: 3 Cognitive Level: Apply Client Needs: Physiological Integrity: Pharmacological Therapies Integrated Process: Clinical Problem-solving Process (Nursing Process) Reference: p. 685, Preadministration Assessment 4. A nurse is caring for a client prescribed gemcitabine. On the morning laboratory results, the nurse discovers the following: white blood cell count 4500/mm3 and platelets 135,000/mm3. The nurse anticipates discovering which sign on the ongoing assessment? a. Bloody urine b. Concentrated urine c. Frequent micturition d. Pain on urination Answer: A Rationale: Thrombocytopenia is characterized by a platelet count of less than 100,000/mm3. The client is at risk for thrombocytopenia due to bone marrow suppression, which is indicated by hematuria. Concentrated urine, frequent micturition, or pain on urination is not indicative of thrombocytopenia. Frequent urination is a potential sign of an infection. Leukopenia or white counts of less than 2500/mm3 would need to be reported to the health care provider. Question format: Multiple Choice Chapter: 50 Learning Objective: 3 Cognitive Level: Apply Client Needs: Physiological Integrity: Reduction of Risk Potential Integrated Process: Clinical Problem-solving Process (Nursing Process) Reference: p. 688, Fatigue, Injury Risk, and Infection Risk 5. A nurse is teaching a client about the chemotherapeutic agent that has been prescribed. When asked about potential hair loss, which answer should the nurse prioritize? a. Forewarn about hair loss as permanent b. Explain it is not life threatening c. Suggest the use of a wig or cap d. Explain that hair has no true function Answer: C Rationale: The nurse can assist the client in being comfortable with their body image by suggesting that the client use a wig or cap until the hair grows back. The nurse should forewarn about hair loss to prepare the client for the outcome of the treatment. The nurse should explain that hair preserves body heat and loss of hair is not life threatening to help put the client at ease during treatment. Question format: Multiple Choice Chapter: 50 Learning Objective: 4 Cognitive Level: Apply Client Needs: Psychosocial Integrity Integrated Process: Caring Reference: p. 689, Altered Body Image Perception 6. A nurse is caring for a client during chemotherapeutic drug therapy and determines a nursing diagnosis of altered tissue integrity is appropriate. Which action would be appropriate for the nurse to suggest during the teaching session? a. Scrub and clean skin often. b. Wear loose protective clothing. c. Ensure adequate sunlight. d. Have frequent baths. Answer: B Rationale: The nurse should suggest to the client to wear loose protective clothing and to watch areas of skinfolds for breakdown. The nurse should not suggest that the client scrub and clean the skin often, ensure adequate sunlight, or have frequent baths as these measures may aggravate the condition and cause further impairment to the tissue. The client is advised to avoid sunlight. Question format: Multiple Choice Chapter: 50 Learning Objective: 4 Cognitive Level: Apply Client Needs: Physiological Integrity: Pharmacological Therapies Integrated Process: Clinical Problem-solving Process (Nursing Process) Reference: p. 690, Altered Tissue Integrity 7. A client, who has been prescribed melphalan for the treatment of an ovarian tumor, wants to know how the drug acts. Which response would the nurse integrate into the answer?