Chapter 46: Antineoplastic Drugs Part 2: Cell Cycle–Nonspecific Drugs
and Miscellaneous Drugs Lilley: Pharmacology and the Nursing Process,
10th Edition
1. When giving cisplatin, the nurse is aware that adverse effect of this drug is which
condition?
A. Alopecia
B. Kidney damage
C. Cardiotoxicity
D. Stomatitis
Answer: B
Explanation: Cisplatin is highly nephrotoxic, and close monitoring of renal function, along
with adequate hydration, is essential to prevent kidney damage.
2. The nurse is teaching a class about the various chemotherapy drugs. Which of
these statements explains why alkylating drugs are also called "cell
cycle–nonspecific drugs"?
A. They are cytotoxic during a specific cell cycle.
B. They are cytotoxic in any phase of the cell cycle.
C. They are effective against several types of neoplasms.
D. They are more highly differentiated than cell cycle–specific drugs.
Answer: B
Explanation: Cell cycle–nonspecific drugs, such as alkylating agents, are cytotoxic during
any phase of the cell cycle, unlike cell cycle–specific drugs which are only effective during
specific phases.
3. A patient is receiving doxorubicin as part of treatment for ovarian cancer.
Which of these is a possible adverse effect of doxorubicin?
A. Cardiotoxicity
B. Pulmonary toxicity
C. Neurotoxicity
D. Hyperuricemia
Answer: A
Explanation: Doxorubicin is known to cause dose-related cardiotoxicity, which can lead to
decreased cardiac output and heart failure. The other toxicities are not typically associated
with this drug.
4. What is the nurse’s priority action if extravasation of an antineoplastic drug
occurs during intravenous (IV) administration?
A. Reduce the infusion rate.
, B. Remove the IV, and apply warm compresses.
C. Stop the infusion immediately, but leave the IV catheter in place.
D. Change the infusion to normal saline, and inject the area with hydrocortisone.
Answer: C
Explanation: If extravasation is suspected, the infusion must be stopped immediately to
prevent further tissue damage. The IV catheter is left in place so that an antidote can be
administered through it before the catheter is removed.
5. A patient is receiving a third session of chemotherapy with daunorubicin. The
nurse will assess the patient for which signs of a potential severe toxic effect of
this drug?
A. Tinnitus and hearing loss
B. Numbness and tingling in the fingers
C. A weight gain of 2 pounds or more in 24 hours
D. Decreased blood urea nitrogen and creatinine levels
Answer: C
Explanation: Daunorubicin can cause cardiotoxicity. A rapid weight gain of 2 pounds or
more in 24 hours may indicate fluid retention secondary to cardiac dysfunction and should be
reported immediately.
6. The nurse is hanging a new infusion bag of a chemotherapy drug, but the tubing
becomes disconnected and a small amount of the solution drips onto the floor.
Which action by the nurse is appropriate?
A. Let it dry, and then mop the floor.
B. Wipe the area with a disposable paper towel.
C. Use a spill kit to clean the area.
D. Ask the housekeeping department to clean the floor.
Answer: C
Explanation: Chemotherapy spills, no matter how small, must be cleaned up using a
specialized spill kit to protect health care workers from the cytotoxic effects of the drugs.
7. Just before the second course of chemotherapy, the laboratory calls to report
that the patient’s neutrophil count is 450 cells/mm³. The nurse expects that the
oncologist will follow which course of treatment?
A. Chemotherapy will continue as scheduled.
B. Chemotherapy will resume with a lowered dosage.
C. Chemotherapy will resume after a transfusion of neutrophils.
D. Chemotherapy will be withheld until the neutrophil count returns toward normal
levels.
Answer: D
, Explanation: A neutrophil count of 450 cells/mm³ indicates severe neutropenia (<500
cells/mm³), which carries a high risk for infection. Chemotherapy is typically withheld until
the count recovers to safer levels.
8. A female patient is receiving palliative therapy with androgen hormones as part
of treatment for inoperable breast cancer. The nurse will discuss with the patient
which potential body image changes that may occur as adverse effects?
A. Hirsutism and acne
B. Weight gain
C. Flushing and hot flashes
D. Alopecia and body odor
Answer: A
Explanation: Androgen therapy can cause virilization in females, leading to body image
changes such as hirsutism (excessive hair growth) and acne.
9. During chemotherapy, a patient develops severe diarrhea caused by a vasoactive
intestinal peptide-secreting tumor (VIPoma). The nurse expects to administer
which drug for this problem?
A. Dexrazoxane
B. Allopurinol
C. Octreotide
D. Bismuth subsalicylate
Answer: C
Explanation: Octreotide is a somatostatin analog used to manage severe diarrhea associated
with VIPomas. The other drugs are not indicated for this condition.
10. The nurse is assessing a patient who is receiving chemotherapy with an
alkylating drug. Which assessment findings would be considered indications of
an oncologic emergency? (Select all that apply.)
A. Dry, "scratchy," or "swollen" throat
B. Loss of hair
C. Decreased red blood cell count
D. White patches in the mouth or throat
E. Temperature of 100.7°F (38.2°C)
F. Decreased urine output
Answer: A, D, E, F
Explanation: Indications of an oncologic emergency include fever (>100.5°F/38.1°C), signs
of infection like white patches in the mouth/throat, a "scratchy" throat, and changes in urinary
output. Hair loss and decreased RBCs are expected side effects of chemotherapy, not
emergencies.
and Miscellaneous Drugs Lilley: Pharmacology and the Nursing Process,
10th Edition
1. When giving cisplatin, the nurse is aware that adverse effect of this drug is which
condition?
A. Alopecia
B. Kidney damage
C. Cardiotoxicity
D. Stomatitis
Answer: B
Explanation: Cisplatin is highly nephrotoxic, and close monitoring of renal function, along
with adequate hydration, is essential to prevent kidney damage.
2. The nurse is teaching a class about the various chemotherapy drugs. Which of
these statements explains why alkylating drugs are also called "cell
cycle–nonspecific drugs"?
A. They are cytotoxic during a specific cell cycle.
B. They are cytotoxic in any phase of the cell cycle.
C. They are effective against several types of neoplasms.
D. They are more highly differentiated than cell cycle–specific drugs.
Answer: B
Explanation: Cell cycle–nonspecific drugs, such as alkylating agents, are cytotoxic during
any phase of the cell cycle, unlike cell cycle–specific drugs which are only effective during
specific phases.
3. A patient is receiving doxorubicin as part of treatment for ovarian cancer.
Which of these is a possible adverse effect of doxorubicin?
A. Cardiotoxicity
B. Pulmonary toxicity
C. Neurotoxicity
D. Hyperuricemia
Answer: A
Explanation: Doxorubicin is known to cause dose-related cardiotoxicity, which can lead to
decreased cardiac output and heart failure. The other toxicities are not typically associated
with this drug.
4. What is the nurse’s priority action if extravasation of an antineoplastic drug
occurs during intravenous (IV) administration?
A. Reduce the infusion rate.
, B. Remove the IV, and apply warm compresses.
C. Stop the infusion immediately, but leave the IV catheter in place.
D. Change the infusion to normal saline, and inject the area with hydrocortisone.
Answer: C
Explanation: If extravasation is suspected, the infusion must be stopped immediately to
prevent further tissue damage. The IV catheter is left in place so that an antidote can be
administered through it before the catheter is removed.
5. A patient is receiving a third session of chemotherapy with daunorubicin. The
nurse will assess the patient for which signs of a potential severe toxic effect of
this drug?
A. Tinnitus and hearing loss
B. Numbness and tingling in the fingers
C. A weight gain of 2 pounds or more in 24 hours
D. Decreased blood urea nitrogen and creatinine levels
Answer: C
Explanation: Daunorubicin can cause cardiotoxicity. A rapid weight gain of 2 pounds or
more in 24 hours may indicate fluid retention secondary to cardiac dysfunction and should be
reported immediately.
6. The nurse is hanging a new infusion bag of a chemotherapy drug, but the tubing
becomes disconnected and a small amount of the solution drips onto the floor.
Which action by the nurse is appropriate?
A. Let it dry, and then mop the floor.
B. Wipe the area with a disposable paper towel.
C. Use a spill kit to clean the area.
D. Ask the housekeeping department to clean the floor.
Answer: C
Explanation: Chemotherapy spills, no matter how small, must be cleaned up using a
specialized spill kit to protect health care workers from the cytotoxic effects of the drugs.
7. Just before the second course of chemotherapy, the laboratory calls to report
that the patient’s neutrophil count is 450 cells/mm³. The nurse expects that the
oncologist will follow which course of treatment?
A. Chemotherapy will continue as scheduled.
B. Chemotherapy will resume with a lowered dosage.
C. Chemotherapy will resume after a transfusion of neutrophils.
D. Chemotherapy will be withheld until the neutrophil count returns toward normal
levels.
Answer: D
, Explanation: A neutrophil count of 450 cells/mm³ indicates severe neutropenia (<500
cells/mm³), which carries a high risk for infection. Chemotherapy is typically withheld until
the count recovers to safer levels.
8. A female patient is receiving palliative therapy with androgen hormones as part
of treatment for inoperable breast cancer. The nurse will discuss with the patient
which potential body image changes that may occur as adverse effects?
A. Hirsutism and acne
B. Weight gain
C. Flushing and hot flashes
D. Alopecia and body odor
Answer: A
Explanation: Androgen therapy can cause virilization in females, leading to body image
changes such as hirsutism (excessive hair growth) and acne.
9. During chemotherapy, a patient develops severe diarrhea caused by a vasoactive
intestinal peptide-secreting tumor (VIPoma). The nurse expects to administer
which drug for this problem?
A. Dexrazoxane
B. Allopurinol
C. Octreotide
D. Bismuth subsalicylate
Answer: C
Explanation: Octreotide is a somatostatin analog used to manage severe diarrhea associated
with VIPomas. The other drugs are not indicated for this condition.
10. The nurse is assessing a patient who is receiving chemotherapy with an
alkylating drug. Which assessment findings would be considered indications of
an oncologic emergency? (Select all that apply.)
A. Dry, "scratchy," or "swollen" throat
B. Loss of hair
C. Decreased red blood cell count
D. White patches in the mouth or throat
E. Temperature of 100.7°F (38.2°C)
F. Decreased urine output
Answer: A, D, E, F
Explanation: Indications of an oncologic emergency include fever (>100.5°F/38.1°C), signs
of infection like white patches in the mouth/throat, a "scratchy" throat, and changes in urinary
output. Hair loss and decreased RBCs are expected side effects of chemotherapy, not
emergencies.
