Nurs 305 Final
Which patients are at increased risk for adverse drug events? (Select all that apply.)
a. A 2-month-old infant taking a medication for gastro esophageal reflux disease
b. A 23-year-old female taking an antibiotic for the first time
c. A 40-year-old male who is intubated in the intensive care unit and taking antibiotics
and cardiac medications
d. A 7-year-old female receiving insulin for diabetes
e. An 80-year-old male taking medications for COPD - answer
Before administering a medication, what does the nurse need to know to evaluate how
individual patient variability might affect the patient's response to the medication?
(Select all that apply.)
a. Chemical stability of the medication
b. Ease of administration
c. Family medical history
d. Patient's age
e. Patient's diagnosis - answer
The prescriber has ordered an antibiotic for a patient with a bacterial infection. The
nurse provides patient education at discharge and instructs the patient to take the drug
on an empty stomach. When should the patient take the drug? (Select all that apply.)
a. 1 hour or more before a meal
b. Only after an 8-hour fast
c. Only after the patient has missed a meal
d. At least 2 hours after a meal
e. Shortly before a meal - answer
"Unresponsiveness to feedback mechanisms that control cellular growth in healthy
tissue" describes which of these characteristic of cancer cells? - answerPersistent
proliferation is a characteristic of malignancy in which cells are able to continue
multiplying under conditions that would suppress further growth and division of normal
cells. Invasive growth describes a condition in which malignant cells are free of
constraints that inhibit invasion to adjacent tissue. Metastases arise when malignant
cells form in areas distant from the site of origin to form new cancers. Telomerase is an
enzyme, and its activity allows for infinite cellular divisions in cancer cells. This activity is
rarely expressed in normal cells.
A nurse is caring for a patient who has thrombocytopenia after chemotherapy. Which
action should the nurse take?
Take the pulse before and after activity.
Administer a colony-stimulating factor.
Obtain blood cultures and then begin antibiotic therapy.
, Use minimal cuff inflation when taking the blood pressure. - answerThrombocytopenia,
a reduction in circulating platelets, increases the risk for bleeding. Routine procedures
such as blood pressure readings should be performed with care and only as needed.
because overinflation of the cuff may cause bruising. Taking the pulse before and after
activity may be done to assess a patient's response to anemia. Administering a colony-
stimulating factor and obtaining blood cultures are appropriate nursing actions for a
patient with neutropenia.
Which statement explains why cancer treatment is more effective when multiagent
chemotherapy is used?
Drug resistance occurs less frequently.
The intervals between dosages are shorter.
Normal cell repopulation is not necessary.
The effect occurs during the mitotic phase of the cell cycle. - answerMultiagent
chemotherapy can suppress drug resistance, which is acquired through random
mutational events. The probability of a cell undergoing the single mutation needed for
resistance to one agent is greater than that of the cell undergoing two or more
mutations and developing resistance to a combination of agents. Normal cell
repopulation is needed for most chemotherapeutic agents, regardless of whether they
are used alone or in combination. The intervals between dosages also depend on
normal cell recovery. Combination therapy uses agents that are targeted to all phases
of the cell cycle, not just the mitotic phase.
A nurse develops a plan of care for a patient receiving chemotherapy whose neutrophil
count has reached the nadir. Which nursing action is the priority?
Provide daily oral hygiene.
Limit contact with visitors.
Obtain temperature frequently.
Restrict all fresh fruits and vegetables. - answerThe nadir is the lowest neutrophil
count, which occurs between days 10 and 14 after chemotherapy. The usual signs of
infection depend on a sufficient supply of neutrophils. In a patient who is neutropenic,
monitoring fever as the principal early sign of infection is a priority for the diagnosis of
infection, which can be life-threatening. Minimizing exposure to pathogens through daily
oral hygiene, limiting visitors, and restricting fresh fruits and vegetables are also
important, but they are not as important as monitoring fever as an early sign of infection
when the usual signs are not present.
The nurse identifies which class of anticancer drugs as used most often in the treatment
of patients?
Targeted drugs
Cytotoxic drugs
Immunomodulating agents
Biologic response modifiers - answerOf the four major classes of anticancer drugs, the
cytotoxic agents are used most often.
, A patient with cancer who is neutropenic is hospitalized. Which action by the nursing
assistant requires the supervising nurse to intervene?
The nursing assistant delivers a fresh fruit basket to the patient's room.
The nursing assistant obtains the patient's temperature at frequent intervals.
The nursing assistant maintains isolation protocol for the patient.
The nursing assistant assists the patient in basic hygiene as needed. - answerWhen
working with hospitalized patients who are neutropenic, every precaution must be taken
to prevent nosocomial infection. Patients should be given an isolation room and
monitored frequently for fever. Certain foods, such as salads and fresh fruit, contain a
great deal of pathogenic bacteria and must be avoided.
A patient who has cancer requires considerable assistance and frequent medical care.
The nurse would rate this patient's Karnofsky Performance Scale as what?
90
80
50
20 - answerA patient who scores the following points on the Karnofsky Performance
Scale would most likely be described as follows: 90—able to carry on normal activity
with minor signs or symptoms of disease; 80—able to carry on normal activity with effort
and signs and symptoms of the disease; 50—requires considerable assistance and
frequent medical care; 20—very sick; hospitalized supportive treatment necessary
Which cytotoxic anticancer drug does the nurse identify as being the least emetogenic
agent?
Bleomycin Correct
Carboplatin
Methotrexate
Cisplatin - answerThe emetogenic potential of the following cytotoxic anticancer drugs
includes: bleomycin—mild, carboplantin—moderately severe, methotrexate—moderate,
and cisplantin—severe.
A high tissue growth fraction allows chemotherapeutic medications to be more toxic to
tissues in which phases of the cell cycle? (Select all that apply.)
S
G1
G0
M
G2 - answerActive phases of the cell cycle in which mitotic division are carried out are
G1, S, G2, and M. Cells that enter G0 become mitotically dormant (resting) and are not
active participants in the cell cycle. Cytotoxic agents are more active against
proliferating cells than they are against cells in G0. The ratio of proliferating cells to G0
cells is called the growth fraction. A tissue with a large percentage of proliferating cells
and few cells in G0 has a high growth fraction.
Chemotherapy is dose limiting primarily because of toxicity to the cells in which tissues?
(Select all that apply.)
Which patients are at increased risk for adverse drug events? (Select all that apply.)
a. A 2-month-old infant taking a medication for gastro esophageal reflux disease
b. A 23-year-old female taking an antibiotic for the first time
c. A 40-year-old male who is intubated in the intensive care unit and taking antibiotics
and cardiac medications
d. A 7-year-old female receiving insulin for diabetes
e. An 80-year-old male taking medications for COPD - answer
Before administering a medication, what does the nurse need to know to evaluate how
individual patient variability might affect the patient's response to the medication?
(Select all that apply.)
a. Chemical stability of the medication
b. Ease of administration
c. Family medical history
d. Patient's age
e. Patient's diagnosis - answer
The prescriber has ordered an antibiotic for a patient with a bacterial infection. The
nurse provides patient education at discharge and instructs the patient to take the drug
on an empty stomach. When should the patient take the drug? (Select all that apply.)
a. 1 hour or more before a meal
b. Only after an 8-hour fast
c. Only after the patient has missed a meal
d. At least 2 hours after a meal
e. Shortly before a meal - answer
"Unresponsiveness to feedback mechanisms that control cellular growth in healthy
tissue" describes which of these characteristic of cancer cells? - answerPersistent
proliferation is a characteristic of malignancy in which cells are able to continue
multiplying under conditions that would suppress further growth and division of normal
cells. Invasive growth describes a condition in which malignant cells are free of
constraints that inhibit invasion to adjacent tissue. Metastases arise when malignant
cells form in areas distant from the site of origin to form new cancers. Telomerase is an
enzyme, and its activity allows for infinite cellular divisions in cancer cells. This activity is
rarely expressed in normal cells.
A nurse is caring for a patient who has thrombocytopenia after chemotherapy. Which
action should the nurse take?
Take the pulse before and after activity.
Administer a colony-stimulating factor.
Obtain blood cultures and then begin antibiotic therapy.
, Use minimal cuff inflation when taking the blood pressure. - answerThrombocytopenia,
a reduction in circulating platelets, increases the risk for bleeding. Routine procedures
such as blood pressure readings should be performed with care and only as needed.
because overinflation of the cuff may cause bruising. Taking the pulse before and after
activity may be done to assess a patient's response to anemia. Administering a colony-
stimulating factor and obtaining blood cultures are appropriate nursing actions for a
patient with neutropenia.
Which statement explains why cancer treatment is more effective when multiagent
chemotherapy is used?
Drug resistance occurs less frequently.
The intervals between dosages are shorter.
Normal cell repopulation is not necessary.
The effect occurs during the mitotic phase of the cell cycle. - answerMultiagent
chemotherapy can suppress drug resistance, which is acquired through random
mutational events. The probability of a cell undergoing the single mutation needed for
resistance to one agent is greater than that of the cell undergoing two or more
mutations and developing resistance to a combination of agents. Normal cell
repopulation is needed for most chemotherapeutic agents, regardless of whether they
are used alone or in combination. The intervals between dosages also depend on
normal cell recovery. Combination therapy uses agents that are targeted to all phases
of the cell cycle, not just the mitotic phase.
A nurse develops a plan of care for a patient receiving chemotherapy whose neutrophil
count has reached the nadir. Which nursing action is the priority?
Provide daily oral hygiene.
Limit contact with visitors.
Obtain temperature frequently.
Restrict all fresh fruits and vegetables. - answerThe nadir is the lowest neutrophil
count, which occurs between days 10 and 14 after chemotherapy. The usual signs of
infection depend on a sufficient supply of neutrophils. In a patient who is neutropenic,
monitoring fever as the principal early sign of infection is a priority for the diagnosis of
infection, which can be life-threatening. Minimizing exposure to pathogens through daily
oral hygiene, limiting visitors, and restricting fresh fruits and vegetables are also
important, but they are not as important as monitoring fever as an early sign of infection
when the usual signs are not present.
The nurse identifies which class of anticancer drugs as used most often in the treatment
of patients?
Targeted drugs
Cytotoxic drugs
Immunomodulating agents
Biologic response modifiers - answerOf the four major classes of anticancer drugs, the
cytotoxic agents are used most often.
, A patient with cancer who is neutropenic is hospitalized. Which action by the nursing
assistant requires the supervising nurse to intervene?
The nursing assistant delivers a fresh fruit basket to the patient's room.
The nursing assistant obtains the patient's temperature at frequent intervals.
The nursing assistant maintains isolation protocol for the patient.
The nursing assistant assists the patient in basic hygiene as needed. - answerWhen
working with hospitalized patients who are neutropenic, every precaution must be taken
to prevent nosocomial infection. Patients should be given an isolation room and
monitored frequently for fever. Certain foods, such as salads and fresh fruit, contain a
great deal of pathogenic bacteria and must be avoided.
A patient who has cancer requires considerable assistance and frequent medical care.
The nurse would rate this patient's Karnofsky Performance Scale as what?
90
80
50
20 - answerA patient who scores the following points on the Karnofsky Performance
Scale would most likely be described as follows: 90—able to carry on normal activity
with minor signs or symptoms of disease; 80—able to carry on normal activity with effort
and signs and symptoms of the disease; 50—requires considerable assistance and
frequent medical care; 20—very sick; hospitalized supportive treatment necessary
Which cytotoxic anticancer drug does the nurse identify as being the least emetogenic
agent?
Bleomycin Correct
Carboplatin
Methotrexate
Cisplatin - answerThe emetogenic potential of the following cytotoxic anticancer drugs
includes: bleomycin—mild, carboplantin—moderately severe, methotrexate—moderate,
and cisplantin—severe.
A high tissue growth fraction allows chemotherapeutic medications to be more toxic to
tissues in which phases of the cell cycle? (Select all that apply.)
S
G1
G0
M
G2 - answerActive phases of the cell cycle in which mitotic division are carried out are
G1, S, G2, and M. Cells that enter G0 become mitotically dormant (resting) and are not
active participants in the cell cycle. Cytotoxic agents are more active against
proliferating cells than they are against cells in G0. The ratio of proliferating cells to G0
cells is called the growth fraction. A tissue with a large percentage of proliferating cells
and few cells in G0 has a high growth fraction.
Chemotherapy is dose limiting primarily because of toxicity to the cells in which tissues?
(Select all that apply.)
