NURS 6521 Week 9 Quiz – Question and Answers
NURS 6521 Week 9 Quiz – Question and Answers
QUESTION 1
1. A nurse is discussing oprelvekin therapy
... [Show More] with a male patient. Which of the following will the nurse tell the patient is the most common adverse effect of the drug?
A. Medullary bone pain
B. Fluid retention/weight gain
C. Atrial arrhythmia
D. Papilledema
1 points
QUESTION 2
1. A patient has been scheduled to begin treatment with rituximab for non-Hodgkin's lymphoma. The nurse who will administer this drug should understand that it targets
A. specific antigens on the surface of malignant B cells.
B. the molecular structure of the cells making up the semipermeable membrane of cancerous cells.
C. the function of the complement system.
D. the DNA of mature plasma cells.
1 points
QUESTION 3
1. A patient with a diagnosis of chronic myeloid leukemia has met with her oncologist, who has recommended treatment with the kinase inhibitor imatinib. What route of administration should the nurse explain to the patient?
A. Weekly IV infusions over 6 to 8 hours through a central line
B. Peripheral IV administration three times a day for 7 to 10 days
C. Daily intramuscular injections throughout the course of treatment
D. Oral administration of imatinib in a home setting
1 points
QUESTION 4
1. A female patient is prescribed oprelvekin therapy to treat thrombocytopenia. Which of the following should the nurse continuously monitor to determine the efficacy and duration of the oprelvekin therapy?
A. Weight gain
B. Red and white blood cell count
C. Cardiac arrhythmias
D. Platelet count
1 points
QUESTION 5
1. A nurse has been assigned to a female patient who is to begin chemotherapy. The nurse will initiate the prescribed oprelvekin therapy
A. 6 days after chemotherapy.
B. 6 to 24 hours after chemotherapy.
C. 2 days after chemotherapy.
D. 10 days after chemotherapy.
1 points
QUESTION 6
1. A middle-aged patient has received a diagnosis of GI stromal tumor following an extensive diagnostic workup. Imatinib has been recommended as a component of the patient's drug regimen. What patient education should the nurse provide to this patient?
A. “It's important that you let us know if you develop any significant swelling or puffiness.”
B. “Try to keep your PICC line dressing as dry as possible at all times.”
C. “If you experience significant nausea after taking a dose, stop taking the drug and schedule an appointment at the clinic.”
D. “You'll likely experience a lot of dry mouth while you're taking this drug, so it's helpful to chew ice chips.”
1 points
QUESTION 7
1. An oncology nurse is aware of the risks for injury that exist around the preparation, transportation, and administration of chemotherapeutic agents. In order to reduce these risks of injury, the nurse should take which of the following actions?
A. Use an IV system for administration that includes needles to reduce the risk of accidental spills.
B. Dispose of intravenous lines used for chemotherapy administration in a covered trash can in the patient's room.
C. Encourage patients who have been receiving chemotherapy to use a bedside commode rather than a toilet.
D. Prime the IV tubing with an approved IV solution rather than with the drug itself.
1 points
QUESTION 8
1. A nurse on an oncology unit is aware of the need to assess for adverse effects in patients who are being treated with rituximab. The risks of adverse effects are highest at what point during the course of treatment.
A. At each point that the dosage of rituximab is increased
B. After 6 to 8 weeks of treatment at the maximum dose
C. Shortly after the initiation of the first infusion of rituximab
D. 48 to 72 hours after the first dose has been administered
1 points
QUESTION 9
1. A patient with a recent diagnosis of chronic myelogenous leukemia (CML) is discussing treatment options with his care team. What aspect of the patient's condition would contraindicate the use of cyclophosphamide for the treatment of leukemia?
A. The patient's bone marrow function is significantly depressed.
B. The patient has had a history of nonadherence to medical treatment.
C. The patient has decreased renal function.
D. The patient has a diagnosis of type 2 diabetes and takes oral antihyperglycemics.
1 points
QUESTION 10
1. A 60-year-old patient experienced a sudden onset of chest pain and shortness of breath and was subsequently diagnosed with a pulmonary embolism in the emergency department. The patient has been started on an intravenous heparin infusion. How does this drug achieve therapeutic effect?
A. By promoting the rapid excretion of vitamin K by the gastrointestinal mucosa
B. By inactivating clotting factors and thus stopping the coagulation cascade
C. By inhibiting the action of vitamin K at its sites of action
D. By inhibiting platelet aggregation on vessel walls and promoting fibrinolysis
1 points
QUESTION 11
1. Mr. Singh is a 66-year-old man who is receiving chemotherapy for the treatment of lung cancer that has metastasized to his liver. In an effort to prevent infection, Mr. Singh has been prescribed filgrastim (Neupogen). Which of the nurse's following assessment questions most directly addresses a common adverse effect of filgrastim?
A. “Do you feel like you're having any pain in your bones?”
B. “Have you had any shortness of breath lately?”
C. “Are you experiencing any waves of cool, clammy skin?”
D. “Have you noticed any bleeding in your gums or cheeks?”
1 points
QUESTION 12
1. A nurse has completed a medication reconciliation of a patient who has been admitted following a motor vehicle accident. Among the many drugs that the patient has received in the previous year is rituximab. The nurse would be justified in suspecting the patient may have received treatment for which of the following diseases?
A. Renal cell carcinoma
B. Nonsmall cell lung cancer
C. Malignant melanoma
D. Non-Hodgkin's lymphoma
1 points
QUESTION 13
1. A nurse is caring for a patient with cancer who has been prescribed dronabinol (Marinol) to help reduce nausea and vomiting from chemotherapy. The nurse will inform the patient that he or she is taking an oral form of
A. cocaine.
B. methamphetamine.
C. nicotine.
D. marijuana.
1 points
QUESTION 14
1. A 45-year-old woman with acute leukemia is going to begin chemotherapy with vincristine. The nurse is aware that vincristine must always be administered
A. at a slow infusion rate.
B. at a rapid infusion rate.
C. through a central line.
D. through an IV line primed with vincristine.
1 points
QUESTION 15
1. A patient with chronic lymphocytic leukemia (CLL) will imminently begin a course of treatment with rituximab. In order to minimize the risk of adverse effects, what strategy for administration will be adopted?
A. Administering the drug by slow infusion to two peripheral IV sites simultaneously
B. Admitting the patient to the intensive care unit in anticipation of the initial bolus of the drug
C. Administering the initial doses by slow infusion while observing for adverse reactions
D. Administering diphenhydramine 30 minutes prior to the initial dose of rituximab
1 points
QUESTION 16
1. A nurse is caring for a 64-year-old female patient who is receiving IV heparin and reports bleeding from her gums. The nurse checks the patient's laboratory test results and finds that she has a very high aPTT. The nurse anticipates that which of the following drugs may be ordered?
A. Protamine sulfate
B. Coumadin
C. Ticlopidine
D. Alteplase
1 points
QUESTION 17
1. A female patient has follicular non-Hodgkin's lymphoma and is receiving thalidomide (Thalomid). It will be most important for the nurse to monitor this patient for which of the following?
A. Bleeding
B. Fever
C. Chills and rigors
D. Angina
1 points
QUESTION 18
1. When planning care for a patient who is receiving filgrastim (Neupogen) for a nonmyeloid malignancy, the nurse should formulate which of the following patient outcomes? (Select all that apply.)
A. The patient will not experience bone pain.
B. The patient will be able to self-administer filgrastim at home.
C. The patient will not retain fluid.
D. The patient will not develop an infection.
E. The patient will not develop febrile neutropenia.
1 points
QUESTION 19
1. A male patient is receiving rituximab therapy for non-Hodgkin's lymphoma. Which of the following would be a priority nursing intervention to reduce the risk for cytotoxicity and tumor lysis syndrome?
A. Ensure that the patient maintains a normal breathing pattern.
B. Ensure that the patient maintains a normal fluid and electrolyte balance.
C. Monitor the patient for deterioration in renal function.
D. Protect the patient from exposure to infections.
1 points
QUESTION 20
1. A patient receiving high-dose cisplatin therapy exhibits symptoms of hypomagnesemia. Which of the following should the nurse suggest to help offset the magnesium losses from the cisplatin therapy?
A. Drinking 2 to 3 liters of fluid a day
B. Consuming dairy products
C. Consuming potassium-rich foods
D. Consuming chocolates
1 points
QUESTION 21
1. An older adult woman has been diagnosed with acute lymphoblastic leukemia (ALL) and her care team has identified potential benefits of imatinib. Which of the following characteristics of this patient's current health status may preclude the use of imatinib?
A. The patient has type 2 diabetes mellitus that is controlled using diet and oral antihyperglycemics.
B. The patient had a total knee arthroplasty several months earlier.
C. The patient experienced a mild ischemic stroke several years ago and had transient ischemic attacks last year.
D. The patient has chronic heart failure resulting in significant peripheral edema.
1 points
QUESTION 22
1. During ongoing assessment of a patient receiving 5-FU therapy, the nurse finds the patient's platelet count to be 92,000 cells/mm 3. The nurse should do which of the following?
A. Consult the prescriber for discontinuation of the drug
B. Consult the prescriber for a decrease in dosage
C. Continue the therapy as prescribed
D. Consult the prescriber for an increase in dosage
1 points
QUESTION 23
1. A 28-year-old woman has completed rituximab therapy for an autoimmune disease. She tells the nurse that she and her husband would like to start a family. The nurse will advise her to
A. discontinue birth control, but avoid breast-feeding after the child is born.
B. pursue fertility testing.
C. continue using birth control for at least 12 months.
D. stop using birth control for the next several weeks.
1 points
QUESTION 24
1. A nurse has been assigned to a 55-year-old woman who has a malignant brain tumor. The patient is receiving her first dose of carmustine. It will be critical for the nurse to observe for which of the following?
A. Inability to drink fluids for 6 hours
B. Reddish urine
C. Respiratory difficulty
D. Nausea and vomiting
1 points
QUESTION 25
1. A patient has just received her first dose of imatinib and the nurse on the oncology unit is amending the patient's care plan accordingly. What nursing diagnosis is most appropriate in light of this addition to the patient's drug regimen?
A. Risk for Deficient Fluid Volume related to changes in osmotic pressure
B. Risk for Impaired Skin Integrity related to exaggerated inflammatory response
C. Risk for Acute Confusion related to adverse neurological effects of imatinib
D. Risk for Infection related to bone marrow suppression
1 points
QUESTION 26
1. Intravenous carmustine has been prescribed for a patient with cancer. The nurse should help relieve the discomfort of pain and burning during the infusion by
A. administering a dose of 2 units of bleomycin before carmustine.
B. decreasing the total volume of the primary IV infusion.
C. slowing the infusion.
D. decreasing the volume used for dilution.
1 points
QUESTION 27
1. Mr. Lepp is a 63-year-old man who was diagnosed with colon cancer several weeks ago and who is scheduled to begin chemotherapy. He reports to the nurse that he read about the need for erythropoietin in an online forum for cancer patients and wants to explore the use of epoetin alfa with his oncologist. Which of the following facts should underlie the nurse's response to Mr. Lepp?
A. The potential benefits of epoetin alfa must be weighed carefully against the potential adverse effects in cancer patients.
B. Treatment with epoetin alfa will likely begin 4 to 6 days before Mr. Lepp's first round of chemotherapy and continue indefinitely.
C. Epoetin alfa is normally contraindicated in patients who are receiving radiotherapy or chemotherapy.
D. Mr. Lepp's oncologist should have begun treatment with epoetin alfa immediately after he was diagnosed.
1 points
QUESTION 28
1. An oncology nurse is reviewing the pathophysiology of cancer and is discussing with a colleague the factors that contribute to the success or failure of a patient's chemotherapy. Which of the following cancerous cells is most susceptible to the effects of chemotherapeutic drugs?
A. Cells that have a rapid mitotic rate
B. Cells that lack a blood supply
C. Cells with a long generation time
D. Cells that lack contact inhibition
1 points
QUESTION 29
1. A 39-year-old woman is receiving doxorubicin for the treatment of cancer. After each treatment, the patient has acute nausea and vomiting accompanied by a slightly increased heart rate. The nurse will advise her to
A. perform relaxation techniques after the treatments.
B. perform light exercise after administration of the drug.
C. take the drug only at bedtime.
D. make an appointment for cardiac function tests.
1 points
QUESTION 30
1. A female patient is taking filgrastim (Neupogen) to decrease the incidence of infection. The nurse notices a small increase in the neutrophil count 2 days after starting therapy. The nurse's evaluation of the increase is that
A. the therapeutic effect of the drug is slow, and it is likely to cause adverse effects.
B. the increase in the neutrophil count is only transient.
C. the drug therapy is proving to be ineffective.
D. the therapeutic effect of the drug is fully evident.
1 points
QUESTION 31
1. A nurse is assessing a patient who has chronic lymphoblastic myelogenous leukemia. The treatment plan includes hydroxyurea (Hydrea). The nurse will assess the patient for which of the following?
A. Leukopenia
B. Hypoglycemia
C. Diabetes mellitus
D. Hypertension
1 points
QUESTION 32
1. A nurse has administered filgrastim to a diverse group of patients in recent months. Which of the following patients should the nurse observe for extremely elevated white blood cell counts following administration of the drug?
A. A 47-year-old male with aplastic anemia
B. A 19-year-old male receiving radiotherapy
C. A 25-year-old female with a diagnosis of congenital neutropenia
D. A 39-year-old female with a nonmyeloid malignancy
1 points
QUESTION 33
1. A patient has completed 4 weeks of treatment with epoetin alfa. Which of the following assessment findings would most strongly indicate that treatment has been effective?
A. Capillary refill in the patient's nail beds is less than or equal to 3 seconds
B. The patient white blood cell level is within reference ranges
C. The patient maintains an oxygen saturation of 92% on room air
D. The patient's hemoglobin level is 11 g/dL
1 points
QUESTION 34
1. A patient with non-Hodgkin's lymphoma (NHL) will be starting a course of doxorubicin shortly. When planning this patient's care, what nursing diagnosis should the nurse prioritize?
A. Risk for Impaired Skin integrity related to cytotoxic effects of doxorubicin
B. Risk for Ineffective Airway Clearance related to decreased neurological function
C. Risk for Infection related to suppressed bone marrow function
D. Risk for Imbalanced Nutrition: More Than Body Requirements related to metabolic effects of doxorubicin
1 points
QUESTION 35
1. Which of the following patients will be at the greatest risk for anemia and would be the most likely candidate for epoetin alfa therapy?
A. A 20-year-old female
B. A 62-year-old male with cancer
C. A 30-year-old pregnant woman
D. A 40-year-old male with a high w
SET 2
• Question 1
1 out of 1 points
A nurse is discussing oprelvekin therapy with a male patient. Which of the following will the nurse tell the patient is the most common adverse effect of the drug?
Response Feedback: Fluid retention with weight gain is the most common adverse effect of oprelvekin. Medullary bone pain (pain within the marrow) is the only consistently observed adverse effect associated with filgrastim. Papilledema is an adverse effect that is only occasionally reported in older adults who take oprelvekin. Atrial arrhythmia is not associated with this drug.
• Question 2
1 out of 1 points
A patient has been scheduled to begin treatment with rituximab for non-Hodgkin's lymphoma. The nurse who will administer this drug should understand that it targets
Response Feedback: Rituximab is a type of monoclonal antibody that binds specifically to the CD20 antigen found on the surface of normal and malignant B lymphocytes and causes cell lysis. The drug does not target the complement system, plasma cell DNA, or the cell membrane of malignant cells.
• Question 3
1 out of 1 points
A patient with a diagnosis of chronic myeloid leukemia has met with her oncologist, who has recommended treatment with the kinase inhibitor imatinib. What route of administration should the nurse explain to the patient?
Response Feedback: Imatinib is administered orally. Consequently, it can be administered in an outpatient environment. IV or IM administration is not performed.
• Question 4
0 out of 1 points
A female patient is prescribed oprelvekin therapy to treat thrombocytopenia. Which of the following should the nurse continuously monitor to determine the efficacy and duration of the oprelvekin therapy?
Response Feedback: Oprelvekin stimulates the formation of platelets, so the nurse should regularly monitor the platelet count to determine the duration of the therapy. The therapy should be continued until the postnadir platelet count is at least 50,000 cells/mm 3. The oprelvekin therapy is effective if the platelet count rises to a normal range without severe bleeding. Fluid retention, weight gain, and arrhythmias are major adverse effects of oprelvekin therapy and would not be a measure of the efficacy and duration of the therapy.
• Question 5
1 out of 1 points
A nurse has been assigned to a female patient who is to begin chemotherapy. The nurse will initiate the prescribed oprelvekin therapy
Response Feedback: Administration of oprelvekin should begin 6 to 24 hours after the end of chemotherapy. Oprelvekin should be discontinued at least 2 days before the next chemotherapy session begins.
• Question 6
1 out of 1 points
A middle-aged patient has received a diagnosis of GI stromal tumor following an extensive diagnostic workup. Imatinib has been recommended as a component of the patient's drug regimen. What patient education should the nurse provide to this patient?
Response Feedback: Patients must understand the importance of reporting edema of weight gain while taking imatinib. The patient will not likely have a PICC line. Nausea and dry mouth are not common adverse effects and the patient should not unilaterally stop taking the drug.
• Question 7
1 out of 1 points
An oncology nurse is aware of the risks for injury that exist around the preparation, transportation, and administration of chemotherapeutic agents. In order to reduce these risks of injury, the nurse should take which of the following actions?
Response Feedback: IV lines should be primed with a compatible nonhazardous solution before the actual
drug administration. Intravenous lines should be disposed of in an approved biohazard container, not normal trash cans. Needleless systems should be used and a toilet is preferable to a commode because it can be flushed of contents without prior handling of waste by care providers.
• Question 8
1 out of 1 points
A nurse on an oncology unit is aware of the need to assess for adverse effects in patients who are being treated with rituximab. The risks of adverse effects are highest at what point during the course of treatment?
Response Feedback: Infusion-related effects reportedly occur in 80% of patients within 30 minutes to 2 hours after beginning the first rituximab infusion. These exceed the incidence of adverse effects at other points in the course of treatment.
• Question 9
1 out of 1 points
A patient with a recent diagnosis of chronic myelogenous leukemia (CML) is discussing treatment options with his care team. What aspect of the patient's condition would contraindicate the use of cyclophosphamide for the treatment of leukemia?
Response Feedback: Patients with severely compromised bone marrow functions cannot tolerate treatment with cyclophosphamide. Diabetes, impaired renal function, and previous nonadherence to treatment must be addressed when planning the patient's care, but these factors do not necessarily contraindicate the use of cyclophosphamide.
• Question 10
1 out of 1 points
A 60-year-old patient experienced a sudden onset of chest pain and shortness of breath and was subsequently diagnosed with a pulmonary embolism in the emergency department. The patient has been started on an intravenous heparin infusion. How does this drug achieve therapeutic effect?
Response Feedback: Heparin, along with antithrombin, rapidly promotes the inactivation of factor X, which, in turn, prevents the conversion of prothrombin to thrombin. Heparin does not achieve its therapeutic effect through the excretion or inhibition of vitamin K or by inhibiting platelet aggregation.
• Question 11
1 out of 1 points
Mr. Singh is a 66-year-old man who is receiving chemotherapy for the treatment of lung cancer that has metastasized to his liver. In an effort to prevent infection, Mr. Singh has been prescribed filgrastim (Neupogen). Which of the nurse's following assessment questions most directly addresses a common adverse effect of filgrastim?
Response Feedback: Medullary bone pain is a consistently observed adverse effect that can be attributed to drug therapy with filgrastim; it is mild to moderate in severity and is reported in 56% of patients taking the drug. Shortness of breath, mucosal bleeding, and cool, clammy skin are not adverse effects typical of filgrastim.
• Question 12
1 out of 1 points
A nurse has completed a medication reconciliation of a patient who has been admitted following a motor vehicle accident. Among the many drugs that the patient has received in the previous year is rituximab. The nurse would be justified in suspecting the patient may have received treatment for which of the following diseases?
Response Feedback: Rituximab has historically been used to treat CD20-positive B-cell malignancies such as B-cell leukemias, chronic lymphocytic leukemia, non-Hodgkin's lymphoma, and some multiple myeloma. It is not normally used to treat malignant melanoma, lung cancer, or kidney cancer.
• Question 13
1 out of 1 points
A nurse is caring for a patient with cancer who has been prescribed dronabinol (Marinol) to help reduce nausea and vomiting from chemotherapy. The nurse will inform the patient that he or she is taking an oral form of
Response Feedback: The major ingredient of Marinol is 9-tetrahydrocannabinol (THC), the active ingredient in marijuana.
• Question 14
1 out of 1 points
A 45-year-old woman with acute leukemia is going to begin chemotherapy with vincristine. The nurse is aware that vincristine must always be administered
Response Feedback: If vincristine is administered as a continuous infusion, a central line should always be used. It is important to prime IV lines for chemotherapy administration with 5% dextrose in water or normal saline, not with vincristine, before administering the drug. The infusion rate, although important, is not as important a factor for vincristine administration as is the need for a central line.
• Question 15
1 out of 1 points
A patient with chronic lymphocytic leukemia (CLL) will imminently begin a course of treatment with rituximab. In order to minimize the risk of adverse effects, what strategy for administration will be adopted?
Response Feedback: If no reactions are apparent after 30 minutes of rituximab infusion, the dose may be escalated every 30 minutes by 50 mg/h until a maximum infusion rate of 400 mg/h is reached. Admission to an ICU and administration of diphenhydramine do not reduce the risk of adverse effects. Rituximab is not administered through multiple IV sites simultaneously.
• Question 16
1 out of 1 points
A nurse is caring for a 64-year-old female patient who is receiving IV heparin and reports bleeding from her gums. The nurse checks the patient's laboratory test results and finds that she has a very high aPTT. The nurse anticipates that which of the following drugs may be ordered?
Response Feedback: If a patient who receives IV heparin is found to be highly anticoagulated, protamine sulfate may be prescribed. Protamine sulfate, which is a strong base, reacts with heparin, which is a strong acid, to form a stable salt, thereby neutralizing the anticoagulant effects of heparin. Protamine sulfate does not produce the same effects for coumadin, alteplase, or ticlopidine.
• Question 17
1 out of 1 points
A female patient has follicular non-Hodgkin's lymphoma and is receiving thalidomide (Thalomid). It will be most important for the nurse to monitor this patient for which of the following?
Response Feedback: Common adverse effects of thalidomide include thrombotic problems, drowsiness, photosensitivity, and peripheral neuropathies. Chills, rigors, fever, and angina are not associated with the use of this drug.
• Question 18
1 out of 1 points
When planning care for a patient who is receiving filgrastim (Neupogen) for a nonmyeloid malignancy, the nurse should formulate which of the following patient outcomes? (Select all that apply.)
Response Feedback: Desired outcomes for a patient receiving filgrastim include that febrile neutropenia will be avoided and infection and bone pain will not develop, or at least bone pain will not be unmanageable if it develops. Also, because this drug is administered subcutaneously every day during therapy, management of their own administration would be a positive outcome for patients. A patient who is taking oprelvekin would be at risk for fluid retention. Filgrastim is not associated with this adverse effect.
• Question 19
1 out of 1 points
A male patient is receiving rituximab therapy for non-Hodgkin's lymphoma. Which of the following would be a priority nursing intervention to reduce the risk for cytotoxicity and tumor lysis syndro [Show Less]