Holland/Adams/Brice, Core Concepts in Pharmacology 5th Edition Test Bank
Chapter 29

Question 1

Type: MCMA

The nurse is providing education to a client who has recently been diagnosed with cancer. Which statements are true regarding cancer cells? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected.

1. The abnormal cells often travel to distant sites where they populate new tumors, a process called metastasis.
2. Cancer cells divide slowly.
3. Cancer cells lose their normal functions.
4. Cancer is thought to result from damage to genes controlling cell growth.
5. Cancer cells don’t invade surrounding cells.

Cognitive Level: Applying

Client Need: Health Promotion and Maintenance

Page Number: 468

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 29-1 Explain differences between normal cells and cancer cells.

Question 2

Type: MCMA

The client asks the nurse to explain ways to decrease the risk of cancer. Which items are appropriate for the nurse to include in client teaching? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected.

1. Limit or eliminate alcoholic beverage use.
2. Maintain a healthy diet low in fat and high in fresh vegetables and fruit.
3. Exercise regularly and keep body weight within optimum guidelines.
4. Eliminate tobacco use and exposure to secondhand tobacco smoke.
5. Drink plenty of caffeinated beverages.

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 469

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 29-2 Identify factors associated with an increased incidence of cancer.

Question 3

Type: MCSA

A client asks whether a benign tumor is cancerous. What is the best response by the nurse?

1. “No, these rarely require drug treatment.”
2. “No, but if surgically removed, it will grow back.”
3. “Yes, this word is often used interchangeably with tumor.”
4. “Yes, these grow rapidly and can become resistant to treatment.”

Cognitive Level: Understanding

Client Need: Physiological Integrity

Page Number: 468

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 29-2 Identify factors associated with an increased incidence of cancer.

Question 4

Type: MCMA

The nurse is distinguishing differences between malignant and benign tumors. Which tumors would the nurse include in the list of benign tumors? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected.

1. Adenoma
2. Lipoma
3. Carcinoma
4. Sarcoma
5. Melanoma

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 468

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 29-2 Identify factors associated with an increased incidence of cancer.

Question 5

Type: MCSA

The nurse is caring for a client who has a tumor. The client is confused and states, “the healthcare provider used another term and I just want to be sure we are all on the same page.” Which term does the nurse anticipate that the healthcare provider used when talking with the client?

1. Adenoma
2. Sarcoma
3. Carcinoma
4. Neoplasm

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 468

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 29-2 Identify factors associated with an increased incidence of cancer.

Question 6

Type: MCMA

The client asks the nurse what the possible treatments for cancer are. Which responses by the nurse are appropriate? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected.

1. Diet restrictions
2. Radiation
3. Chemotherapy
4. Surgery
5. Exercise

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 470

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 29-4 Explain why cancer is difficult to cure.

Question 7

Type: MCMA

The nurse is teaching a client about the general goals of chemotherapy. What items should the nurse include in the teaching session? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected.

1. Control
2. Prevention
3. Cure
4. Palliation
5. Extinction

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 469

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 29-3 Identify the primary goals of chemotherapy.

Question 8

Type: MCSA

The client asks the nurse why cancer is difficult to cure. Which statement by the nurse is the most appropriate?

1. “Every cancer cell must be removed or destroyed to cure cancer.”
2. “Most people will not take the medications.”
3. “The only way to cure cancer is to use medication, surgery, and radiation in all clients.”
4. “Surgery is the only way to cure cancer.”

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 470

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 29-4 Explain why cancer is difficult to cure.

Question 9

Type: MCSA

The nurse explains to the client why combination therapy and special dosing schedules are used to treat cancer. Which client response indicates the need for further teaching?

1. “This is more effective than using one medication.”
2. “Lower doses of the medications can be given.”
3. “The medications need to be given in higher doses when used in combination.”
4. “This reduces the resistance to medication.”

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 471

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 29-5 Explain how combination therapy and special dosing schedules increase the effectiveness of chemotherapy.

Question 10

Type: MCSA

A client recently diagnosed with ovarian cancer is concerned about alopecia while taking cyclophosphamide (Cytoxan). Which response by the client reflects understanding of the teaching of cyclophosphamide (Cytoxan)?

1. “I don’t need to worry about losing my hair.”
2. “My hair will probably grow back.”
3. “I will never have hair again.”
4. “Wigs only exacerbate the alopecia.”

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 474

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 29-6 Describe the general adverse effects of antineoplastic drugs.

Question 11

Type: MCSA

The nurse educates the client on possible side effects of chemotherapy. What should not be included in the teaching?

1. Nausea
2. Increased red blood cells
3. Hair loss
4. Decreased white blood cells

Cognitive Level: Understanding

Client Need: Physiological Integrity

Page Number: 472

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 29-6 Describe the general adverse effects of antineoplastic drugs.

Question 12

Type: MCSA

The nurse is caring for a client who experiences nausea and vomiting with each treatment of chemotherapy. What should the nurse advise the client to do to decrease nausea and vomiting?

1. Do not eat for 12 hours before treatment
2. Increase food intake
3. Take antiemetic medications prior to treatment
4. Decrease water intake

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 472

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 29-6 Describe the general adverse effects of antineoplastic drugs.

Question 13

Type: MCSA

Cyclophosphamide (Cytoxan) has been prescribed orally for a client. What is the rationale for why this medication has been prescribed orally for this client?

1. There are few side effects when given orally.
2. It is only available parenterally.
3. It is one of only a few anticancer drugs that are well absorbed when given orally.
4. The client has a new diagnosis of cancer.

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 474

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 29-7 Explain the role of alkylating agents in the treatment of cancer.

Question 14

Type: MCMA

The nurse is reviewing methotrexate (Rheumatrex). Which types of tumors or cancers is this medication an effective part of the treatment regimen? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected.

1. Bone cancers
2. Head and neck cancers
3. Benign cancers
4. Lymphoma
5. Testicular cancer

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 475

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 29-8 Explain the role of antimetabolites in the treatment of cancer.

Question 15

Type: MCSA

The nurse is caring for a client who is receiving doxorubicin (Adriamycin). Which serious adverse effect will the nurse monitor this client for during the assessment?

1. Cardiac toxicity
2. Hair loss
3. Vomiting
4. Secondary malignancies

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 477

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 29-9 Explain the role of cytotoxic antibiotics in the treatment of cancer.

Question 16

Type: MCSA

A client is diagnosed with bone cancer, and is placed on methotrexate (Mexate). What is the correct classification for this medication?

1. An alkaloid
2. An antimetabolite
3. An alkylating agent
4. An antitumor antibody

Cognitive Level: Understanding

Client Need: Physiological Integrity

Page Number: 475

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 29-8 Explain the role of antimetabolites in the treatment of cancer.

Question 17

Type: MCMA

The nurse is teaching a client about the adverse effects of anticancer drugs. Which topics should the nurse include in the teaching session? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected.

1. Fatigue
2. Increase appetite
3. Alopecia
4. Anemia
5. Weight gain

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 472

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 29-6 Describe the general adverse effects of antineoplastic drugs.

Question 18

Type: MCSA

A client with breast cancer is started on chemotherapy. Her daughter is started on the same drug prophylactically. The daughter is considered high risk for developing breast cancer. Which medication does the nurse anticipate has been prescribed to both the client and her daughter?

1. Anastrozole (Arimidex)
2. Medroxyprogesterone (Provera)
3. Goserelin (Zoladex)
4. Tamoxifen (Nolvadex)

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 480

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 29-11 Explain the role of hormone and hormone antagonists in the treatment of cancer.

Question 19

Type: MCSA

A client with hairy cell leukemia complains of flu-like symptoms including fever, chill, dizziness, and fatigue during the first few weeks of chemotherapy. Which medication on the client’s medication administration record (MAR) does the nurse anticipate is causing these symptoms?

1. Paclitaxel (Taxol)
2. Letrozole (Femara)
3. Daunorubicin liposomal (DaunoXome)
4. Interferon alfa-2 (Roferon A)

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 481

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 29-12 Explain the role of targeted therapies in the treatment of cancer.

Question 20

Type: MCSA

The nurse is caring for a client who is diagnosed with Kaposi sarcoma. Which medication does the nurse anticipate to be included in the plan of care?

1. Letrozole (Femara)
2. Doxorubicin (Adriamycin)
3. Interferon alfa-2 (Roferon A)
4. Paclitaxel (Taxol)

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 481

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 29-12 Explain the role of targeted therapies in the treatment of cancer.

Question 21

Type: MCSA

A client is undergoing antineoplastic therapy. The nurse, in an effort to minimize the toxic effects of therapy, administers which growth factor?

1. Filgrastim (Neupogen)
2. Megestrol (Megace)
3. Carmustine (Gliadel)
4. Teniposide (Vumon)

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 482

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 29-13 Explain the role of adjunct medications in treating the adverse effects of cancer chemotherapy.

Question 22

Type: MCMA

The nurse is caring for a group of clients who are receiving chemotherapy. The nurse is preparing to administer the medications. Which medications does the nurse correctly identify as alkylating agents? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected.

1. Cisplatin (Platinol)
2. Cyclophosphamide (Cytoxan)
3. Chlorambucil (Leukeran)
4. Estramustine (Emcyt)
5. Interferon alfa-2 (Roferon A)

Cognitive Level: Remembering

Client Need: Physiological Integrity

Page Number: 473

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome:29-7 Explain the role of alkylating agents in the treatment of cancer.

Question 23

Type: MCSA

A nurse is preparing to administer an antineoplastic medication. Upon reviewing the medication administration record, the nurse does not see a medication to prevent nausea and vomiting. Which group of medications is used for this purpose?

1. Analgesics

2. Serotonin receptor antagonists

3. Hematopoietic drugs

4. Alkylating drugs

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 481

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 29-13 Explain the role of adjunct medications in treating the adverse effects of cancer chemotherapy.

Question 24

Type: MCSA

A client is undergoing antineoplastic therapy with vincristine (Oncovin). Which statement by the client understands how this medication works?

1. Vincristine affects the cells by encouraging rapid division.

2. The medication is made from plant.

3. Immunosuppression is a serious and life-threatening adverse effect.

4. Alopecia is permanent.

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 478

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 29-10 Explain the role of natural products in the treatment of cancer.

Question 25

Type: MCMA

Which groups of antineoplastic medications have been extracted from plants? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected.

1. Vinca alkaloids

2. Topoisomerase inhibitors

3. Taxanes

4. Alkylating agents

5. Antimetabolite agents

Cognitive Level: Understanding

Client Need: Physiological Integrity

Page Number: 477

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 29-10 Explain the role of natural products in the treatment of cancer.

Question 26

Type: MCSA

A client tells the nurse that they thought they were receiving cancer chemotherapy but they overheard the healthcare prescriber talking about antibiotics. Which is the nurse’s best response?

1. The antibiotics used for cancer are the same for infectious diseases.

2. The cancer antibiotics have the ability to kill cancer cells.

3. All the antitumor antibiotics interact with the RNA similar to the hormone antagonists.

4. There are limited adverse effects of the antitumor antibiotics.

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 476

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 29-9 Explain the role of cytotoxic antibiotics in the treatment of cancer.

Question 27

Type: MCSA

A client tells the nurse that they are confused by the terms benign and malignant tumors. Which best describes these terms?

1. Benign tumors grow rapidly and metastasize.

2. Malignant tumors grow slowly and do not require treatment.

3. Benign tumors need to be surgically removed and require antineoplastic therapy.

4. Malignant tumors are called cancer and become resistant to treatment.

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 468

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 29-1 Explain differences between normal cells and cancer cells.

Question 28

Type: MCMA

The nurse notes that the client is to receive radiation therapy. Which are the reasons radiation therapy is added to a cancer treatment plan? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected.

1. Used for localized tumors

2. Used for palliation to shrink tumor size pressing on organs

3. Used before cancer chemotherapy is started

4. Added to all cancer treatment plans

5. Used to kill cancer cells after surgery

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 469

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 29-3 Identify the primary goals of chemotherapy.

Question 29

Type: MCSA

The nurse explains to the client why special dosing schedules are used to treat cancer. Which is a statement the nurse would state?

1. Special dosing schedules allow for normal cells time to recover from adverse effects.

2. Schedules are very rigid and follow the same time frame for all cancers.

3. The usual pattern is 6 weeks with the medication and then 6 weeks without the medication.

4. It has been shown that the dosing schedule depends on the stage of the disease.

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 471

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 29-5 Explain how combination therapy and special dosing schedules increase the effectiveness of chemotherapy.