NURS 6521- ADVANCED PHARMACOLOGY FINAL EXAM-with 100% verified solutions-2023-2024, Exams of Health sciences

Download NURS 6521- ADVANCED PHARMACOLOGY FINAL EXAM-with 100% verified solutions-2023-2024 and more Exams Health sciences in PDF only on Docsity! NURS 6521- ADVANCED PHARMACOLOGY FINAL EXAM-with 100% verified solutions-2023-2024 NURS 6521 – WEEK 9 QUIZ 1. A nurse is administering rituximab to a patient via the IV route. The nurse will set the IV pump at 50mg/hour for the first half hour of the initial infusion. If there are not apparent reactions after 30 minutes of the infusion, the nurse will increase the dosage every 30 minutes by 50mg/hour until the maximum infusion rate reaches which of the following? – 400mg/hour 2. 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 disease? – Non-Hodgkin’s lymphoma 3. A 62 year old patient taking tamoxifen exhibits increased bone and tumor pain along with a local disease flare. The nurse interprets this as an indication of which of the following? – A tumor responding to treatment 4. A nurse has been assigned to a female patient who is to begin chemotherapy. The nurse will initiate the prescribed oprelvekin therapy: - 6 to 24 hours after therapy 5. 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? – Fluid retention/weight gain 6. A nurse educator who coordinates the staff education on an oncology unit is conducting an inservice on targeted therapies. What potential benefit of targeted therapies should the nurse highlight in this education session? – Targeted therapies have the potential to damage cancerous cells while leaving normal body cells less affected 7. A patient has completed 4 weeks of treatment with epoetin alfa. Which of the following assessment findings would most strongly indicate the treatment has been effective? – The patient’s hemoglobin level is 11 g/dL 8. 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? - Ensure that the patient maintains a normal fluid and electrolyte balance 9. During ongoing assessment of a patient receiving 5-FU therapy, the nurse finds the patient’s platelet count to be 92,000 cells/mm. The nurse should do which of the following? – The drug should be discontinued of the patient’s platelet count is less than 100,000 cells/mm 10. A patient will soon begin targeted therapy as a component of her treatment plan for chronic leukemia. The nurse is conducting health education about this new aspect of the patient’s drug regimen and the patient has asked about the potential side effects of treatment. How should the nurse best respond? – Both classes of drugs have adverse effects, but targeted therapies tend to have less of an effect on healthy body cells 32. 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: - Perform relaxation techniques after the treatments 33. 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? – Risk for infection related to suppressed bone marrow function 34. A nurse is to use a single dose 1mL vial to administer 0.5mL of epoetin alfa to a 39 year old woman who is being treated for chemotherapy-induced anemia. Which of the following will the nurse do with the unused portion of the drug? – Discard the unused portion of the drug 35. 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? – Shortly after the initiation of the first infusion of rituximab 36. A patient with a diagnosis of chronic myeloid leukemia has met with her oncologist, who has recommended treatment with kinase inhibitor imatinib. What route of administration should the nurse explain to the patient? – Oral administration of imatinib in a home setting 37. 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? – The patient’s bone marrow function is significantly depressed 38. 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? – By inactivating clotting factors and thus stopping the coagulation cascade • Question 1 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 2 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 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 1 out of 1 points 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 Response Feedback: Rituximab is not recommended for use in pregnancy or when women are lactating. The patient should consequently be advised to continue using birth control for the duration of treatment. • Question 5 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 6 1 out of 1 points Which of the following patients will be at the greatest risk for anemia and would be the most likely candidate for epoetin alfa therapy? Response Older adults who have cancer and are receiving chemotherapy are Feedback: especially vulnerable to the adverse effects of anemia as a result of chemotherapy and would therefore be the most likely candidates for epoetin alfa therapy. Young adults over age 18, pregnant women, and patients with a high white blood cell count are not as vulnerable to anemia and would not require epoetin alfa therapy. • Question 7 1 out of 1 points A nurse is administering rituximab to a patient via the IV route. The nurse will set the IV pump at 50 mg/hour for the first half hour of the initial infusion. If there are not apparent reactions after 30 minutes of the infusion, the nurse will increase the dosage every 30 minutes by 50 mg/hour until the maximum infusion rate reaches which of the following? Response Feedback: Infusion-related effects occur in 80% of patients within 30 minutes to 2 hours after the first rituximab infusion, but the severity of most reactions dissipates when the infusion rate is slowed or interrupted. Reactions may be related to dose, so it is advisable not to exceed the maximum infusion rate of 400 mg/hour. • Question 8 1 out of 1 points A patient will soon begin targeted therapy as a component of her treatment plan for chronic leukemia. The nurse is conducting health education about this new aspect of the patient's drug regimen and the patient has asked about the potential side effects of treatment. How should the nurse best respond? Response Feedback: Targeted therapies are generally considered to be less toxic than traditional chemotherapy drugs. However, adverse reactions to targeted therapies can occur such as severe skin reactions, GI toxicities, skin reactions, and thrombosis. • Question 9 1 out of 1 points 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 Response Feedback: The nurse can relieve the discomfort of infusion by slowing the infusion, increasing the volume used for dilution, and increasing the total volume of the primary IV infusion. Giving 2 units of bleomycin before administering carmustine would not help relieve discomfort. • Question 10 1 out of 1 points 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 Response The nurse should explain to the patient that many patients experience • Question 18 1 out of 1 points 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? Response Feedback: Like many cancer treatments, imatinib causes bone marrow suppression that creates a consequent risk of infection. The drug does not typically result in cognitive changes, fluid overload, or skin breakdown. • Question 19 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 20 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 21 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 22 1 out of 1 points 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? Response Feedback: In patients with cancer, epoetin alfa should only be used when anemia is due to concomitant myelosuppressive chemotherapy and should be discontinued when the chemotherapy course is completed. The use of epoetin alfa during cancer may shorten survival and/or increase the risk of tumor progression or recurrence. Patients with cancer are also at risk for serious cardiovascular and thrombovascular events. Consequently, the benefits of treatment must be considered in light of these potentially adverse effects. • Question 23 1 out of 1 points A 67-year-old man who is being treated for prostate cancer is taking epoetin alfa. The nurse will instruct the patient to Response Feedback: After each dose adjustment, the nurse should ensure that the patient makes an appointment to have the hemoglobin measured twice a week for at least 2 to 6 weeks to verify that it is in the normal range. A high WBC count and hypertension have not been identified as adverse effects of epoetin alfa. • Question 24 1 out of 1 points A patient with chronic heart failure has begun treatment with epoetin alfa, which she will receive in her own home from a home health nurse. The nurse should teach the patient to supplement this treatment with a diet that is high in Response Feedback: Patients receiving epoetin alfa should maintain adequate iron intake, which may aid in the effectiveness of epoetin alfa. Foods high in iron include green leafy vegetables, beans, and organ meats. • Question 25 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 26 1 out of 1 points 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? Response Feedback: Patients with hypomagnesemia, or low magnesium levels, should increase their dietary intake of magnesium. Dark chocolate is high in magnesium and will help offset losses from the cisplatin therapy. Calcium and magnesium compete to gain entrance into the intestines, so calcium-rich foods should be limited. Consumption of potassium- rich foods would have no effect on the patient's magnesium levels. The incidence of hemorrhagic cystitis can be reduced by a vigorous hydration regimen of at least 2 to 3 liters of fluid a day, but this would not help control symptoms of hypomagnesemia. • Question 27 1 out of 1 points A patient's current course of cancer treatment involves the administration of a conjugated monoclonal antibody. What characteristic of the drug is specified by the fact that it is classified as a conjugated drug? Response Feedback: Monoclonal antibodies can be conjugated, meaning that they are combined with another substance such as radiation or a toxic drug that then produces indirect cell destruction as the conjugate infiltrates the cell. A conjugated drug is not necessarily derived from nonhuman sources, and it does not possess the ability to modify pharmacokinetics. • Question 28 1 out of 1 points A nurse is to use a single-dose 1 mL vial to administer 0.5 mL of epoetin alfa to a 39- year-old woman who is being treated for chemotherapy-induced anemia. Which of the following will the nurse do with the unused portion of the drug? Response Feedback: The single-dose 1-mL vial does not have preservatives. In order to prevent contamination, the nurse will discard the unused portion of the drug. A 2-mL vial does have preservatives and would be stored at 2°C to 8°C to be used again. The 2-mL vial should be discarded 21 days after initial entry to prevent use of a possibly contaminated product. • Question 29 0 out of 1 points 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? Response Feedback: The drug should be discontinued if the patient's platelet count is less than 1,00,000 cells/mm 3 because it indicates that the patient has developed thrombocytopenia. Increasing the dosage or continuing the therapy with a decreased dosage is not appropriate.