Chapter 38: Targeted Therapies to Treat Cancer Nursing School Test Banks

Chapter 38: Targeted Therapies to Treat Cancer
Test Bank

MULTIPLE CHOICE

1. The nurse is teaching a patient who will begin receiving targeted therapy for cancer. The patient asks how targeted therapy differs from other types of chemotherapies. The nurse will explain that targeted therapy
a. damages cancer cell DNA to prevent cell replication.
b. directly kills or damages cancerous cells.
c. interferes with specific molecules in cancer cells.
d. prevents metastasis of cancer cells.
ANS: C
Targeted therapy differs from traditional cancer chemotherapy by taking advantage of biologic features particular to cancer cells and targeting specific mechanisms. They block the growth and spread of cancer by interfering with specific molecules within the cancer cells. Traditional chemotherapeutic agents damage cell DNA of cancer cells as well as normal cells. Targeted therapies do not directly kill or damage cancer cells or prevent metastasis.

DIF: COGNITIVE LEVEL: Understanding (Comprehension) REF: Page 531
TOP: NURSING PROCESS: Nursing Intervention: Patient Teaching
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

2. A patient who has breast cancer tells the nurse that a cousin who had breast cancer received trastuzamab (Herceptin) and wonders why this drug is not given to her. The nurse will explain that her cancer cells do not have
a. significant HER2 receptors.
b. epidermal growth factor receptor-tyrosine kinase.
c. the BRCA1 suppressor gene.
d. VGEF proteins.
ANS: A
Trastuzamab acts by binding to the HER2 protein on the surface of cancer cells that overexpress this receptor. If patients do not have this overexpression, this targeted therapy will not work. Gefitinib is used when EGFR-TK are present. Bevacizumab is used when VGEF proteins are present.

DIF: COGNITIVE LEVEL: Understanding (Comprehension) REF: Page 531
TOP: NURSING PROCESS: Nursing Intervention: Patient Teaching
MSC: NCLEX: Physiological Integrity: Pathophysiology

3. The nurse is performing a history on a patient who will begin taking bevacizumab (Avastin). Which aspect of the patients history should be reported to the oncologist treating this patient?
a. History of hepatitis
b. Hypertension
c. Recent surgical history
d. Weight loss
ANS: C
Bevacizumab carries a boxed warning for gastrointestinal perforations, wound dehiscence, impaired wound healing, hemorrhage, and fistula formation after surgery. The drug should not be used within 28 days after major surgery.

DIF: COGNITIVE LEVEL: Applying (Application) REF: Page 544
TOP: NURSING PROCESS: Assessment/Planning
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

4. The patient asks the nurse what apoptosis means. The nurse will explain that apoptosis refers to
a. alteration of cellular functions.
b. inhibition of cell division.
c. prevention of cell phase progression.
d. slow, planned cellular death.
ANS: D
Apoptosis is programmed cell death, designed to ensure that tissues contain only healthy and optimally functional cells.

DIF: COGNITIVE LEVEL: Remembering (Knowledge) REF: Page 533
TOP: NURSING PROCESS: Nursing Intervention: Patient Teaching
MSC: NCLEX: Physiological Integrity: Pathophysiology

5. The nurse is preparing to administer intravenous monoclonal antibodies to a patient who has cancer. What is an important nursing action for this patient?
a. Having resuscitation equipment readily available
b. Monitoring the patients renal function during the infusion
c. Observing the patient closely for development of a rash
d. Performing careful intake and output
ANS: A
When administering monoclonal antibodies intravenously, resuscitation equipment should be nearby, and nurses should stay with the patient for the first 15 minutes of the infusion.

DIF: COGNITIVE LEVEL: Applying (Application) REF: Page 545
TOP: NURSING PROCESS: Nursing Intervention
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

6. The nurse performs a medication history on a patient who will begin targeted therapy for cancer with gefitinib (Iressa). The nurse learns that the patient is taking carbamazepine, a histamine2 blocker, and warfarin. The nurse will anticipate that the provider will make which change to the medication regimen?
a. decrease the gefitinib dose.
b. decrease the warfarin dose.
c. increase the histamine2 blocker dose.
d. increase the carbamazepine dose.
ANS: B
When patients taking warfarin take gefitinib, the effectiveness of the warfarin is greatly increased, and bleeding risks increase. Carbamazepine and histamine2 blockers decrease the effectiveness of gefitinib, so decreasing the gefitinib dose or decreasing the carbamazapine or histamine2 blocker is not recommended.

DIF: COGNITIVE LEVEL: Applying (Application) REF: Page 545
TOP: NURSING PROCESS: Assessment/Planning
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

7. The nurse is preparing to administer intravenous temsirolimus (Torisel). To prevent a common adverse drug effect, the nurse will expect to administer which type of drug?
a. An antibiotic
b. An anticoagulant
c. An antiemetic
d. An antihistamine
ANS: D
Hypersensitivity reactions to temsirolimus are common, and pretreatment with antihistamines is recommended. Other drugs are given as needed but not prophylactically.

DIF: COGNITIVE LEVEL: Applying (Application) REF: Page 547
TOP: NURSING PROCESS: Nursing Intervention
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

8. A patient who is taking the tyrosine kinase inhibitor sunitinib (Sutent) calls to report red, painful, and swollen palms and soles of feet. The nurse will perform which action?
a. Notify the patients provider of this adverse reaction.
b. Reassure the patient that these are common side effects.
c. Recommend taking acetaminophen for discomfort.
d. Suggest taking diphenhydramine to help with the swelling.
ANS: A
The nurse should notify the provider if the patient reports these symptoms, since they may indicate erythrodysesthesia. Reassuring the patient or recommending OTC treatments is not indicated.

DIF: COGNITIVE LEVEL: Applying (Application) REF: Page 542
TOP: NURSING PROCESS: Evaluation
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

9. The nurse is preparing to give a dose of dasatinib (Sprycel) to a patient. The nurse notes that the patient has just completed a meal. The tablet is in the packaging but is broken in two pieces. What is the correct action by the nurse?
a. Administer the medication with an antacid.
b. Return the tablet to the pharmacy.
c. Wait for 2 hours before giving the medication.
d. Wear gloves when handling the tablet.
ANS: D
Because the contents of the tablet are toxic, nurse should wear gloves if the tablets are crushed or broken. If patients are taking antacids, the medication should be given 2 hours before or after the antacid. The medication should be given with meals.

DIF: COGNITIVE LEVEL: Applying (Application) REF: Page 535
TOP: NURSING PROCESS: Nursing Intervention
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

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