Combination chemotherapy is used in the treatment of cancer because:
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Solution
Single-agent therapy produces cell lines that are resistant.
Single-agent therapy tends to produce resistant tumor cells, making remission or cure impossible.
Which of the following contributes most to the debilitation of an individual during a course of chemotherapy?
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Solution
Diarrhea
Diarrhea will cause debilitation as fluid and nutrients are lost at a time when the body most needs to be nourished.
Which of the following is the priority nursing diagnosis for a client undergoing chemotherapy?
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Solution
Decreased cardiac output
Decreased cardiac output is more important than the other choices because it can jeopardize the client’s life.
Lorraine who is on chemotherapy has a history of cardiac disease. The client is at risk for cardiac complications because:
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Solution
Oxygen-carrying capacity may be reduced.
If hemoglobin and red cell counts drop from myelosuppression, the oxygen-carrying capacity will fall, leaving the person at risk for angina.
Enrique who is under chemotherapy has the following CBC results: WBC 5000/mm3, RBC platelet 10,000/mm3. Which of the following is he at risk for?
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Solution
Bleeding
A platelet count of 10,000/mm3 means that the client does not have enough platelets to clot the blood; therefore, the possibility of bleeding is high. Choice A is a normal value of WBC. Angina would only be a risk if the client had a lower RBC count.
Nurse Pia is instructing a client receiving probenecid (Benemid), she should cover all of the following information except the need to:
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Solution
Have frequent laboratory work done.
Side effects of probenecid treatment are relatively benign, and there is no indication that there is a need for frequent laboratory evaluation.
Frequent eye examinations are recommended in clients receiving:
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Solution
chloroquine
Corneal deposits are an adverse reaction associated with chloroquine administration, necessitating frequent eye examination.
Which of the following agents can be used in treatment of rheumatoid arthritis, Sjögren’s syndrome, and SLE?
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Solution
chloroquine (Aralen)
Chloroquine has had documented success in the treatment of rheumatoid arthritis, Sjögren’s syndrome, and SLE. Auranofin and sulfasalazine are used in the treatment of rheumatoid arthritis, but none are used in the treatment of all three syndromes.
Gold compounds are contraindicated in clients with:
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Solution
Liver dysfunction
An adverse reaction to gold compounds is liver toxicity; therefore, use care in clients with preexisting liver dysfunction.
Antirheumatics are used to:
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Solution
Retard progression of joint deterioration
These drugs cannot stop the disease itself but are believed to retard or prevent the process of joint deterioration. For choice A, the inflammatory process is affected indirectly. Autoantibodies are not excreted. Disease modifying antirheumatic drugs are used in combination with NSAIDs but do not mediate their effect.
Which of the following client comments demonstrates that teaching has been successful regarding cyclosporine therapy?
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Solution
“I need to be consistent about when i take it and also monitor how much fat is in my food.”
Cyclosporines need to be taken consistently in relation to meals, and fat content should not vary to maintain serum levels.
Client teaching for mycophenolate mofetil must include instructions to:
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Solution
Practice effective contraception.
Effective contraception is essential because of the potential for teratogenic effects. It is recommended that the drug be taken on empty stomach. The drug is often given with corticosteroid. All medication should be monitored for side effects.
In a transplant client, the action of cyclosporine is to:
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Solution
Inhibit T cells in response to antigens.
The primary action of cyclosporine is to inhibit T-cell generation in response to transplant antigens.
Which of the following laboratory tests should be monitored when a client is receiving azathioprine?
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Solution
CBC
CBC will identify leukopenia, a common side effect.
Nurse Corrine may expect to administer azathioprine (Imuran) to a transplant client in which of the following conditions?
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Solution
Prevention of acute rejection
Azathioprine inhibits humoral and cellular immunity during the early stages of lymphoid differentiation and is useful in preventing the onset of acute rejection.