A nurse is caring for a client who has lymphoma and is receiving vincristine, prednisone, and rituximab as induction chemotherapy. The nurse should identify that vincristine can cause neurotoxicity and instruct the client to report which of the following manifestations?
Constipation, urinary retention, and abdominal distension
Hearing loss, tinnitus, and vertigo
Blurred vision, photophobia, and eye irritation
Numbness, tingling, and pain in the extremities
Headache, confusion, and altered mental status
The Correct Answer is D
Choice D reason:
These are manifestations of neurotoxicity from vincristine, which is a chemotherapy drug that belongs to the vinca alkaloids. Vinca alkaloids work by binding to tubulin and inhibiting the formation of microtubules, which are essential for cell division and function. Neurotoxicity is one of the most common and doselimiting adverse effects of vincristine, which can affect up to 80% of patients. Neurotoxicity can manifest as peripheral neuropathy, which is the damage to the nerves in the hands and feet, causing numbness, tingling, burning, or pain. The nurse should monitor the client for peripheral neuropathy and provide pain relief and supportive care as needed³.
Choice A reason:
These are not manifestations of neurotoxicity from vincristine, but rather of paralytic ileus from vincristine. Paralytic ileus is the loss of intestinal motility, causing constipation, urinary retention, and abdominal distension. Paralytic ileus is another common adverse effect of vincristine, which can affect up to 40% of patients. Paralytic ileus is caused by the inhibition of microtubules in the smooth muscle cells of the intestine and bladder, leading to reduced peristalsis and urine flow. The nurse should monitor the client for paralytic ileus and provide laxatives, catheterization, and fluids as ordered⁴.
Choice B reason:
These are not manifestations of neurotoxicity from vincristine, but rather of ototoxicity from cisplatin, which is another chemotherapy drug that is used in combination with vincristine and prednisone for lymphoma. Ototoxicity is the damage to the inner ear or hearing nerve, causing hearing loss, tinnitus, and vertigo. Ototoxicity is one of the most serious and doselimiting adverse effects of cisplatin, which can affect up to 50% of patients. Ototoxicity is caused by the accumulation of cisplatin in the cochlea and vestibular system, leading to oxidative stress and cell death. The nurse should monitor the client for ototoxicity and provide hearing tests and vestibular rehabilitation as needed .
Choice C reason:
These are not manifestations of neurotoxicity from vincristine, but rather of ocular toxicity from rituximab, which is another chemotherapy drug that is used in combination with vincristine and prednisone for lymphoma. Ocular toxicity is the damage to the eyes or vision, causing blurred vision, photophobia, and eye irritation. Ocular toxicity is a rare but serious adverse effect of rituximab, which can affect up to 1% of patients. Ocular toxicity is caused by the infusionrelated reactions or immunemediated reactions induced by rituximab, leading to inflammation and edema in the eyes. The nurse should monitor the client for ocular toxicity and provide eye drops and steroids as ordered .
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason:
Epoetin alfa (Epogen) is a drug that stimulates the production of red blood cells in the bone marrow, not platelets⁴. It is used to treat anemia caused by chemotherapy, chronic kidney disease, or other conditions.
Choice B reason:
Filgrastim (Neupogen) is a drug that stimulates the production of white blood cells in the bone marrow, not platelets⁴. It is used to prevent or treat neutropenia caused by chemotherapy, bone marrow transplant, or other conditions.
Choice C reason:
Sargramostim (Leukine) is a drug that stimulates the production of white blood cells and red blood cells in the bone marrow, not platelets⁴. It is used to prevent or treat neutropenia caused by chemotherapy, bone marrow transplant, or other conditions.
Choice D reason:
Oprelvekin (Neumega) is a drug that stimulates the production of platelets in the bone marrow⁴. It is used to prevent or treat thrombocytopenia caused by chemotherapy. It works by mimicking the action of thrombopoietin, a hormone that regulates platelet development.
Correct Answer is ["C","D"]
Explanation
Choice A reason:
Epoetin alfa (Epogen) is a drug that stimulates the production of red blood cells in the bone marrow, but not neutrophils. It is used to treat anemia caused by chemotherapy, chronic kidney disease, or other conditions.
Choice B reason:
Filgrastim (Neupogen) is a drug that stimulates the production of neutrophils in the bone marrow, but not red blood cells. It is used to prevent or treat neutropenia caused by chemotherapy, bone marrow transplant, or other conditions.
Choice C reason:
Sargramostim (Leukine) is a drug that stimulates the production of both red blood cells and neutrophils in the bone marrow. It is used to prevent or treat anemia and neutropenia caused by chemotherapy, bone marrow transplant, or other conditions.
Choice D reason:
Pegfilgrastim (Neulasta) is a drug that stimulates the production of both red blood cells and neutrophils in the bone marrow⁴. It is a longacting form of filgrastim that works in the same way but can be given less often. It is used to prevent or treat anemia and neutropenia caused by chemotherapy.
Choice E reason:
Darbepoetin alfa (Aranesp) is a drug that stimulates the production of red blood cells in the bone marrow, but not neutrophils. It is a longacting form of epoetin alfa that works in the same way but can be given less often. It is used to treat anemia caused by chemotherapy, chronic kidney disease, or other conditions.
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