A nurse is educating a client who has breast cancer and is receiving paclitaxel, a natural product, as part of chemotherapy. The nurse should instruct the client to report which of the following manifestations that indicate peripheral neuropathy?
"I have trouble hearing highpitched sounds."
"I have chest pain and shortness of breath."
"I have numbness and tingling in my hands and feet."
"I have redness and swelling at the infusion site."
The Correct Answer is C
Choice A reason: Hearing loss is not a common side effect of paclitaxel, a natural product that interferes with the growth of cancer cells. Hearing loss may be caused by other factors, such as aging, exposure to loud noises, or ear infections.
Choice B reason: Chest pain and shortness of breath are not signs of peripheral neuropathy, but may indicate cardiac or pulmonary problems. Paclitaxel can cause hypersensitivity reactions, such as flushing, rash, and dyspnea, but these usually occur during or shortly after the infusion.
Choice C reason: Numbness and tingling in the hands and feet are symptoms of peripheral neuropathy, which is a common adverse effect of paclitaxel. Peripheral neuropathy is a condition that affects the nerves that carry messages to and from the brain and spinal cord. Paclitaxel can damage these nerves and cause sensory changes, such as numbness, tingling, burning, or pain. The client should report these symptoms to the provider, as they may require dose adjustment or discontinuation of the drug.
Choice D reason: Redness and swelling at the infusion site are not signs of peripheral neuropathy, but may indicate phlebitis or infiltration. Phlebitis is inflammation of the vein, which can cause pain, warmth, and redness along the vein. Infiltration is leakage of the drug into the surrounding tissue, which can cause swelling, pain, and skin damage. The nurse should monitor the infusion site for these complications and stop the infusion if they occur.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason: Cyclophosphamide is an alkylating agent that can cause damage to the kidneys and bladder, leading to nephrotoxicity and hemorrhagic cystitis. Nephrotoxicity is the impairment of kidney function due to exposure to toxic substances, and hemorrhagic cystitis is the inflammation and bleeding of the bladder wall. The nurse should monitor the client's urine output, specific gravity, blood urea nitrogen, creatinine, and urinalysis for signs of renal impairment and hematuria. The nurse should also encourage the client to drink plenty of fluids, administer mesna (a protective agent), and alkalinize the urine to prevent these complications .
Choice B reason: Cardiotoxicity and extravasation injury are not common adverse effects of cyclophosphamide. Cardiotoxicity is the damage to the heart muscle caused by certain drugs, such as anthracyclines (e.g., doxorubicin) or trastuzumab. Extravasation injury is the leakage of a vesicant drug (a drug that causes tissue damage) into the surrounding tissues, causing pain, swelling, necrosis, and infection. Cyclophosphamide is not a vesicant drug, but vinca alkaloids (e.g., vincristine) or platinum compounds (e.g., cisplatin) are .
Choice C reason: Peripheral neuropathy and pulmonary fibrosis are not common adverse effects of cyclophosphamide. Peripheral neuropathy is the damage to the nerves of the peripheral nervous system, causing numbness, tingling, pain, or weakness in the hands or feet. Pulmonary fibrosis is the scarring of the lung tissue, causing shortness of breath, cough, and reduced oxygen levels. These complications are more likely to occur with drugs such as taxanes (e.g., paclitaxel) or bleomycin .
Choice D reason: Hepatotoxicity and gastrointestinal toxicity are not specific adverse effects of cyclophosphamide. Hepatotoxicity is the damage to the liver cells caused by certain drugs, such as methotrexate or acetaminophen. Gastrointestinal toxicity is the irritation of the mucous membranes of the digestive tract, causing nausea, vomiting, diarrhea, or mucositis. These side effects can occur with many chemotherapy drugs, but they are not unique to cyclophosphamide .
Correct Answer is C
Explanation
Choice A reason: Blocking the estrogen receptors on the cancer cells and inhibiting their growth is the mechanism of action of tamoxifen, a selective estrogen receptor modulator (SERM) that is used to treat breast cancer. Tamoxifen is not effective for prostate cancer, which is stimulated by testosterone, not estrogen.
Choice B reason: Stimulating the production of testosterone and increasing the sensitivity of the cancer cells to chemotherapy is not the mechanism of action of leuprolide, a hormone that is used to treat prostate cancer. Leuprolide does not increase testosterone, but decreases it. Increasing testosterone would worsen prostate cancer, not improve it.
Choice C reason: Suppressing the secretion of luteinizing hormone and reducing the level of testosterone is the mechanism of action of leuprolide, a gonadotropinreleasing hormone (GnRH) agonist that is used to treat prostate cancer. Leuprolide binds to the GnRH receptors in the pituitary gland and initially stimulates the release of luteinizing hormone (LH) and folliclestimulating hormone (FSH). However, with continuous administration, leuprolide desensitizes the receptors and inhibits the secretion of LH and FSH. This leads to a decrease in the production of testosterone by the testes, which reduces the growth of prostate cancer cells.
Choice D reason: Altering the metabolism of cortisol and inducing apoptosis of the cancer cells is not the mechanism of action of leuprolide, a hormone that is used to treat prostate cancer. Leuprolide does not affect cortisol, but testosterone. Cortisol is a glucocorticoid hormone that regulates stress response, inflammation, and metabolism. Apoptosis is a process of programmed cell death that can be triggered by some chemotherapy drugs, such as cisplatin and doxorubicin.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today