Question 1

The nurse is preparing to administer interleukin-2 (aldesleukin) to a patient who has cancer. The patient reports shortness of breath. The nurse assesses clear breath sounds, a respiratory rate of 22 breaths per minute, a heart rate of 80 beats per minute, an oxygen saturation of 88% on room air, and a blood pressure of 92/68 mm Hg. The nurse will perform which action?

Accepted Answer

A)   Administer the dose as ordered.
B)   Administer oxygen while giving the dose.
C)   Discuss permanently discontinuing this treatment with the provider.
D)   Hold the dose and notify the provider. D

Question 2

A patient is receiving bone marrow transplantation for cancer and receives filgrastim (Neupogen). The patient reports severe abdominal pain in the left upper quadrant. The nurse will perform which action?

Accepted Answer

A)   Administer acetaminophen 650 mg.
B)   Administer an antiemetic medication.
C)   Report a potentially life-threatening event.
D)   Request an order for cardiac enzyme levels. C

Question 3

A patient is receiving the erythropoietin-stimulating agent (ESA) epoetin alfa (Procrit). Which assessment finding would cause the nurse to notify the patient's provider?

Accepted Answer

A)   Blood pressure of 90/65 mm Hg
B)   Headache and nausea
C)   Hemoglobin >11 g/dL
D)   Infiltration of the IV C

Question 4

A patient with cancer is receiving aldesleukin. The patient reports black stools, which the nurse recognizes as:

Accepted Answer

A)   a sign of cancer metastasis.
B)   an indication of gastrointestinal bleeding.
C)   caused by inadequate hydration.
D)   renal failure.

Question 5

The nurse is preparing to give sargramostim to a patient who has acute myelogenous leukemia. The nurse assesses a heart rate of 78 beats per minute and a blood pressure of 120/70 mm Hg. The patient reports shortness of breath and has a cough and bilateral crackles. What will the nurse do next?

Accepted Answer

A)   Contact the provider; discuss giving a lower dose.
B)   Contact the pharmacist; request a bronchodilator.
C)   Contact the pharmacist; request an order for furosemide.
D)   Contact the provider; suggest administration of antibiotics.

Question 6

A patient is receiving interferon alpha (Roferon-A) subcutaneously. The patient experiences chills, fatigue, and malaise, and the nurse assesses a temperature of 102° F. The nurse will notify the provider of the temperature and will anticipate which order?

Accepted Answer

A)   Administer acetaminophen (Tylenol) .
B)   Change to intravenous (IV)  interferon alpha.
C)   Give diphenhydramine (Benadryl) .
D)   Obtain a serum blood urea nitrogen (BUN)  and creatinine level.

Question 7

Prior to administration of interferon alpha, the nurse will administer which medications?

Accepted Answer

A)   Acetaminophen and diphenhydramine
B)   Heparin and meperidine
C)   Lorazepam and furosemide
D)   Narcotic analgesics and loratadine

Question 8

A patient has been receiving an ESA for 8 weeks. The nurse reviews the patient's chart and notes no increase in hemoglobin levels from 8 g/dL on week 3 of therapy. The nurse will request an order for which of the following?

Accepted Answer

A)   a complete blood count and serum iron levels.
B)   an increased dose of the ESA.
C)   more frequent dosing of the ESA.
D)   packed red blood cell infusions.

Question 9

A patient who is receiving cancer chemotherapy has been ordered to receive epoetin alfa (Procrit) 150 units/kg 3 times weekly. The nurse reviews the patient's chart and notes a hemoglobin level of 10.9 g/dL. The nurse will perform which action?

Accepted Answer

A)   Administer the medication as ordered.
B)   Hold the dose and notify the provider.
C)   Reduce the dose by 25%.
D)   Request an order for an increased dose.

Question 10

A patient who has cancer will begin treatment with a colony-stimulating factor. The patient verbalizes understanding of why the drug is being used with which statement?

Accepted Answer

A)   "This drug permit use of higher doses of chemotherapy."
B)   "This drug has antitumor activity."
C)   "This drug has cytotoxic effects."
D)   "This drug has antiviral effects."

Question 11

Which of the following is an indication for use of IFN-ß?

Accepted Answer

A)   Chronic granulomatous disease.
B)   Hairy cell leukemia.
C)   Multiple sclerosis.
D)   Kaposi sarcoma.

Exam 34: Biologic Response Modifiers

A patient is receiving bone marrow transplantation for cancer and receives filgrastim (Neupogen) . The patient reports severe abdominal pain in the left upper quadrant. The nurse will perform which action?

A patient is receiving the erythropoietin-stimulating agent (ESA) epoetin alfa (Procrit) . Which assessment finding would cause the nurse to notify the patient's provider?