Page 1365 - Saunders Comprehensive Review For NCLEX-RN

with etoposide.
Level of Cognitive Ability: Analyzing
Client Needs: Physiological Integrity
Integrated Process: Nursing Process—Assessment
Content Area: Pharmacology: Oncology Medications: Topoisomerase Inhibitors
Health Problem: Adult Health: Cancer: Laryngeal and Lung
Priority Concepts: Cellular Regulation; Clinical Judgment
Reference: Gahart, Nazareno, Ortega (2017), pp. 548-549.

476. Answer: 3

Rationale: Because antineoplastic medications lower the resistance of the body,
clients must be informed not to receive immunizations without the PHCP’s
approval. Clients also need to avoid contact with individuals who have recently
received a live virus vaccine. Clients need to avoid aspirin and aspirin-containing
products to minimize the risk of bleeding, and they need to avoid alcohol to
minimize the risk of toxicity and side/adverse effects.
Test-Taking Strategy: Focus on the subject, client teaching about an antineoplastic
medication, and think about the side/adverse effects of antineoplastic medications.
Recalling that antineoplastic medications lower the resistance of the body will direct
you to the correct option.
Level of Cognitive Ability: Applying
Client Needs: Health Promotion and Maintenance
Integrated Process: Teaching and Learning
Content Area: Adult Health: Oncology
Health Problem: N/A
Priority Concepts: Cellular Regulation; Client Education
Reference: Lilley et al. (2017), p. 787;
www.hrsa.gov/vaccinecompensation/index.html

477. Answer: 4

Rationale: An adverse effect specific to vincristine is peripheral neuropathy,
which occurs in almost every client. Peripheral neuropathy can be manifested as
numbness and tingling in the fingers and toes. Depression of the Achilles tendon
reflex may be the first clinical sign indicating peripheral neuropathy. Constipation
rather than diarrhea is most likely to occur with this medication, although diarrhea
may occur occasionally. Hair loss occurs with nearly all antineoplastic medications.
Chest pain is unrelated to this medication.
Test-Taking Strategy: Eliminate options 1 and 2 first because they are comparable
or alike and are side/adverse effects associated with many of the antineoplastic
agents. Note that the question asks for the adverse effect specific to this medication.
Correlate peripheral neuropathy with vincristine.
Level of Cognitive Ability: Analyzing
Client Needs: Physiological Integrity
Integrated Process: Nursing Process—Assessment
Content Area: Pharmacology: Oncology Medications: Miotic Inhibitors

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