ATI RN
NCLEX questions on chemotherapy drugs Questions
Question 1 of 5
A 12-year-old male complains of red plaques covered by silver scales on his elbows and knees. He has one older sister with similar lesions. In each case, the lesions are worse in the winter months. His pediatrician prescribes acitretin. Which of the following may this boy experience as a result of this treatment?
Correct Answer: B
Rationale: Acitretin, a retinoid for psoriasis, commonly causes alopecia (hair loss) due to its effects on epithelial cell turnover and differentiation.
Question 2 of 5
A 35-year-old man with HIV disease presents to the emergency department with a severe headache and fever for the past 6 h. His fever was measured to be 103°F. He also has chills, stiff neck, and nausea. He is diagnosed with Cryptococcus neoformans meningitis and started on amphotericin B. What is the mechanism of action of amphotericin B?
Correct Answer: A
Rationale: Amphotericin B binds ergosterol in fungal membranes, forming pores that cause cell leakage and death, effective against Cryptococcus neoformans.
Question 3 of 5
A 21-year-old female presented to clinic for lesions on her vulva. The painful and itchy lesions have a red base and are vesicular. She recently has had a new sexual partner. The diagnosis of herpes is established and the patient is started on acyclovir. She becomes resistant to acyclovir and it therefore becomes ineffective. What is the mechanism of resistance for acyclovir?
Correct Answer: A
Rationale: Acyclovir resistance in HSV is primarily due to lack or mutation of viral thymidine kinase, preventing its phosphorylation into the active form needed to inhibit viral DNA polymerase.
Question 4 of 5
A 5-year-old male patient’s parents complain of recurring fever in their son over the course of a month. Past medical history is significant for easy bruisability. A CBC reveals a white blood cell count of 30,000 cells per microliter. A bone marrow biopsy confirms the diagnosis of acute lymphoblastic leukemia. This child is started on a chemotherapeutic regimen. Which of the following chemotherapy drugs interferes with DNA synthesis after its metabolite is incorporated into the growing DNA strand?
Correct Answer: C
Rationale: Cytarabine (ara-C) is incorporated into DNA as a false nucleotide, inhibiting DNA polymerase and chain elongation, a key mechanism in treating ALL.
Question 5 of 5
A 66-year-old man with a history of gout was recently diagnosed with non-Hodgkin’s lymphoma. Because of frequent gout attacks, he has been placed on allopurinol. He is started on medication for his lymphoma, and shortly after, he develops GI upset and elevated liver enzymes. Because of taking allopurinol, what medication should have been avoided in this patient?
Correct Answer: B
Rationale: Allopurinol inhibits xanthine oxidase, increasing 6-mercaptopurine levels (metabolized by this enzyme), leading to toxicity (GI upset, liver damage) in lymphoma treatment.