ATI RN
NCLEX questions on chemotherapy drugs Questions
Question 1 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 2 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 3 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.
Question 4 of 5
A 47-year-old woman with a rheumatoid arthritis comes to clinic for her annual visit. Her arthritis has not worsened over the past 6 months since starting on infliximab. Her arthritis is worst in the joints of her hands. After her morning stiffness ceases, she can usually go through the rest of the day with minimal pain. What is the mechanism of action of infliximab?
Correct Answer: A
Rationale: Infliximab is a monoclonal antibody that binds TNF-α, neutralizing its inflammatory effects in rheumatoid arthritis, reducing joint inflammation and pain.
Question 5 of 5
A 37-year-old man with a schizophrenia presents to the emergency room with worsening symptoms. He has been hearing voices in his head that tell him to hurt other people. He is scared by these thoughts and wants help. He is currently taking risperidone. The physician changes him to clozapine. What should the physician monitor while the patient is taking clozapine?
Correct Answer: B
Rationale: Clozapine requires monitoring of complete blood counts due to the risk of agranulocytosis, a potentially fatal drop in white blood cells, critical in schizophrenia management.