ATI RN
NCLEX questions on chemotherapy drugs Questions
Question 1 of 5
A 45-year-old man with HIV disease and herpesvirus has begun on therapy with foscarnet. The medication is administered intravenously. If serum electrolytes are drawn on this patient after 1 week of therapy, which of the following laboratory values would be expected to be abnormal?
Correct Answer: A
Rationale: Rationale: The correct answer is A) Calcium. Foscarnet is known to cause electrolyte imbalances, particularly by binding to and decreasing serum calcium levels. This occurs due to foscarnet's chelating properties, leading to hypocalcemia. Calcium is crucial for muscle function, nerve transmission, and blood clotting. Therefore, a decrease in serum calcium levels can result in muscle spasms, tetany, and cardiac arrhythmias. Option B) Chloride is incorrect because foscarnet does not directly affect chloride levels in the serum. Option C) Creatinine is incorrect as foscarnet does not impact renal function or creatinine levels directly. Option D) Glucose is incorrect as foscarnet does not interfere with glucose metabolism or levels in the body. Educational context: Understanding the side effects and potential laboratory abnormalities associated with chemotherapy drugs is crucial for nurses and healthcare professionals caring for patients undergoing such treatments. Knowledge of potential electrolyte imbalances caused by specific medications, like foscarnet in this case, is essential for monitoring and managing patients' well-being effectively. This question challenges the test-taker to apply pharmacological knowledge in a clinical scenario to ensure safe and competent patient care.
Question 2 of 5
A 63-year-old woman presents with a productive cough, shortness of breath, and fever and chills. Past medical history is significant for chronic renal disease. After a standard dose of which of the following drugs would you expect to see the greatest increase in serum drug concentration?
Correct Answer: A
Rationale: The correct answer is A) Cefepime. In this scenario, the patient has chronic renal disease, which significantly impacts drug metabolism and elimination. Cefepime is primarily eliminated through the kidneys, and in patients with renal impairment, there is a decreased clearance of the drug leading to a higher serum concentration. This can potentially increase the risk of toxicity. Option B) Cyclosporine is primarily metabolized in the liver and excreted through the bile, not significantly affected by renal impairment. Option C) Doxycycline is primarily eliminated through feces and does not undergo significant renal excretion. Option D) Erythromycin is metabolized in the liver and excreted in bile and urine, but renal impairment does not have a significant impact on its metabolism. Understanding the pharmacokinetics of drugs in patients with renal impairment is crucial for safe and effective medication management. Nurses and healthcare providers need to consider dose adjustments or alternative medications in patients with renal dysfunction to prevent adverse drug reactions. This case highlights the importance of individualized drug therapy based on a patient's renal function to ensure optimal outcomes and minimize harm.
Question 3 of 5
An 18-year-old female plans to take a mission trip to Ghana for 2 weeks during the summer following her senior year of high school. Her doctor recommends starting a regimen of mefloquine before her trip for malaria prophylaxis rather than the traditional chloroquine because of widespread resistance to chloroquine. What is the mechanism of chloroquine resistance?
Correct Answer: C
Rationale: In this scenario, the correct answer is C) Increased activity of efflux pumps. Chloroquine resistance in malaria is primarily due to the increased activity of efflux pumps in the Plasmodium parasite. These efflux pumps actively pump the drug out of the parasite's digestive vacuole, reducing the effective concentration of chloroquine within the parasite and rendering it ineffective. Option A) Antigenic variation is not relevant to the mechanism of chloroquine resistance. Option B) Chloroquine is indeed an antimalarial drug, so this statement is incorrect. Option D) Increased protozoal metabolism is also not associated with chloroquine resistance. In an educational context, understanding the mechanisms of drug resistance is crucial for healthcare professionals, especially when dealing with infectious diseases like malaria. Knowing why certain drugs become ineffective helps in making informed decisions regarding treatment options, ensuring better patient outcomes. This knowledge is particularly important for those studying for exams like the NCLEX, where a deep understanding of pharmacology is essential for providing safe and effective care to patients.
Question 4 of 5
A 24-year-old primigravid woman’s water breaks at 39 weeks gestation. Twenty-four hours later, she is having regular contractions 3 min apart. Her labor lasts 8 h. At the hospital, she gives birth to a baby boy, who initially appeared healthy. Within the next 12 h, the baby boy begins to have temperature fluctuations, difficulty breathing, and reduced movements. You suspect neonatal sepsis, so IV ampicillin is started. Which additional antibiotic could be given simultaneously to have a synergistic effect in controlling this infection?
Correct Answer: C
Rationale: In this scenario, the correct additional antibiotic to give along with IV ampicillin for neonatal sepsis is Gentamicin (Option C). Gentamicin is a broad-spectrum antibiotic that is commonly used in combination with ampicillin to cover a wider range of bacterial pathogens. This combination provides a synergistic effect, meaning that the two antibiotics work together to enhance their effectiveness in controlling the infection. Amoxicillin (Option A) and Penicillin G (Option D) are both beta-lactam antibiotics like ampicillin. Using them together would not provide the same synergistic effect as using an aminoglycoside like Gentamicin. Cephalexin (Option B) is a cephalosporin antibiotic, which is not typically used in combination with ampicillin for neonatal sepsis. Educationally, understanding the rationale behind antibiotic combinations is crucial in clinical practice, especially in scenarios like neonatal sepsis where prompt and effective treatment is vital. Knowing which antibiotics work synergistically can help healthcare providers make informed decisions to optimize patient outcomes and prevent the development of antibiotic resistance.
Question 5 of 5
A 19-year-old college student man presents to the student health service with a 2-week history of headache, malaise, sore throat, and dry cough, which has become productive over the last 4 days. He states that several of his dorm mates have complained of similar problems in the last few weeks. Pulmonary auscultation reveals scattered coarse rhonchi bilaterally. What is the best treatment for this patient?
Correct Answer: C
Rationale: In this scenario, the best treatment option for the 19-year-old college student with respiratory symptoms consistent with community-acquired pneumonia is oral erythromycin (Option C). Erythromycin is a macrolide antibiotic effective against the typical pathogens causing community-acquired pneumonia, such as Mycoplasma pneumoniae and Chlamydophila pneumoniae. Option A, Cephazolin, is a cephalosporin antibiotic typically used for gram-positive bacterial infections, not the atypical pathogens commonly associated with community-acquired pneumonia. Option B, Ciprofloxacin, is a fluoroquinolone effective against gram-negative bacteria but not the preferred choice for community-acquired pneumonia. In this educational context, understanding the appropriate selection of antibiotics based on the likely causative pathogens in pneumonia is crucial for effective treatment. Educating healthcare providers on the spectrum of activity of different antibiotics helps in making informed decisions to optimize patient outcomes and prevent antibiotic resistance. It is important to consider patient age, clinical presentation, and likely pathogens when choosing the most appropriate antibiotic therapy.