HESI-P HESI Pharmacology - Set 5 - Part 1

Correct Answer: Measure current weight and height

Chemotherapy dosing is based on total body surface area, requiring a current accurate height and weight before each medication administration. This ensures the client receives optimal therapeutic doses while protecting normal cells from excessive exposure today. Option a is incorrect because self-reported weight introduces inaccuracy that can shift body surface area calculations and produce under-dosing or toxic over-dosing. Measured values are needed each cycle, not a remembered figure from prior visits. Option b is incorrect because body mass index reflects weight relative to height squared and is used for nutritional screening. Chemotherapy doses derive from body surface area calculated from fresh measurements, not from a body mass index calculation. Option d is incorrect because abdominal girth tracks fluid retention or tumor mass but plays no role in body surface area math. It will not generate the data the dosing formula needs and would delay safe medication preparation.

Correct Answer: Pulmonary function studies

Bleomycin can cause interstitial pneumonitis that progresses to pulmonary fibrosis. Pulmonary function studies establish a baseline and detect early decline, along with lung sound assessment for dyspnea and crackles, prompting immediate discontinuation if toxicity develops. Option b is incorrect because electrocardiography monitors cardiac rhythm changes and is matched to doxorubicin or daunorubicin, not bleomycin. The chapter pairs bleomycin specifically with pulmonary toxicity, so a cardiac test would miss the priority adverse effect today. Option c is incorrect because cervical radiography images bony structures of the neck rather than alveolar function. The drug's threat is interstitial pneumonitis progressing to fibrosis, which radiography of the cervical spine cannot detect or trend during therapy. Option d is incorrect because echocardiography measures ventricular function and is used before anthracyclines that cause cardiomyopathy. It is comparable to electrocardiography i

Correct Answer: Serum uric acid level

Busulfan causes a rise in uric acid level. Hyperuricemia can produce uric acid nephropathy, renal stones, and acute kidney injury, so periodic monitoring detects the problem early and supports timely allopurinol prescription. Option a is incorrect because clotting time reflects platelet and coagulation status rather than the metabolic effect of busulfan. The chapter ties this drug to uric acid elevation, not to a coagulation derangement tracked by clotting time. Option b is incorrect because potassium levels are followed with cisplatin and several other drugs that disturb electrolytes. Busulfan is not the drug the chapter pairs with potassium disturbances, so this value would not be the specific monitor. Option c is incorrect because glucose tracking belongs with tacrolimus or atazanavir or steroid co-therapy. Hyperglycemia is not listed among busulfan derangements, so a blood glucose trend would miss the uric acid problem this drug actually produces.

Correct Answer: Orthostatic hypotension during the infusion

An adverse effect specific to etoposide is orthostatic hypotension. The drug must be infused slowly over thirty to sixty minutes to avoid hypotension, and blood pressure is monitored throughout the infusion to detect drops. Option a is incorrect because alopecia occurs broadly with nearly all antineoplastic medications and is not the etoposide-specific finding. The question asks for the effect tied to this drug, which excludes general class adverse effects shared across chemotherapy categories. Option c is incorrect because pulmonary fibrosis is the signature toxicity for bleomycin, not etoposide. The chapter pairs lung fibrosis with antitumor antibiotic therapy, so naming it for a topoisomerase inhibitor would misattribute the adverse effect. Option d is incorrect because chest pain is not listed by the chapter for etoposide and would more typically prompt evaluation for cardiac ischemia. Naming chest pain ignores the actual hemodynamic concern of orthostatic blood pressure drop.

Correct Answer: Consult provider before any immunizations

Antineoplastic medications lower body resistance, so clients must not receive immunizations without provider approval. Live virus vaccines are avoided, and clients also avoid contact with people who recently received live vaccines to reduce opportunistic infection. Option b is incorrect because aspirin must be avoided during antineoplastic therapy because of bleeding risk linked to thrombocytopenia. The chapter directs clients away from aspirin-containing products, making this statement unsafe for routine self-administration during treatment. Option c is incorrect because alcohol must be avoided during chemotherapy to minimize toxicity and side effects. Permitting evening drinks contradicts the chapter's guidance and would expose the client to additional hepatic stress while normal cells already are vulnerable. Option d is incorrect because any vaccination requires provider clearance during antineoplastic therapy because of lowered resistance. Receiving vaccines without approval r

Correct Answer: Peripheral neuropathy in extremities

Peripheral neuropathy is specific to vincristine and occurs in nearly every client. Numbness and tingling in fingers and toes appear early, and depression of the Achilles tendon reflex may be the first clinical sign. Option a is incorrect because hair loss occurs with nearly all antineoplastic medications and is not the vincristine-specific adverse effect. The question highlights what makes this drug unique, which excludes common class-wide effects shared by chemotherapy agents. Option b is incorrect because constipation rather than diarrhea is most likely with vincristine, sometimes progressing to paralytic ileus. Naming watery diarrhea reverses the bowel pattern the chapter assigns to this drug and would mislead anticipatory nursing care. Option c is incorrect because chest pain is not part of vincristine's adverse effect profile and would prompt cardiac rather than neurological work-up. The chapter pairs this drug with neuropathy and ileus, not with anginal or ischemic complain

Correct Answer: History of pancreatitis

Asparaginase is contraindicated in current or prior pancreatitis because the drug impairs pancreatic function. Pancreatic function tests are performed before therapy begins and after a week or more between doses, with monitoring for abdominal pain. Option a is incorrect because prior myocardial infarction is a cardiac concern that does not appear in the chapter as a contraindication for asparaginase. The drug's organ-specific toxicity targets the pancreas, so an unrelated cardiac history does not block administration. Option b is incorrect because diabetes mellitus is not the chapter's contraindication for asparaginase, although enzyme effects on glucose may need follow-up. The hold trigger named in the rationale is pancreatitis history, which directly affects the drug's tolerability. Option d is incorrect because chronic obstructive pulmonary disease is a respiratory diagnosis not among asparaginase contraindications. The chapter ties this drug to pancreatic toxicity, n

Correct Answer: Serum calcium level

Tamoxifen may increase calcium, cholesterol, and triglyceride levels. Baseline complete blood count, platelet count, and serum calcium are assessed before therapy, with periodic monitoring during treatment and assessment for hypercalcemia signs. Option a is incorrect because glucose tracking belongs with tacrolimus, atazanavir, or steroid co-therapy, not tamoxifen. The chapter assigns calcium, cholesterol, and triglyceride monitoring to this antiestrogen, so glucose would miss the metabolic shifts this drug produces. Option c is incorrect because potassium monitoring belongs with cisplatin and certain antifungals that disturb electrolytes broadly. Tamoxifen is not associated with potassium derangement in the chapter, so it would not be the specific value chosen for ongoing surveillance. Option d is incorrect because prothrombin time tracks warfarin or hepatic synthetic function rather than tamoxifen's metabolic profile. The chapter does not pair this drug with coagulation monitori

Correct Answer: Venous thromboembolism prior history

Megestrol acetate suppresses pituitary luteinizing hormone and shrinks tumor size. It is used with caution if the client has a history of venous thromboembolism, because hormonal manipulation raises clotting risk that compounds existing thrombotic tendency. Option a is incorrect because gout is associated with uric acid metabolism but the chapter does not flag it as a caution for megestrol acetate. The named precaution is venous thromboembolism, connecting to hormonal mechanism rather than uric acid handling. Option b is incorrect because asthma is a respiratory diagnosis that does not appear among megestrol acetate cautions. The chapter focuses on thrombotic risk for this hormonal agent, so airway disease would not prompt a hold or provider notification today. Option c is incorrect because prior myocardial infarction without active angina does not appear in the chapter as a megestrol acetate caution. The thrombotic precaution refers specifically to venous thromboembolism rather than t

Correct Answer: Stop the infusion right away

Stopping the infusion is the first action when extravasation is suspected. The nurse then notifies the provider, prepares to apply heat or ice depending on the medication, and administers a prescribed antidote into the site. Option b is incorrect because increasing the rate would push more vesicant medication into the surrounding tissue and worsen necrosis. The correct first step is to stop the flow, since flushing through extravasated tissue spreads injury rather than rinsing it. Option c is incorrect because restarting distally on the same vein routes drug through the same compromised segment and risks new extravasation. The infusion must be stopped first, and any new access should be in a different limb or site. Option d is incorrect because applying pressure is not the chapter's named action and may force vesicant deeper into subcutaneous tissue. Stopping the infusion comes first, followed by site-specific heat or ice and prescribed antidote injection per the protocol.

Correct Answer: Increased serum uric acid level

Rapid destruction of cells from antineoplastic therapy releases uric acid into the bloodstream. The chapter notes that allopurinol may be prescribed to lower the serum uric acid level and prevent uric acid nephropathy or stones. Option a is incorrect because anemia reflects suppressed erythrocyte production by bone marrow effects, not the immediate uric acid release from tumor lysis. The chapter pairs cell destruction with uric acid elevation as the unique laboratory marker for that mechanism. Option b is incorrect because decreased platelets reflect bone marrow suppression and trigger bleeding precautions rather than represent massive cell destruction. The destruction-specific marker per the chapter is uric acid elevation, not the thrombocytopenia caused by marrow effects. Option d is incorrect because low white blood cell count reflects neutropenic suppression of marrow and triggers infection precautions. Leukopenia tracks a different chemotherapy consequence and would direct isolati

Correct Answer: Increase fluid intake to three liters

Cyclophosphamide and ifosfamide can cause hemorrhagic cystitis. Clients are encouraged to drink two to three liters of fluid daily during therapy, unless contraindicated, to dilute urinary exposure and reduce bladder irritation from metabolites. Option a is incorrect because oral cyclophosphamide is actually administered without food per the chapter. Pairing the dose with a meal contradicts the stated administration guidance and does not address the bladder protection concern that drives the priority instruction. Option b is incorrect because sodium reduction is not a chapter directive for cyclophosphamide therapy. The priority safety teaching addresses bladder protection through high fluid intake, not dietary sodium adjustment, which would not affect hemorrhagic cystitis development. Option c is incorrect because potassium loading does not protect bladder mucosa from the metabolites that drive hemorrhagic cystitis. Generous fluid intake dilutes urinary exposure and is the actual home

Correct Answer: Crackles on lung auscultation

Daunorubicin can cause heart failure and dysrhythmias. Crackles on auscultation along with dyspnea, peripheral edema, and weight gain signal fluid overload from cardiac dysfunction, which the nurse must report promptly so dose modification can occur. Option b is incorrect because fever from leukopenia occurs with nearly all chemotherapy agents and is not specific to daunorubicin. The chapter directs the nurse to heart failure findings as the unique surveillance focus for this antitumor antibiotic. Option c is incorrect because mouth sores reflect stomatitis common across antineoplastic classes and not the daunorubicin-specific concern. The drug's signature adverse effect is cardiotoxicity, so monitoring is anchored on heart failure findings rather than oral mucosa. Option d is incorrect because nausea and vomiting occur with most chemotherapy agents and do not single out daunorubicin's risk. The specific concern is cardiac dysfunction with crackles and edema, which would prom

Correct Answer: Platelet count of fifty thousand

A platelet count below fifty thousand allows minor trauma to cause prolonged bleeding, and a count below twenty thousand can produce spontaneous uncontrollable bleeding. The medication may be withheld and the provider notified once thresholds are crossed. Option a is incorrect because five thousand is within the normal white blood cell range and does not indicate bleeding risk. White cell counts inform neutropenic precautions rather than bleeding precautions, so this value would not change the precaution status. Option c is incorrect because ammonia elevation reflects hepatic dysfunction and is not the chapter's trigger for bleeding precautions. The threshold for bleeding precautions is anchored to platelet count, so ammonia would not direct the nursing action requested. Option d is incorrect because clotting time of ten minutes by itself is not the chapter's bleeding precaution trigger. The chapter sets thresholds based on platelet count rather than clotting time, so this va

Correct Answer: Treats and prevents breast cancer

Tamoxifen competes with estradiol for binding to estrogen receptors in tissues with high receptor concentration. It treats metastatic breast carcinoma in women and men, delays recurrence after mastectomy, and prevents breast cancer in high risk individuals. Option a is incorrect because the closed-ended word only ignores tamoxifen's role in preventing recurrence and reducing risk in high-risk clients. The drug has a wider indication than treatment alone, so this statement misrepresents the chapter's described use. Option b is incorrect because bladder cancer is not an indication for tamoxifen because the drug acts on hormone-sensitive breast tissue rather than urothelial cells. Recommending it for bladder cancer would mislead the family member about appropriate use. Option d is incorrect because tamoxifen is not a universal cancer therapy and works only in tumors with estrogen receptors. Telling the family that any cancer client could take it ignores the receptor-specific mec

Correct Answer: Leucovorin for rescue therapy

When methotrexate is given in large doses, leucovorin is administered as prescribed to prevent toxicity. This protocol is known as leucovorin rescue and protects normal cells from prolonged methotrexate exposure while allowing antineoplastic effect on tumor cells. Option b is incorrect because mesna is given with ifosfamide to reduce hemorrhagic cystitis, not with methotrexate. The chapter pairs mesna with urotoxic alkylating drugs rather than antimetabolites, so it would not be the protective agent for methotrexate. Option c is incorrect because allopurinol lowers serum uric acid after rapid cell destruction releases purines into the bloodstream. It is not the specific rescue agent paired with methotrexate, which uses leucovorin to limit toxicity from prolonged drug exposure. Option d is incorrect because dexrazoxane is the cardioprotective agent given with doxorubicin to reduce cardiomyopathy risk. It is not the rescue medication for methotrexate, which has its own dedicated rescue p

Correct Answer: Tinnitus and numbness in extremities

Cisplatin can cause ototoxicity, tinnitus, hypokalemia, hypocalcemia, hypomagnesemia, and nephrotoxicity. The nurse assesses for dizziness, tinnitus, hearing loss, incoordination, and numbness or tingling in extremities, then reports findings promptly. Option a is incorrect because hemorrhagic cystitis and hematuria belong to cyclophosphamide and ifosfamide rather than cisplatin. The chapter assigns cisplatin its own profile of ototoxicity and electrolyte loss, so naming bladder toxicity would misroute the assessment focus. Option b is incorrect because heart failure and dysrhythmias belong with daunorubicin and the related anthracyclines. Cisplatin is paired with hearing changes and electrolyte disturbance, so cardiac surveillance would not capture the drug-specific adverse profile required. Option c is incorrect because constipation and paralytic ileus belong with vincristine and the vinca alkaloid class. Cisplatin's signature concerns are auditory and renal, so bowel changes wo

Correct Answer: Assess respiratory status of client

Airway and breathing assessment comes first when anaphylaxis is suspected. The nurse then stops the medication, contacts the provider and rapid response team, administers oxygen, maintains intravenous access with normal saline, and gives prescribed epinephrine. Option a is incorrect because documentation occurs after the emergency response stabilizes the client. Charting comes last in the priority sequence so that critical airway, breathing, and circulation actions are completed before time is spent on records. Option c is incorrect because epinephrine is administered after the nurse assesses respiratory status, stops the drug, calls for help, and provides oxygen. It is a later step in the protocol rather than the first action when anaphylaxis is recognized. Option d is incorrect because raising the legs supports perfusion and follows the earlier steps of assessment, drug discontinuation, provider notification, oxygen, and intravenous maintenance. It is not the first action in the chap

Correct Answer: Speeds bone marrow recovery after suppression

Colony-stimulating factors induce more rapid bone marrow recovery after suppression by chemotherapy. They support faster return of neutrophils, allowing the next planned cycle to begin on schedule and reducing the window of severe neutropenic infection risk. Option a is incorrect because colony-stimulating factors do not act on cancer cells directly. They restore marrow output rather than provide tumor cytotoxicity, so explaining them as a cancer treatment would mislead the client about how this support medication works. Option b is incorrect because lowering uric acid after rapid cell destruction is the role of allopurinol, not colony-stimulating factors. The chapter assigns marrow recovery as the support-drug purpose, while purine load is managed by a different prescription category. Option d is incorrect because cardiac protection during anthracycline therapy is provided by dexrazoxane rather than colony-stimulating factors. The chapter pairs marrow recovery with these growth factor

Correct Answer: Use sunscreen and protective clothing

When administering fluorouracil or methotrexate, the client is instructed to use sunscreen and wear protective clothing to prevent photosensitivity reactions. Routine sun exposure during therapy can cause severe skin reactions that disrupt the planned treatment course. Option b is incorrect because limiting fluids would worsen renal handling of antimetabolites and is opposite to the hydration goal. Fluid intake of two thousand milliliters daily is encouraged to maintain renal function rather than restricted during sun exposure. Option c is incorrect because complete avoidance of outdoors is unnecessary and unrealistic for most clients receiving these antimetabolites. The chapter's guidance is sunscreen and protective clothing, allowing reasonable activity while reducing the chance of photosensitivity skin reactions. Option d is incorrect because stopping the medication on sunny days is not the chapter's recommendation and would interrupt the planned chemotherapy schedule. Pho