A nurse is preparing to administer topotecan IV for a client who has metastatic ovarian cancer.
Which of the following medications should the nurse expect to administer to control the adverse effects of topotecan?
Insulin lispro via subcutaneous injection.
Granisetron via transdermal patch.
Magnesium sulfate via intermittent IV bolus.
Prednisone via oral administration.
The Correct Answer is B
Choice A rationale
Insulin lispro is a rapid-acting insulin used to manage hyperglycemia in clients with diabetes mellitus. Its primary mechanism involves facilitating glucose uptake into cells and inhibiting hepatic glucose production. It does not directly mitigate the adverse effects, such as myelosuppression and gastrointestinal issues, associated with topotecan, a topoisomerase I inhibitor used in chemotherapy.
Choice B rationale
Granisetron is a serotonin 5-HT3 receptor antagonist, primarily used to prevent nausea and vomiting induced by chemotherapy. It works by blocking serotonin's action on vagal nerve terminals and in the chemoreceptor trigger zone in the brainstem. This action effectively controls a common and distressing adverse effect of topotecan, thereby improving client comfort and compliance.
Choice C rationale
Magnesium sulfate is an electrolyte replacement and smooth muscle relaxant. It is used in conditions like pre-eclampsia, eclampsia, and hypomagnesemia. Its physiological effects involve stabilizing neuronal excitability and reducing uterine contractions. It is not indicated for the management of topotecan's adverse effects, which predominantly involve myelosuppression and gastrointestinal toxicity.
Choice D rationale
Prednisone is a corticosteroid with potent anti-inflammatory and immunosuppressive properties. It is used to treat various conditions, including autoimmune disorders, allergic reactions, and some cancers. While it can reduce inflammation, it does not specifically target the common adverse effects of topotecan, such as myelosuppression and gastrointestinal disturbances.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["C","D","E"]
Explanation
Choice A rationale
An elevated troponin level indicates myocardial injury or infarction. While severe acetaminophen toxicity can rarely lead to cardiac dysfunction, it is not a primary or common finding. The main organ affected is the liver due to the formation of toxic metabolites.
Choice B rationale
Hyperglycemia is not a typical finding in acetaminophen toxicity. Liver damage can impair glucose regulation, but the immediate and common metabolic derangements are usually related to liver enzyme elevation and acid-base imbalances, not primary glucose elevation.
Choice C rationale
Increased alanine aminotransferase (ALT) level is a critical indicator of hepatotoxicity, the primary concern in acetaminophen overdose. N-acetyl-p-benzoquinone imine (NAPQI), a toxic metabolite, depletes glutathione, leading to hepatocellular necrosis and leakage of intracellular enzymes like ALT (normal range 7–55 U/L).
Choice D rationale
Abdominal discomfort is a common finding in acetaminophen toxicity, particularly as liver damage progresses. This discomfort, often described as right upper quadrant pain, results from hepatocellular injury and inflammation, potentially accompanied by hepatic swelling.
Choice E rationale
Sweating (diaphoresis) can occur as a nonspecific systemic symptom in toxicity stages, often with nausea or malaise. Monitor vital signs and symptoms for systemic involvement.Diaphoresis is a common clinical manifestation during the initial and middle stages of toxicity. It is part of the systemic metabolic stress response to the circulating toxins and early liver dysfunction.
Correct Answer is C
Explanation
Choice A rationale
Metoprolol is a beta-blocker primarily used to treat hypertension, angina, and heart failure. It works by blocking beta-adrenergic receptors, leading to decreased heart rate and blood pressure. It is not indicated for managing tremors or dyskinesias associated with levodopa/carbidopa therapy in Parkinson's disease, as these are typically dopaminergic in origin.
Choice B rationale
Bethanechol is a muscarinic cholinergic agonist that increases bladder tone and stimulates gastrointestinal motility. It is primarily used for urinary retention and gastroesophageal reflux disease. Its mechanism involves directly stimulating muscarinic receptors. It has no role in addressing the motor complications like tremors and twitching seen with levodopa/carbidopa in Parkinson's disease.
Choice C rationale
Amantadine is an antiviral drug also used to treat dyskinesia associated with levodopa therapy in Parkinson's disease. Its precise mechanism of action in Parkinson's is not fully understood, but it is thought to modulate dopaminergic and glutamatergic neurotransmission. It can help reduce tremors, rigidity, and involuntary movements.
Choice D rationale
Gabapentin is an anticonvulsant and neuropathic pain medication. It is structurally related to GABA but does not act directly on GABA receptors. Its mechanism of action involves modulating calcium channels. While it can treat some neurological symptoms, it is not a primary treatment for levodopa-induced tremors and twitching in Parkinson's disease.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today
Report Wrong Answer on the Current Question
Do you disagree with the answer? If yes, what is your expected answer? Explain.
Kindly be descriptive with the issue you are facing.