A nurse on an oncology unit is preparing to administer doxorubicin to a client who has breast cancer. Prior to beginning the infusion, the nurse verifies the client's current cumulative lifetime dose of the medication. For which of the following reasons is this verification necessary?

Exceeding the lifetime cumulative dose limit of doxorubicin might cause extravasation.

Exceeding the lifetime cumulative dose limit of doxorubicin might produce red tinged urine and sweat.

An excess amount of doxorubicin can lead to cardiomyopathy.

An excess amount of doxorubicin can lead to myelosuppression.

Answer and Explanation

The Correct Answer is C

Choice A reason: This is incorrect because extravasation is not related to the lifetime cumulative dose limit of doxorubicin, but to the leakage of the medication from the vein into the surrounding tissue. Extravasation can cause severe tissue damage and necrosis, and should be prevented by using a central venous catheter and monitoring the infusion site.

Choice B reason: This is incorrect because red tinged urine and sweat are not related to the lifetime cumulative dose limit of doxorubicin, but to the normal excretion of the medication from the body. Red tinged urine and sweat are expected side effects of doxorubicin and do not indicate toxicity or harm.

Choice C reason: This is correct because an excess amount of doxorubicin can lead to cardiomyopathy, which is a serious and potentially fatal complication of the medication. Cardiomyopathy is a condition in which the heart muscle becomes weak and unable to pump blood effectively. The risk of cardiomyopathy increases with the cumulative lifetime dose of doxorubicin, which should not exceed 450 to 550 mg/m2.

Choice D reason: This is incorrect because myelosuppression is not related to the lifetime cumulative dose limit of doxorubicin, but to the dose-dependent effect of the medication on the bone marrow. Myelosuppression is a condition in which the production of blood cells is reduced, leading to anemia, leukopenia, and thrombocytopenia. Myelosuppression can be managed by adjusting the dose and frequency of doxorubicin and monitoring the blood counts.

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Correct Answer is C

Explanation

Choice A reason: This is not a problem for a client who has hypertension and a new prescription for metoprolol, as metoprolol is a beta-blocker that can reduce the workload of the heart and improve the symptoms of heart failure.

Choice B reason: This is not a problem for a client who has hypertension and a new prescription for metoprolol, as metoprolol does not have any significant interactions with antibiotics or other medications used to treat pneumonia.

Choice C reason: This is a problem for a client who has hypertension and a new prescription for metoprolol, as tadalafil is a phosphodiesterase-5 inhibitor that can lower the blood pressure and cause hypotension when taken with metoprolol. The nurse should investigate further and notify the provider of the potential interaction.

Choice D reason: This is not a problem for a client who has hypertension and a new prescription for metoprolol, as metoprolol does not affect the blood glucose levels or the management of diabetes.

A. The client has a history of hypertension. B. The client has a history of hypothyroidism. C. The client has a history of bronchial asthma. D. The client has a history of migraine headaches.

Correct Answer is C

Explanation

Choice A reason: The client has a history of hypertension is not the correct answer. Hypertension is a condition in which the blood pressure is abnormally high, usually above 140/90 mmHg. Propranolol is a beta-blocker that lowers the blood pressure and reduces the workload of the heart. Propranolol is indicated for the treatment of hypertension and angina pectoris, which is a type of chest pain caused by reduced blood flow to the heart. The nurse does not need to report this finding to the provider, as it is consistent with the prescription.

Choice B reason: The client has a history of hypothyroidism is not the correct answer. Hypothyroidism is a condition in which the thyroid gland does not produce enough thyroid hormones, which regulate the metabolism and energy levels. Propranolol can mask some of the signs of hypothyroidism, such as tachycardia, tremors, and anxiety. Propranolol can also interfere with the absorption and conversion of thyroid hormones. The nurse should monitor the client's thyroid function tests and report any abnormal values to the provider, but this finding is not a contraindication to the use of propranolol.

Choice C reason: The client has a history of bronchial asthma is the correct answer. Bronchial asthma is a chronic inflammatory disorder of the airways that causes wheezing, coughing, and shortness of breath. Propranolol is a non-selective beta-blocker that blocks the beta-1 receptors in the heart and the beta-2 receptors in the lungs. Blocking the beta-2 receptors can cause bronchoconstriction, which can worsen the symptoms of asthma and trigger an asthma attack. Propranolol is contraindicated in clients who have bronchial asthma, and the nurse should report this finding to the provider immediately.

Choice D reason: The client has a history of migraine headaches is not the correct answer. Migraine headaches are recurrent episodes of severe and throbbing pain, usually on one side of the head, that can be accompanied by nausea, vomiting, and sensitivity to light and sound. Propranolol is effective in preventing migraine headaches, as it reduces the frequency and severity of the attacks. Propranolol is indicated for the prophylaxis of migraine headaches, and the nurse does not need to report this finding to the provider, as it is consistent with the prescription.

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A nurse on an oncology unit is preparing to administer doxorubicin to a client who has breast cancer. Prior to beginning the infusion, the nurse verifies the client's current cumulative lifetime dose of the medication. For which of the following reasons is this verification necessary?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is reviewing the medical record of a client who has hypertension and a new prescription for metoprolol. Which of the following findings should the nurse investigate further?

Correct Answer is C

Explanation

A nurse is reviewing the health history for a client who has angina pectoris and a prescription for propranolol hydrochloride PO 40 mg twice daily. Which of the following findings in the history should the nurse report to the provider?

Correct Answer is C

Explanation

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