Author Question: A 43-year-old patient with a strong family history of breast cancer considers taking tamoxifen ... (Read 60 times)

nummyann · **on:** Jul 23, 2018

A 43-year-old patient with a strong family history of breast cancer considers taking tamoxifen (Nolvadex) for cancer prevention. Which assessment finding is a possible contraindication?

a. History of deep vein thrombosis (DVT)
b. History of osteoporosis
c. Hyperlipidemia
d. Prior hysterectomy

Question 2

The nurse is caring for a patient who has been receiving vinorelbine (Navelbine) for about 5 days. Which assessment finding in this patient would cause the nurse to withhold the next dose and notify the prescriber?

a. Alopecia
b. Dyspnea and cough
c. Neutrophil count of 1200/mm3
d. Peripheral neuropathy

popopong · **Reply #1 on:** Jul 23, 2018

Answer to Question 1

ANS: A
The patient's age and DVT history place her at risk for thrombosis. Tamoxifen would not be indicated for this patient. A prior hysterectomy, osteoporosis, and hyperlipidemia are not contraindications to tamoxifen.

Answer to Question 2

ANS: B
The nurse should withhold the dose if the patient has new-onset cough and dyspnea, because these may indicate the development of interstitial pulmonary changes and acute respiratory distress syndrome. Alopecia would not cause the nurse to withhold the dose. Neutropenia is expected and is not at a critical level. Although this count is low, it would not prevent administration of the medication. Peripheral neuropathy is expected with vinorelbine.