A nursing student asks a nurse how cancer cells become resistant ...

[erika]

A nursing student asks a nurse how cancer cells become resistant to methotrexate Rheumatrex. The nurse is correct to respond by saying that cancer cells acquire resistance to methotrexate by:
 
  a. reduced production of transporter that pumps methotrexate out of cells.
  b. reduced synthesis of dihydrofolate reduc-tase.
  c. reduced uptake of methotrexate into cells.
  d. increased ability to convert the drug to a polyglutamated form.

Question 2

A patient who has urinary bladder cancer will begin receiving the chemotherapeutic agent valrubicin Valstar. What will the nurse do when administering this drug?
 
  a. Administer the drug intravenously using a large bore needle and tubing.
  b. Ensure that the tubing used to administer the drug does not contain polyvinyl chlo-ride.
  c. Monitor the patient closely for a variety of systemic drug adverse effects.
  d. Use a normal saline or sterile water diluent to dilute the medication.

Question 3

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

[wergv]

Answer to Question 1

This is great. Thanks

Answer to Question 2

Many thanks to you.

Answer to Question 3

A
The patient's age and DVT history place her at risk for thrombosis. Tamoxifen would not be in-dicated for this patient. A prior hysterectomy, osteoporosis, and hyperlipidemia are not contrain-dications to tamoxifen.

[erika]

TYSM

[Sarahjh]

Thanks for the timely response, appreciate it