Question: Tamoxifen (Nolvadex) is prescribed for the client with metastatic breast carcinoma. The nurse administering the medication understands that the primary action of this medication is to:
1. Increase DNA and RNA synthesis.
2. Promote the biosynthesis of nucleic acids.
3. Increase estrogen concentration and estrogen response.
4. Compete with estradiol for binding to estrogen in tissues containing high concentrations of receptors.
Rationale:Tamoxifen (Nolvadex) is an antineoplastic medication that competes with estradiol for binding to estrogen in tissues containing high concentrations of receptors. Tamoxifen is used to treat metastatic breast carcinoma in women and men. Tamoxifen is also effective in delaying the recurrence of cancer following mastectomy. Tamoxifen reduces DNA synthesis and estrogen response.
Test-Taking Strategy: Use the process of elimination. Eliminate options 1 and 2 first because they are comparable or alike. Nucleic acids include DNA and RNA. From this point, select option 4, because it is unlikely that treatment of metastatic breast carcinoma would focus on increasing estrogen concentration and estrogen response. If you had difficulty with this question, review the action of this medication.
Level of Cognitive Ability: Understanding
Client Needs: Physiological Integrity
Integrated Process: Nursing Process—Implementation
Content Area: Pharmacology
Reference: Hodgson, B., & Kizior, R. (2010). Saunders nursing drug handbook 2010 (p. 1072). St. Louis: Saunders.
This week’s NCLEX exam practice question came from:
Silvestri: Saunders Comprehensive Review for the NCLEX-RN Examination, 5th Edition, Chapter 53, Page 642, Question 563
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