# A client with breast cancer is starting doxorubicin chemotherapy. Which baseline assessment is essential before the first dose?

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=391862&lang=en  
> language: en  
> subject: Medical Emergencies  
> category: PA

## Question

A client with breast cancer is starting doxorubicin chemotherapy. Which baseline assessment is essential before the first dose?

## Option

1. Baseline echocardiogram or MUGA scan for LVEF — doxorubicin causes dose-dependent cumulative cardiotoxicity **✔ Correct answer**
2. Bone density scan
3. Pulmonary function test
4. Cervical cancer screening

**Correct answer: 1**

## Explanation

Correct (2): Doxorubicin (and other anthracyclines) cause dose-dependent cumulative cardiomyopathy; lifetime dose ≤450-550 mg/m². Baseline LVEF via echo or MUGA + periodic monitoring. Dexrazoxane is a cardioprotectant in high-dose regimens. Also expect red urine (harmless) and severe vesicant risk. (1,3,4) Unrelated to anthracycline cardiac safety.

## In-depth explanation

Memory Tip Anthracycline = "Red Devil" — red urine, red drug, red flag for HEART. Dexrazoxane = cardioprotectant. Lifetime dose cap critical.

## Clinical scenario

Scenario 52-year-old female with stage III breast cancer starting doxorubicin regimen. Pre-treatment workup.

## Key concepts

- **Doxorubicin (Adriamycin)** — Anthracycline; cumulative cardiotoxicity; vesicant; "red devil" — red urine.
- **Cardiotoxicity monitoring** — Baseline LVEF + serial echo/MUGA during/after anthracycline therapy.
- **Dexrazoxane** — Cardioprotectant given before high-dose anthracycline to reduce cardiotoxicity.

## Related questions

- [A nurse is caring for an alert adult client with type 1 diabetes who reports tremors, swea…](https://mymerci.kr/pages/nclex_q.php?qn_id=360524&lang=en)
- [A 68-year-old client with COPD is admitted with shortness of breath and SpO2 86% on room a…](https://mymerci.kr/pages/nclex_q.php?qn_id=362940&lang=en)
- [A 58-year-old client arrives at the emergency department with crushing substernal chest pa…](https://mymerci.kr/pages/nclex_q.php?qn_id=362976&lang=en)
- [A 72-year-old client is brought to the emergency department by family who report that the …](https://mymerci.kr/pages/nclex_q.php?qn_id=363003&lang=en)
- [A 79-year-old client is admitted from a long-term care facility with diarrhea, decreased o…](https://mymerci.kr/pages/nclex_q.php?qn_id=363089&lang=en)
- [A 76-year-old female with chronic heart failure and atrial fibrillation receives digoxin 0…](https://mymerci.kr/pages/nclex_q.php?qn_id=374883&lang=en)
- [A 70-year-old client on long-term digoxin therapy reports new yellow-green halos around li…](https://mymerci.kr/pages/nclex_q.php?qn_id=374884&lang=en)
- [A 58-year-old client with type 2 diabetes mellitus and migraine prophylaxis is taking prop…](https://mymerci.kr/pages/nclex_q.php?qn_id=374893&lang=en)

## Read in another language

- [en](https://mymerci.kr/pages/nclex_q.php?qn_id=391862&lang=en)
- [ko](https://mymerci.kr/pages/nclex_q.php?qn_id=391862&lang=ko)
- [ja](https://mymerci.kr/pages/nclex_q.php?qn_id=391862&lang=ja)
- [zh-TW](https://mymerci.kr/pages/nclex_q.php?qn_id=391862&lang=zh-tw)
- [vi](https://mymerci.kr/pages/nclex_q.php?qn_id=391862&lang=vi)

---

More free questions: [NCLEX-RN Practice](https://mymerci.kr/pages/nclex_bank.php?lang=en)

_For study reference only. Always follow current clinical guidelines and your institution’s protocols._