Nokea
A client has a hypersensitivity reaction to pegfilgrastim (Neufasta). The nurse would expect to administer which of the following to treat the hypersensitivity reaction and maintain the use of colony-stimulating factors? Select all that apply.
- A. Prednisone
- B. Diphenhydramine
- C. Albuterol
- D. Naproxen
- E. Hydrocodone
Correct Answer: A,B,C
Rationale: Colony-stimulating factors, like pegfilgrastim (Neulasta), can cause hypersensitivity reactions and should be treated with antihistamines (diphenhydramine), steroids (prednisone), and bronchodilators (albuterol) to maintain their use.
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The nurse is preparing to administer vitamin B12 to a client. The nurse would administer the drug cautiously if the client had which condition?
- A. Pulmonary disease
- B. Hypertension
- C. Heart disease
- D. Seizures
Correct Answer: A
Rationale: Vitamin B12 is cautiously administered to clients with pulmonary disease. Epoetin alfa and darbepoetin alfa are administered cautiously to clients with hypertension, heart disease, and a history of seizures.
A nurse is providing care to a client experiencing hematologic failure. The nurse understands that this can include which of the following? Select all that apply.
- A. Anemia
- B. Bleeding
- C. Hypertension
- D. Infection
- E. Hypoglycemia
Correct Answer: A,B,D
Rationale: Hematologic failure results when inadequate numbers of blood cells are produced, leading to decreased oxygen transportation, blood coagulation, or inability for the body to prevent the invasion of microorganisms, which can lead to anemia, bleeding, and infection.
A client receives filgrastim to treat neutropenia associated with chemotherapy. The nurse monitors the client's absolute neutrophil count (ANC). The nurse anticipates stopping the drug when the ANC reaches which level?
- A. 2500/mm³
- B. 5000/mm³
- C. 7500/mm³
- D. 10000/mm³
Correct Answer: D
Rationale: Injections of the CSF filgrastim are started at least 24 hours after the completion of a cycle of chemotherapy. The absolute neutrophil count (ANC) is monitored and therapy is continued until an ANC count of at least 10,000/mm³ is achieved.
Prior to administering a drug used to treat anemia, the nurse should assess a client's vital signs, ability to carry out activities of daily living, and general appearance, and for the presence of which of the following other general symptoms? Select all that apply.
- A. Fatigue
- B. Pallor
- C. Headache
- D. Shortness of breath
- E. Sore tongue
Correct Answer: A,B,C,D,E
Rationale: Prior to administering a drug used to treat anemia, the nurse should assess a client's vital signs, client's ability to carry out activities of daily living, and client's general appearance, and for the presence of other general symptoms including fatigue, shortness of breath, sore tongue, headache, and pallor.
A client is prescribed ferrous sulfate (Feosol). Which of the following adverse reactions should the nurse discuss with a client prior to the administration of this drug? Select all that apply.
- A. Constipation
- B. Fluid retention
- C. Nausea
- D. Fatigue
- E. Dark stools
Correct Answer: A,C,E
Rationale: GI irritation, nausea, vomiting, constipation, diarrhea, darker stools, headache, backache, and allergic reactions are adverse reactions the nurse should discuss with a client prior to the administration of ferrous sulfate (Feosol).