Nokea
A client is to receive darbepoetin alfa (Aranesp). When administering the drug, the nurse integrates knowledge of which of the following? Select all that apply.
- A. The drug is a glycoprotein.
- B. It is used to stimulate the production of erythrocytes.
- C. It helps stimulate differentiation of leukocytes.
- D. The drug promotes the maturation of megakaryocytes.
- E. It is used to stimulate thrombopoiesis
Correct Answer: A,B
Rationale: The following is true of the drug darbepoetin alfa (Aranesp): it is a glycoprotein, erythropoiesis-stimulating agent used to stimulate and regulate the production of erythrocytes (erythropoiesis).
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After administering methoxy polyethylene epoetin beta, the nurse would be alert for the development of which of the following as a possible adverse reaction? Select all that apply.
- A. Bone pain
- B. Fluid retention
- C. Hypertension
- D. Fatigue
- E. Arthralgia
Correct Answer: C,D,E
Rationale: Hypertension, headache, nausea, vomiting, diarrhea, rashes, fatigue, arthralgia, and injection site skin reactions are adverse reactions the nurse should discuss with a client prior to the administration of methoxy polyethylene epoetin beta (Mircera).
A nurse administers a test dose of iron dextran IM. The nurse would wait at least how long before administering the remainder of the dose?
- A. 15 minutes
- B. 30 minutes
- C. 45 minutes
- D. 60 minutes
Correct Answer: D
Rationale: After giving the test dose, the nurse would monitor the client for an allergic response for at least 1 hour after the test dose and before administering the remaining dose. Epinephrine is kept on standby in the event of severe anaphylactic reaction.
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 client with megaloblastic anemia is prescribed leucovorin. The nurse would identify which of the following as a contraindication for this drug?
- A. Pernicious anemia
- B. Hemochromatosis
- C. Uncontrolled hypertension
- D. Hypersensitivity to human albumin
Correct Answer: A
Rationale: Leucovorin is contraindicated in clients with pernicious anemia or other anemias in which vitamin B12 is deficient. Leucovorin is not contraindicated in clients with hemochromatosis, uncontrolled hypertension, and hypersensitivity to human albumin. Epoetin alfa is contraindicated in clients with uncontrolled hypertension and hypersensitivity to human albumin. Iron compounds are contraindicated in clients with hemochromatosis or hemolytic anemia.
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.