Nokea
After reviewing information about colony-stimulating factors, a group of nursing students demonstrate understanding of the information when they identify which of the following as true about filgrastim (Neupogen)? Select all that apply.
- A. Is a glycoprotein
- B. Promotes proliferation of leukocytes
- C. Stimulates differentiation of erythrocytes
- D. Stimulates maturation of megakaryocytes
- E. Is used to treat chemotherapy-induced neutropenia
Correct Answer: A,B,E
Rationale: Colony-stimulating factors such as filgrastim (Neupogen) are glycoproteins used to stimulate proliferation, differentiation, and maturation of leukocytes. They are used to treat chemotherapy-induced neutropenia.
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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.
A nurse should encourage a client with megaloblastic anemia to eat which of the following foods, as they are rich in folate? Select all that apply.
- A. Collard greens
- B. Grapes
- C. Wheat bread
- D. Salmon
- E. Chicken
Correct Answer: A,C,D,E
Rationale: A deficiency of folic acid (folate) results in megaloblastic anemia, and the nurse should encourage a client to eat foods rich in folic acid including leafy green vegetables (collard greens), fish (salmon), meat, poultry (chicken), and whole grains (wheat bread).
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 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.
A client is prescribed sargramostim (Leukine). Before administering the drug, the nurse would inform the client that which of the following may occur with this drug? Select all that apply.
- A. Bone pain
- B. Anemia
- C. Infection
- D. Nausea
- E. Rash
Correct Answer: A,D,E
Rationale: Headache, bone pain, nausea, vomiting, diarrhea, alopecia, and rash are adverse reactions the nurse should inform the client about prior to the administration of sargramostim (Leukine).