Nokea
During therapy with the hematopoietic drug epoetin alfa, the nurse instructs the patient about adverse effects that may occur, such as
- A. Anxiety
- B. Drowsiness
- C. Hypertension
- D. Constipation
Correct Answer: C
Rationale: Hypertension is an adverse effect of hematopoietic drugs, along with headache, fever, pruritus, rash, nausea, vomiting, arthralgia, cough, and injection site reaction.
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A cancer patient is receiving drug therapy with epoetin alfa. The nurse knows that the medication must be stopped if which laboratory result is noted?
- A. White blood cell count of 550 cells/mm?³
- B. Hemoglobin level of 12 g/dL
- C. Potassium level of 4.2 mEq/L
- D. Glucose level of 78 mg/dL
Correct Answer: B
Rationale: If epoetin is continued when hemoglobin levels are above 11 g/dL, patients may experience serious adverse events, including heart attack, stroke, and death. Caution must be used when hemoglobin levels are above 10 g/dL for cancer patients and 11 g/dL for renal patients.
A woman who is planning to become pregnant should ensure that she receives adequate levels of which supplement to reduce the risk for fetal neural tube defects?
- A. Vitamin B12
- B. Vitamin D
- C. Iron
- D. Folic acid
Correct Answer: D
Rationale: It is recommended that administration of folic acid be begun at least 1 month before pregnancy and continue through early pregnancy to reduce the risk for fetal neural tube defects.
A patient has been receiving epoetin alfa for severe iron-deficiency anemia. Today, the provider changed the order to darbepoetin. The patient questions the nurse, 'What is the difference in these drugs?' Which response by the nurse is correct?
- A. There is no difference in these two drugs.
- B. Aranesp works faster than Epogen to raise your red blood cell count.
- C. Aranesp is given by mouth, so you will not need to have injections.
- D. Aranesp is a longer-acting form, so you will receive fewer injections.
Correct Answer: D
Rationale: Darbepoetin (Aranesp) is longer-acting than epoetin alfa (Epogen); therefore, fewer injections are required.
A patient has been taking iron supplements for anemia for 2 months. During a follow-up assessment, the nurse will observe for which therapeutic response?
- A. Decreased weight
- B. Increased activity tolerance
- C. Decreased palpitations
- D. Increased appetite
Correct Answer: B
Rationale: Absence of fatigue, increased activity tolerance and well-being, and improved nutrition status are therapeutic responses to iron supplementation.
A patient is to receive iron dextran injections. Which technique is appropriate when the nurse is administering this medication?
- A. Intravenous administration mixed with 5% dextrose
- B. Intramuscular injection in the upper arm
- C. Intramuscular injection using the Z-track method
- D. Subcutaneous injection into the abdomen
Correct Answer: C
Rationale: Intramuscular iron is given using the Z-track method deep into a large muscle mass. If given intravenously, it is given with normal saline, not 5% dextrose.