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Prior to administering filgrastim, the nurse reviews the laboratory report results for the 3-year-old who completed the second round of chemotherapy three weeks ago. Which finding indicates a therapeutic response to filgrastim?
- A. Hematocrit of 31%
- B. Eosinophil count of 6%
- C. WBC count of 6800/mm3
- D. Platelet count of 150,000/mm3
Correct Answer: C
Rationale: A: The Hct of 31% is normal but is unaffected by filgrastim, a colony-stimulating factor. B: The eosinophil count of 6% is elevated (0 to 2% is normal) but is not related to filgrastim use. C: Filgrastim (Neupogen) is a colony-stimulating factor used to increase the production of WBCs in persons who have bone marrow depression from chemotherapy. D: The platelet count of 150,000/mm3 is normal but is not used to evaluate the therapeutic effectiveness of filgrastim.
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The child is to start on medication therapy for enuresis that has not resolved with behavioral interventions. Which medication should the nurse anticipate being prescribed for the child?
- A. Lorazepam
- B. Desmopressin
- C. Nitrofurantoin
- D. Spironolactone
Correct Answer: B
Rationale: A: Lorazepam (Ativan) is a benzodiazepine used to treat anxiety. A side effect is drowsiness, which could impair a child's ability to waken for voiding. B: Desmopressin (DDAVP) is an analog of arginine vasopressin, which acts as an antidiuretic. It promotes resorption of water in the renal tubule or decreases bladder filling. C: Nitrofurantoin (Macrobid) is a urinary tract antiseptic used to treat UTIs and would not be used with enuresis. D: Spironolactone (Aldactone) is a potassium-sparing diuretic that would promote, not inhibit, diuresis.
A pregnant client asks how she can prevent getting Group B Strep. What is the LPN's best response?
- A. You should have your partner wear a condom every time you have intercourse.
- B. You cannot prevent getting Group B Strep, you can only treat it.
- C. You should be extra vigilant about hand-washing, especially in the third trimester.
- D. The Group B Strep vaccine is the only proven way to prevent the disease.
Correct Answer: B
Rationale: Group B Strep lives in the vagina, rectum, and intestines of about 25% of the female population. It is considered normal flora and is not a sexually transmitted disease. The same woman can test positive in one pregnancy and negative in another, which is why testing is done every pregnancy, usually within 5 weeks of expected delivery. If a woman tests positive for Group B Strep, she will be given antibiotics during delivery to greatly reduce the risk of complications for her and her baby.
The LPN is taking care of a client with a documented allergy to Penicillin. After rounds, the PN notices that the client has an order for Cefazolin. Which of the following actions would be the least appropriate?
- A. The LPN clarifies the severity of the Penicillin allergy.
- B. The LPN discusses the order with the care team prior to administering Cefazolin.
- C. The LPN administers all ordered medications except for the Cefazolin.
- D. The LPN monitors the client after a test dose of Cefazolin is administered.
Correct Answer: C
Rationale: The LPN should clarify the order with the care team prior to determining the medication should not be given. Even though the client may have a potential reaction due to the Penicillin allergy, the therapeutic benefits of the antibiotic may outweigh the allergic reaction.
The client admitted to the ED has drowsiness, clammy skin, and slow, shallow breathing. A friend states that the client took multiple oxycodone tablets. Which medication should the nurse plan to administer to this client?
- A. Naloxone
- B. Disulfiram
- C. Flumazenil
- D. Acetylcysteine
Correct Answer: A
Rationale: Naloxone (Narcan) reverses CNS and respiratory depression due to opioid overdose.
The nurse telephones the HCP to request a pm anxiolytic medication order for a hospitalized client having occasional anxiety. Which medication, if prescribed, should the nurse question regarding its effectiveness for prn use?
- A. Buspirone
- B. Lorazepam
- C. Clorazepate
- D. Clonazepam
Correct Answer: A
Rationale: Buspirone (BuSpar) has a 10- to 14-day delay in therapeutic onset, making it unsuitable for prn use.