Chapter 49: Drugs Used to Treat Anemias
The nurse administers epoetin alfa (Epogen). What is the therapeutic response the nurse expects to assess? a)Elevated heart rate b)Elevated white blood cell count c)Increased red blood cell count d)Increased resistance to infection
c)Increased red blood cell count
A patient with chronic renal failure receiving epoetin alfa will be having a total left hip arthroplasty. What supplementation should the patient receive prior to surgery? a)A blood transfusion b)A protein supplement c)An iron supplement d)A folic acid supplement
c)Iron supplement
A patient has completed 4 weeks of treatment with epoetin alfa. Which of the following assessment findings would most strongly indicate that treatment has been effective? a)Capillary refill in the patient's nail beds is less than or equal to 3 seconds b)The patient white blood cell level is within reference ranges c)The patient's hemoglobin level is 11 g/dL d)The patient maintains an oxygen saturation of 92% on room air
c)The patient's hemoglobin level is 11 g/dL
Which would be appropriate for a client who is receiving iron therapy? a)Ensuring that the client consumes three large meals per day b)Encouraging the client to take the drug on an empty stomach c)Advising the client to limit the amount of fiber in his diet d)Cautioning the client that stool may be dark or green
d)Cautioning the client that stool may be dark or green
The mature red blood cell contains a nucleus. a)False b)True
a)False
There is a risk of antibody production with the use of epoetin. a)True b)False
a)True
After teaching a patient who is receiving ferrous sulfate about the drug therapy regimen, which patient statement indicates that the teaching was successful? a)"I must take the drug on an empty stomach." b)"My stools might turn dark or green." c)"I need to eat three large meals every day." d)"I need to watch the amount of fiber I eat."
b)"My stools might turn dark or green."
Approximately what percentage of the body's red blood cells (RBCs) is destroyed and replaced each day? a)3% b)1% c)2% d)4%
b)1%
The client is a woman 65 years of age being treated for anemia secondary to chronic kidney disease. The nurse explains to the client that she will be getting a prescription for Epogen. Which of the following additional information would the nurse provide? a)Chronic kidney disease has an affect on the production of red blood cells causing anemia. Epogen minimizes the effect on the production of red blood cells to cause anemia. b)Chronic kidney disease slows the production of red blood cells causing anemia. Epogen stimulates the production of red blood cells to treat anemia. c)Chronic kidney disease stimulates the production of red blood cells causing anemia. Epogen slows the production of red blood cells to cause anemia. d)Chronic kidney disease has no affect on the production of red blood cells causing anemia. Epogen stimulates the production of red blood cells to treat anemia.
b)Chronic kidney disease slows the production of red blood cells causing anemia. Epogen stimulates the production of red blood cells to treat anemia.
Cyanocobalamin is a vitamin B12 in a nasal formulation. a)False b)True
b)True
A 69-year-old female client has been diagnosed with malignant melanoma. The care team has collaborated with the client and her family and agreed on a plan of care that includes administration of interferon alfa-2b. After administering interferon alfa-2b, the oncology nurse should anticipate that the client may develop which adverse effect? a)cyanosis and pallor b)flu-like symptoms c)decreased level of consciousness d)profound diaphoresis
b)flu-like symptoms
A client, currently prescribed epoetin alfa, has recent blood work that reveals a hemoglobin level of 12.8 g/dL. What action does this assessment finding necessitate regarding the epoetin alfa? a)changing the route of administration b)temporarily withholding administration c)administering an unscheduled dose d)requesting a change in the dosage
b)temporarily withholding administration
A patient has been receiving intramuscular injections of hydroxocobalamin as treatment for pernicious anemia. Which statement by the patient indicates that he understands the therapy? a)"I will get the injection for a week and then stop." b)"I need the injections now, but then I can switch to a pill." c)"I will need these injections monthly for the rest of my life." d)"Once my levels are up, I won't need the drug anymore."
c)"I will need these injections monthly for the rest of my life."
Which patient will be at the greatest risk for anemia and be the most likely candidate for epoetin alfa therapy? a)A 20-year-old female b)A 40-year-old male with a high white blood cell count c)A 62-year-old male with cancer d)A 30-year-old pregnant woman
c)A 62-year-old male with cancer
The home care nurse is caring for a client who is self-administering epoetin. What assessment is most important for the nurse to complete during the visit? a)Pulse b)Temperature c)Blood pressure d)Respirations
c)Blood pressure
The nurse is preparing to administer an erythropoesis-stimulating drug. The nurse checks the patient's chart, with the knowledge that the drug should not be administered to a patient with a target hemoglobin above which value? a)8 mg/dL b)14 mg/dL c)10 mg/dL d)12 g/dL
d)12 g/dL
The average lifespan of a red blood cell (RBC) is approximately: a)90 days. b)30 days. c)60 days. d)120 days.
d)120 days.
A patient who is HIV positive is receiving zidovudine 4,2000 mg/week and has an endogenous erythropoietin level of 350 mU/mL. What does the nurse anticipate will be administered for this patient? a)Rocephin 1 GM IV b)A blood transfusion c)An increased dose of zidovudine d)Erythropoietin
d)Erythropoietin
The nurse is caring for a client who is receiving epoetin alfa. What adjunct treatment will the nurse expect the health care provider to order for this client? a)Renal dialysis b)Potassium supplement c)Sodium restriction d)Iron supplement
d)Iron supplement
Adverse effects of epoetin and darbepoetin include increased risks of what condition? a)Diabetes mellitus type 2 b)Cirrhosis of the liver c)Hyperlipidemia d)Myocardial infarction
d)Myocardial infarction
A client has been receiving regular doses of epoetin alfa for several weeks, and the home care nurse has been monitoring the client's condition closely. When taking the client's vital signs, the nurse should pay particular attention to what assessment datum? a)respiratory rate b)heart rate c)temperature d)blood pressure
d)blood pressure
An older adult client diagnosed with chronic renal failure has begun experiencing increasing fatigue. The nurse would anticipate educating the client on what likely medication prescription? a)penicillin G b)interferon gamma c)filgrastim d)epoetin alfa
d)epoetin alfa
A client diagnosed with iron deficiency anemia is learning about her prescribed iron supplement. Which additional information would the nurse include in the client's teaching plan? a)"If constipation or diarrhea become severe, call your primary care provider." b)"If darkening of the stools appears, call your primary care provider." c)"If you have an increased appetite, call your primary provider." d)"If you get a little thirsty, call your primary care provider."
a)"If constipation or diarrhea become severe, call your primary care provider."
The pharmacology class learns that epoetin alfa is an immunosuppressant drug that is designed to have what expected outcome? a)Increased RBC count b)Decreased RBC count c)Decreased WBC count d)Increased WBC count
a)Increased RBC count
The nurse is caring for a patient with chronic kidney disease who is receiving epoetin alfa. Which assessment finding would be of greatest concern for the nurse? a)Reports of calf pain on dorsiflexion of the foot b)A rash under the breast c)Dry, nonproductive cough d)1 pound weight gain in 1 week
a)Reports of calf pain on dorsiflexion of the foot
The nurse is teaching a client about erythrocytes. Which information would the nurse include in the teaching plan? a)Erythrocytes are also called red blood cells. b)Erythrocytes are also called white blood cells. c)Erythrocytes are also called platelets. d)Erythrocytes are also called plasma.
a)Erythrocytes are also called red blood cells
A patient comes to the clinic reporting fatigue and pica. Laboratory findings reveal a low serum iron level and a low ferritin level. Upon evaluation of this assessment and laboratory data, the nurse suspects that the patient will be diagnosed with: a)iron deficiency anemia. b)hemolytic anemia. c)sickle cell anemia. d)pernicious anemia.
a)iron deficiency anemia
What would be the priority nursing diagnosis for a patient who is prescribed epoetin alfa? a)Alteration in bowel elimination due to side effects of the medication b)Impaired tissue oxygenation related to anemia c)Altered skin integrity due to the disease process d)Alteration in nutrition due to poor intake of iron
b)Impaired tissue oxygenation related to anemia
The nurse notes a decreased red blood cell (RBC) count, decreased hemoglobin and hematocrit, as well as a decreased mean corpuscular volume. This could be attributable to a decrease in secretion of what hormone? a)Erythropoietin b)Colony-stimulating factor c)Interleukins d)Interferon
a)Erythropoietin
The patient is being prescribed epoetin alfa for the treatment of anemia related to the renal failure. The patient also has a history of diabetes mellitus, uncontrolled hypertension, osteoarthritis, and hypothyroidism. Which of these conditions should the nurse bring to the physician's attention prior to administering the medication? a)Uncontrolled hypertension b)Hypothyroidism c)Osteoarthritis d)Diabetes mellitus
a)Uncontrolled hypertension
A nursing instructor is teaching students about the myelin sheath of the central nervous system (CNS). The nurse knows that teaching has been effective when a student identifies which vitamin as necessary for the formation of the myelin sheath in the CNS? a)Vitamin B12 b)Vitamin D c)Vitamin C d)Folic acid
a)Vitamin B12
A client, diagnosed with chronic renal failure, has begun experiencing increasing shortness of breath. The nurse suspects that the client is experiencing symptoms associated with which resulting condition? a)anemia b)hypertension c)hypoglycemia d)thrombocytopenia
a)anemia
A male client is self-administering epoetin in the home. The nurse encourages him to include what supplements as part of his daily medication regimen? a)Folic acid b)Iron c)Vitamin A d)Vitamin C
b)Iron
A nurse has been assigned to a 43-year-old man who is to receive epoetin alfa therapy. The patient is HIV-positive and has anemia related to zidovudine therapy. The nurse will monitor: a)Swelling of veins b)Iron levels c)Renal failure d)Chemotherapy
b)Iron levels
After teaching a group of students about the types of anemia, the instructor determines that the teaching was successful when the students identify which anemia results from an inability to produce the intrinsic factor? a)Iron deficiency anemia b)Pernicious anemia c)Sickle cell anemia d)Folic acid deficiency anemia
b)Pernicious anemia
A client is suspected of having impaired erythropoiesis. This client is most likely to exhibit signs and symptoms associated with what health problem? a)sepsis b)anemia c)disseminated intravascular coagulation (DIC) d)venous thromboembolism
b)anemia
The nurse is teaching a nursing student about anemia and knows that it is important to start by explaining the causes of anemia. Which statement is true about the cause of anemia? a)"Anemia is a condition caused by reduced amounts of hemoglobin, causing less oxygen to be delivered to the tissues." b)"Anemia is a condition caused by reduced amounts of platelets, causing less oxygen to be delivered to the tissues." c)"Anemia is a condition caused by reduced amounts of protein, causing less oxygen to be delivered to the tissues." d)"Anemia is a condition caused by reduced amounts of hematocrit, causing less oxygen to be delivered to the tissues."
a)"Anemia is a condition caused by reduced amounts of hemoglobin, causing less oxygen to be delivered to the tissues."
A client is receiving epoetin alfa for anemia. Which adjunctive therapy is imperative with epoetin alfa? a)renal dialysis b)sodium restriction c)potassium supplements d)iron supplement
d)iron supplement
After teaching a group of students about anemias, the instructor determines that the teaching was effective when the students identify what as the critical issue? a)Decreased levels of platelets b)A defect in white blood cell function c)A deficiency of vitamin B12 d)Altered red blood cell production or deficient functioning of red blood cells
d)Altered red blood cell production or deficient functioning of red blood cells
A student nurse is caring for a client who is receiving a hematopoietic agent. To test the student's understanding, the nursing instructor states that the drug could be administered by what route? a)Oral b)Subcutaneous c)Intravenous d)B and C
d)B and C
