NUR334 Hematology, ATI Review

A nurse is assessing a client during transfusion of a unit of whole blood. The client develops a cough, shortness of breath, elevated blood pressure, and distended neck veins. The nurse should anticipate a prescription for which of the following medications? Epinephrine Lorazepam Furosemide Diphenhydramine

Furosemide

A health care professional is caring for a patient who is about to begin factor VIII (Advate) therapy to treat hemophilia A. When administering factor VIII, which of the following actions should the health care professional take? Have emergency equipment ready. Premedicate with aspirin (Ecotrin). Administer via rapid IV bolus. Administer the powdered form orally.

Have emergency equipment ready.

A health care professional is caring for a patient who is about to begin alteplase (Activase) therapy. The health care professional should monitor the patient for which of the following indications of a possible adverse effect? Hives Headache Edema Hypertension

Headache

A health care professional is caring for a patient who is about to begin taking folic acid to treat megaloblastic anemia. The health care professional should monitor which of the following laboratory values? Amylase level Reticulocyte count C-reactive protein Creatinine clearance

Reticulocyte count

a nurse is transfusing a unit of packed red blood cells (PRBCs) for a client who has anemia due to chemotherapy. The client reports a sudden headache and chills. The client's temperature is 2 degrees F higher than her baseline. In addition to notifying the provider, which of the following actions should the nurse take? (Select all that apply.) Stop the transfusion. Place the client in an upright position with feet down. Remove the blood bag and tubing from the IV catheter. Obtain a urine specimen. Infuse dextrose 5% in water through the IV.

Stop the transfusion. Remove the blood bag and tubing from the IV catheter. Obtain a urine specimen.

You are caring for a patient who is about to begin taking clopidogrel (Plavix) to prevent transient ischemic attacks. You should tell the patient to report which of the following adverse effects? (Select all that apply.) Petechiae Tinnitus Diaphoresis Weakness Vision changes

Petechiae Weakness Vision changes

A nurse is caring for a client who is receiving daily doses of oprelvekin. Which of the following laboratory values should the nurse monitor to determine effectiveness of this medication? Hemoglobin Absolute neutrophil count Platelet count Total white blood count

Platelet count Should be greater than 50,000

Which of the following drugs should you have ready in case of heparin overdose? Aminocaproic acid (Amicar) Deferoxamine (Desferal) Vitamin K Protamine

Protamine

A nurse is caring for a hospitalized client who is receiving IV heparin for a deep-vein thrombosis. The client begins vomiting blood. After the heparin has been stopped, which of the following medications should the nurse prepare to administer? Vitamin K1 Atropine Protamine Calcium gluconate

Protamine This reverses the anticoagulant effect of Heparin

A patient who is taking ferrous sulfate (Feosol) to treat iron-deficiency anemia develops severe nausea and vomiting due to iron toxicity. Which of the following drugs should the health care professional use to treat this complication? Flumazenil (Mazicon) Acetylcysteine (Acetadote) Naloxone Deferoxamine (Desferal)

Deferoxamine (Desferal)

A nurse is preparing to administer filgrastim for the first time to a client who has just undergone a bone marrow transplant. Which of the following interventions is appropriate? Administer IM in a large muscle mass to prevent injury Ensure that the medication is refrigerated until just prior to administration Shake vial gently to mix well before withdrawing dose Discard vial after removing one dose of medication

Discard vial after removing one dose of medication

A health care professional is caring for a patient who is about to begin iron dextran (INFeD) therapy. When administering the drug IM, the health care professional should take which of the following actions? (Select all that apply.) Administer a test dose Monitor blood pressure Have epinephrine available Premedicate with atropine Use the Z-track technique

Administer a test dose. Monitor blood pressure. Have epinephrine available. Use the Z-track technique.

A health care professional is caring for a patient who is about to begin alteplase (Activase) therapy to treat pulmonary embolism. Which of the following drugs should the health care professional have available in the event of a severe adverse reaction? Vitamin K Aminocaproic acid (Amicar) Protamine Deferoxamine (Desferal)

Aminocaproic acid (Amicar)

You are reviewing the history of a patient who is about to begin therapy with factor VIII (Advate) to treat hemophilia A. Which of the following drugs that the patient takes should alert you to take further action? Albuterol (Proventil) Phenytoin (Dilantin) Phenelzine (Nardil) Aspirin (Ecotrin)

Aspirin (Ecotrin)

A nurse is assessing a client who has chronic neutopenia and who has been receiving filgrastim. Which of the following actions should the nurse take to assess for an adverse effect of filgrastim? Assess for bone pain Assess for RLQ pain Auscultate for crackles in the bases of the lungs Auscultate the chest to listen for a heart murmur

Assess for bone pain

The provider discharges the patient to home with a prescription for warfarin (Coumadin). You should advise the patient to do which of the following? (Select all that apply.) Avoid taking NSAIDs. Use a disposable razor. Brush his teeth with a soft toothbrush. Increase intake of dark green, leafy vegetables. Ask the provider before taking over-the-counter drugs. Check bowel movements for signs of bleeding.

Avoid taking NSAIDs. Brush his teeth with a soft toothbrush. Ask the provider before taking over-the-counter drugs. Check bowel movements for signs of bleeding.

A health care professional is preparing to administer the prescribed dose of filgrastim (Neupogen) to a patient. The patient's laboratory results indicate that the patient has a WBC count of 12,000/mm3. Which of the following actions should the health care professional take? Clarify the prescription with the provider. Administer the drug with an analgesic. Limit venipunctures. Assess breath sounds.

Clarify the prescription with the provider.

A nurse is monitoring a client who takes aspirin 81 mg PO daily. The nurse should identify which of the following manifestations as adverse effects of a daily aspirin therapy? (Select all that apply.) Hypertension Coffee-ground emesis Tinnitus Paresthesias of the extremities Nausea

Coffee-ground emesis Tinnitus Nausea

A health care professional is caring for a patient who is about to begin taking oprelvekin (Neumega) to treat thrombocytopenia. The health care professional should tell the patient to report which of the following indications of an adverse reaction? (Select all that apply.) Conjunctivitis Tinnitus Swollen ankles Jaundice Palpitations

Conjunctivitis Swollen ankles Palpitations

A patient is about to begin therapy with recombinant factor IX (BeneFix) to treat hemophilia B. The patient asks the health care professional about the risk of disease transmission with recombinant factor IX, as compared with plasma-derived factor IX. The health care professional should explain that recombinant factor IX eliminates the risk for which of the following? HIV Cytomegalovirus Creutzfeldt-Jakob disease Anaphylaxis

Creutzfeldt-Jakob disease

You are talking to a patient who is about to begin taking liquid ferrous sulfate (Feosol) to treat iron-deficiency anemia. Which of the following instructions should you include about the drug? (Select all that apply.) Swish it in your mouth before swallowing it. Drink it through a straw. Do not rinse your mouth after taking it. Dilute it first with water. Take it with food.

Drink it through a straw. Dilute it first with water.

You are caring for a patient who is about to begin taking oprelvekin (Neumega) for thrombocytopenia. To evaluate the potential for adverse effects, you should monitor which of the following during drug therapy? Liver function Hearing ECG Level of consciousness

ECG

A health care professional is caring for a patient who is about to begin taking ferrous sulfate (Feosol) to treat iron-deficiency anemia. When talking with the patient about the drug, the health care professional should include which of the following instructions? (Select all that apply.) Eat iron-enriched foods. Spread the dosage across each day. Take the drug on an empty stomach. Report dark green or black stools. Increase dietary fiber intake.

Eat iron-enriched foods. Spread the dosage across each day. Take the drug on an empty stomach. Increase dietary fiber intake.

A health care professional is caring for a patient who has mild hemophilia A and is about to begin taking desmopressin (DDAVP) to prevent bleeding. The health care professional should monitor for which of the following adverse reactions? Weight loss Edema Polyuria Tachycardia

Edema

A health care professional is caring for a patient who is about to begin taking filgrastim (Neupogen) to treat neutropenia. The health care professional should assess the patient for which of the following adverse effects? Dusky nail beds Petechiae Enlarged spleen Swollen calf

Enlarged spleen

A health care professional is caring for a patient who has a known sensitivity to Escherichia coli-derived proteins. This sensitivity is a contraindication for which of the following drugs? Epoetin alfa (Erythropoietin) Oprelvekin (Neumega) Filgrastim (Neupogen) Alteplase (Activase)

Filgrastim (Neupogen)

A health care professional is caring for a patient who is undergoing bone marrow transplantation following high-dose chemotherapy. Which of the following drugs should the health care professional expect the primary care provider to prescribe to reduce the patient's risk of infection? Epoetin alfa (Erythropoietin) Oprelvekin (Neumega) Filgrastim (Neupogen) Alteplase (Activase)

Filgrastim (Neupogen)

Match the drug in the left column with its pharmacologic action in the right column​ by typing the appropriate letter in the center column.​ Filgrastim (Neupogen) A. Dissolves blood clots Alteplase (Activase) B. Inhibits platelet aggregation Epoetin alfa (Procrit) C. Stimulates leukocyte production Clopidogrel (Plavix) D. Stimulates RBC production

Filgrastim, a leukopoietic growth factor, stimulates leukocyte (WBC) production for patients who are myelosuppressed due to chemotherapy or disease. Alteplase, a thrombolytic drug, dissolves a thrombi or blood clot that is already formed. Epoetin alfa stimulates RBC production in the bone marrow. It treats anemia from renal failure, malignancies, or AIDS. Clopidogrel, an antiplatelet drug, inhibits platelet aggregation and reduces thrombus formation.

Before administering IV folic acid, you should explain to the patient that the drug can cause which of the following adverse effects? Headache Nausea Dizziness Flushing

Flushing

Match the drug in the left column with its therapeutic use in the right column​ by typing the appropriate letter in the center column. Folic acid A. Chronic neutropenia Factor VIII B. Deep-vein thrombosis Filgrastim (Neupogen) C. Hemophilia A Heparin (Lovenox) D. Megaloblastic anemia

Folic acid treats megaloblastic anemia due to malabsorption syndrome, alcohol abuse, or hepatic disease. Factor VIII treats hemophilia A on demand for bleeding episodes or prophylactically to prevent bleeding. Filgrastim treats severe chronic neutropenia and reduces the infection risk associated with bone marrow transplantation. Heparin reduces clotting for an evolving CVA, pulmonary embolism, and deep-vein thrombosis. It prevents postoperative venous thrombosis and treats acute myocardial infarction and disseminated intravascular coagulation.

A nurse is caring for a hospitalized client who has an activated partial thromboplastin time (aPTT) greater than 1.5 times the expected reference range. Which of the following blood products should the nurse prepare to transfuse? Whole blood Platelets Fresh frozen plasma Packed red blood cells

Fresh frozen plasma

A health care professional is caring for a patient who is about to begin taking epoetin alfa (Epogen). Which of the following laboratory values should increase with effective therapy? PT WBC Hgb Platelets

Hgb

A nurse is planning to administer IV alteplase to a client who is demonstrating manifestations of a massive pulmonary embolism. Which of the following interventions should the nurse plan to take? Administer IM enoxaparin along with the alteplase dose Hold direct pressure on puncture sites for up to 30 minutes Administer aminocaproic acid IV prior to alteplase infusion Prepare to administer alteplase within 8 hr of manifestation onset

Hold direct pressure on puncture sites for up to 30 minutes

A health care professional administers epoetin alfa (Epogen) subcutaneously to a patient who has renal failure. The health care professional should monitor the patient for which of the following adverse effects? Hypertension Muscle pain Edema Dry mouth

Hypertension

A nurse is monitoring a client who is receiving epoetin alfa for adverse effects. The nurse should identify which of the following findings as an adverse effect of this medication? (Select all that apply.) Leukocytosis Hypertension Edema Blurred vision Headache

Hypertension Headache

A health care professional is caring for a patient who is about to begin taking warfarin (Coumadin). The health care professional should caution the patient about taking which of the following over-the-counter drugs? Diphenhydramine Dimenhydrinate (Dramamine) Calcium carbonate (Tums) Ibuprofen (Motrin)

Ibuprofen (Motrin)

A health care professional is caring for a patient who is about to begin taking oprelvekin (Neumega). The health care professional should explain to the patient that the drug has which of the following effects? Stimulates leukocyte maturation Causes myelosuppression Increases platelet production Destroys blood clots

Increases platelet production

A health care professional is caring for a patient who is about to begin taking aspirin (Ecotrin) to reduce the risk of a cardiovascular event. The health care professional should understand that the drug inhibits platelet aggregation by which of the following mechanisms? Activating thromboxane A2 Blocking adenosine diphosphate receptor agonists Suppressing specific clotting factors Inhibiting cyclooxygenase action in platelets

Inhibiting cyclooxygenase action in platelets

A nurse is planning to administer subcutaneous enoxaparin 40 mg using a prefilled syringe of enoxaparin 40 mg/0.4 mL to an adult client following hip arthroplasty. Which of the following actions should the nurse plan to take? Expel the air bubble from the prefilled syringe before injecting Insert the needle completely into the clients tissue Administer the injection in the client's thigh Aspirate carefully after inserting the needle into the client's skin

Insert the needle completely into the clients tissue rationale: enoxaparin is a deep SubQ injection.

A health care professional is administering epoetin alfa (Epogen) subcutaneously to a patient who has renal failure. The health care professional should take which of the following actions? Shake the vial before using. Insert the needle into the vial once. Dilute the drug first with normal saline. Save the used vial for the next dose.

Insert the needle into the vial once.

You are caring for a patient who is receiving alteplase (Activase) to dissolve a thrombus. Which of the following should you include in the care plan for the patient? (Select all that apply.) Monitor blood pressure. Reposition frequently. Limit venipunctures. Check level of consciousness. Apply pressure to oozing sites.

Monitor blood pressure. Limit venipunctures. Check level of consciousness. Apply pressure to oozing sites.

A nurse is preparing to transfuse a unit of packed red blood cells (PRBCs) for a client who has severe anemia. Which of the following interventions will prevent an acute hemolytic reaction? Ensure that the client has a patent IV line before obtaining blood product from the refrigerator Obtain help from another nurse to confirm the correct client and blood product Take a complete set of vital signs before beginning transfusion and periodically during the transfusion Stay with the client for the first 15 to 30 min of transfusion

Obtain help from another nurse to confirm the correct client and blood product

A nurse is caring for a client who has atrial fibrillation and a new prescription for dabigatran to prevent development of thrombosis. Which of the following medications is prescribed concurrently to treat an adverse effect of dabigatran? Vitamin K1 Protamine Omeprazole Probenecid

Omeprazole

You are caring for a patient who is taking warfarin (Coumadin) to prevent venous thrombosis. You should explain that taking the drug requires daily blood samples to monitor of which of the following laboratory tests? Fibrinogen PT/INR Platelets aPTT

PT/INR

A health care professional is caring for a patient who is about to begin taking clopidogrel (Plavix) to prevent thrombus formation. The health care professional should question the use of clopidogrel by a patient who has which of the following? Myocardial infarction Peptic ulcer disease Pancreatitis Myasthenia gravis

Peptic ulcer disease

You are caring for a patient who is about to begin taking cyanocobalamin (Nascobal), a vitamin B12 preparation. You should understand that the drug treats which of the following types of anemia? Pernicious ​Sickle cell Aplastic Iron-deficiency

Pernicious

A health care professional is caring for a patient who is about to begin taking clopidogrel (Plavix) to prevent stent stenosis. The health care professional should monitor the patient for which of the following adverse reactions? Thrombocytopenia Hyponatremia Lymphocytopenia Uricemia

Thrombocytopenia

You should monitor a patient throughout continuous heparin therapy for which of the following adverse reactions? (Select all that apply) Thrombocytopenia Hypotension Hypokalemia Deep-vein thrombosis Fever

Thrombocytopenia Hypotension Deep-vein thrombosis Fever

A health care professional should assess a patient who has megaloblastic anemia for indications of which of the following vitamin deficiencies? Vitamin B12 Vitamin K Vitamin C Vitamin D

Vitamin B12

A patient who is taking warfarin (Coumadin) arrives at the emergency department and reports rectal bleeding. Which of the following drugs should the health care professional have available? Filgrastim (Neupogen) Deferoxamine (Desferal) Protamine Vitamin K

Vitamin K

A health care professional is caring for a patient who is about to begin taking alteplase (Activase) to treat acute myocardial infarction. The health care professional should understand the drug is most effective when the patient receives it 24 hr after clot formation. After initiation of anticoagulation. Prior to clot formation. Within 3 hr of symptom onset.

Within 3 hr of symptom onset.

a nurse is preparing to administer a transfusion of 300 mL of pooled platelets for a client who has severe thrombocytopenia. The nurse should plan to administer the transfusion over which of the following time frames? Within 30 min/unit Within 60 min/unit Within 2 hr/unit Within 4 hr/unit

Within 30 min/unit Platelets should be administered 15-30 mins to prevent clumping

A provider prescribes IV heparin for this patient. Which of the following parameters should you monitor for in regard to determining if a therapeutic dose is being administered? INR, two to three times the patient's baseline aPTT, one and a half to two times the patient's baseline Platelet count of 100,000 mm3 PT 11-12.5 sec

aPTT, one and a half to two times the patient's baseline

While the patient is still receiving continuous IV heparin, the provider prescribes oral warfarin (Coumadin). This is because warfarin takes 3 to 5 days to achieve therapeutic effects. IV heparin alone becomes ineffective after the first 1 to 2 days. abrupt cessation of heparin therapy increases the risk for thrombocytopenia. warfarin reduces the risk for hemorrhage.

warfarin takes 3 to 5 days to achieve therapeutic effects.