Chapter 11: Drug Therapy for Hematopoietic Disorders

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. Blood pressure B. Temperature C. Respirations D. Pulse

A

What does the nurse understand about why patients are more compliant with pegfilgrastim therapy versus filgrastim therapy? A. Pegfilgrastim only has to be administered once per chemotherapy cycle instead of daily. B. Pegfilgrastim may be taken by mouth and filgrastim is taken by IV or SC injection. C. Pegfilgrastim has fewer side effects that filgrastim. D. Pegfilgrastim works more rapidly and requires a shorter course of therapy.

A

What would be the priority nursing diagnosis for a patient who is prescribed epoetin alfa? A. Impaired tissue oxygenation related to anemia B. Alteration in nutrition due to poor intake of iron C. Altered skin integrity due to the disease process D. Alteration in bowel elimination due to side effects of the medication

A

During recovery from a gastrointestinal bleed, a client has been prescribed an iron preparation. Prior to beginning therapy, what assessment should the nurse prioritize? A. White cell differential B. Hematocrit and hemoglobin C. Aspartate aminotransferase levels D. Serum creatinine levels

B

The nurse administers interferon alpha-2b to a patient. Which assessment finding will the nurse act on immediately? A. The patient administered the medication at home B. The patient has elevated liver function tests. C. The patient reports felling "fatigued." D. The patient has a form of leukemia.

B

The nurse improves client compliance with the drug regimen of epoetin alfa through what intervention? A. providing the client with an appointment card for each drug administration day B. helping the client set up a reminder system for days when the drug is to be administered C. having the client's pharmacy contact the client on days when the drug should be administered D. arranging a referral for community transportation to come pick up the client from home

B

The nurse is caring for a client who has been newly diagnosed with cancer. The client tells the nurse, "I saw advertisements on epoetin alfa and I want to start taking it immediately so I don't get tired from chemotherapy." What is the nurse's best respons A. "The primary health care provider may order epoetin alfa for you when it is appropriate, but now is not the time." B. "Epoetin alfa is only effective if you develop anemia from chemotherapy that is caused by low levels of erythropoietin." C. "Chemotherapy causes anemia and only when that happens will it be appropriate to prescribe epoetin alfa for you." D. "Being anemic is a requirement for this medication, so I will draw some blood for lab work while you're here."

B

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. Sodium restriction B. Iron Supplement C. Renal Dialysis D. Potassium Supplement

B

A client diagnosed with iron deficiency has been taking oral ferrous sulfate for the past several days. When the nurse is assessing for therapeutic effects, what question is most warranted? A. "Is your skin feeling itchy when you're at rest?" B. "Are you having any leg spasms or restless legs at night?" C. "How is your energy level compared with a few days ago?" D. "Do you feel like you're able to see a bit more clearly now?"

C

A client has chronic renal failure. As the disease progresses, the client is experiencing increasing shortness of breath, due to anemia. The nurse would anticipate which medication order? A. Interferon gamma B. Penicillin C. Epoetin alfa D. Filgrastim

C

A client prescribed epoetin alfa asks how the medication works. Which is the nurse's best response? A. "Releases erythropoiesis from the kidneys to increase the number of platelets" B. "Stimulates the growth and development of white blood cells (WBC) to prevent neutropenia" C. "increases the release of cells to increase the hemoglobin and hematocrit levels." D. "Decrease release of eticulocytes, which inhibits red blood cell (RBC) production."

C

A male client is prescribed interferon. What is his probable diagnosis? A. Bacteremia B. Sepsis C. Viral hepatitis D. Hypertension

C

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. thrombocytopenia B. hypoglycemia C. hypertension D. anemia

D

The client with what condition is most likely to benefit from treatment with interferon beta? A. Hepatitis A B. Parkinson's disease C. Cognition impairment due to Alzheimer's disease D. Multiple sclerosis

D

The pharmacology class learns that epoetin alfa is an immunosuppressant drug that is designed to have what expected outcome? A. Increased WBC count B. Decreased WBC count C. Decreased RBC count D. Increased RBC count

D

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. Venous Thromboembolism D. Disseminated intravascular coagulation (DIC)

B

The nurse is caring for a client who has been receiving filgrastim. The nurse expects to perform which action concerning this drug on the day prior to the client's chemotherapy treatment? A. Ensure that the client's diet has no herbs B. Give the medication both morning and evening C. Administer IV instead of SC D. Hold the medication

D

The nurse is teaching a client about erythrocytes. Which information would the nurse include in the teaching plan? A. Erythrocytes are also called white blood cells. B. Erythrocytes are also called platelets. C. Erythrocytes are also called plasma. D. Erythrocytes are also called red blood cells.

D

The pharmacology instructor is talking about interferon. The instructor explains that agents such as interferons have more than one biologic function. What function is NOT associated with interferons? A. Immunomodulatory B. Antiviral C. Antiproliferative D. Antibacterial

D

A client is receiving darbepoetin. The laboratory report indicates that the client's hemoglobin level increased 2 g/dL in 2 weeks and is now 12 g/dL. What would the nurse expect the health care provider to do? A. Reduce the medication B. Increase the medication C. Maintain the current dose D. Discontinue the medication

A

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. Temporarily withholding administration B. Changing the route of administration C. Requesting a change in the dosage D. Administering an unscheduled dose

A

A patient has just received IV cytotoxic chemotherapy. Which patient statement indicates a need for further teaching about this therapy with filgrastim (Neupogen)? A. "I am going to administer my Neupogen as soon as I get home today." B. "I will be careful and not stay around people who have infections." C. "I will take acetaminophen (Tylenol) if I have bone pain." D. "I will tell my healthcare provider if I have breathing difficulties after receiving this medication."

A

Katie, a 45-year-old patient with breast cancer, is currently undergoing chemotherapy. She is started on epoetin alfa secondary to decreased hemoglobin and hematocrit levels. What rule is important when administering epoetin alfa, after reconstituting it? A. Do not shake the drug vigorously. B. Shake the drug before use. C. Warm the drug before use. D. Administer the drug immediately, without allowing time for the hematocrit to rise.

A

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's hemoglobin level is 11 g/dL C. The patient white blood cell level is within reference ranges D. The patient maintains an oxygen saturation of 92% on room air

B

A client taking epoetin alfa requests changing the medication from the subcutaneous route to the PO route. How should the nurse respond? A. The drug dose must be increased if being given via the oral route. B. The oral route is not as effective. C. This medication is destroyed in the stomach and can only be given by injection. D. This medication causes severe diarrhea if given orally.

C

A patient has just been told that her cancer has metastasized to the right kidney. An interferon has been prescribed to treat this metastasis. The patient asks why the interferon is ordered. What is the nurse's best response? A. It has been shown to have direct proliferative effect on renal tumors B. It has been shown to protect autologous tumor cells C. It has been shown to inhibit tumor growth D. It has been shown to enhance allogeneic stem-cell transplantation.

C

The nurse has just admitted a client to the unit who is newly diagnosed with Kaposi's sarcoma. The health care provider has order an IV infusion of an interferon. What drug has the provider ordered? A. Interferon beta-1a B. Peginterferon alfa-2b C. Interferon alfa-2b D. Interferon gamma-1b

C

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. Chemotherapy C. Renal Failure D. Iron levels.

D

The nurse is caring for a client who had a postpartum hemorrhage 2 weeks ago that resulted in anemia. The client has called the clinic after passing dark stools, stating, "I looked this up online, and I'm worried I might have stomach or intestinal bleeding." What is the nurse's best initial action? A. See if the client was treated with erythropoietin. B. Ask how much blood the client lost postpartum. C. Assess the client's usual bowel pattern. D. Determine if the client is taking iron supplements.

D

The nurse is caring for a client who had a postpartum hemorrhage 2 weeks ago that resulted in anemia. The client has called the clinic after passing dark stools, stating, "I looked this up online, and I'm worried I might have stomach or intestinal bleeding." What is the nurse's best initial action? A. See if the client was treated with erythropoietin. B. Ask how much blood the client lost postpartum C. Assess the clients usual bowl pattern. D. Determine if the client is taking iron supplements.

D

While reviewing a client's the record, the nurse sees that the client received a dose of interferon alpha-2b? For what disorder does the nurse suspect the client was being treated? A. bacterial pneumonia B. ankylosing spondylosis C. asthma D. chronic hepatitis C

D