Pharmacology Chapter 31 Practice Quiz

The nurse explains to the client that the development of pernicious anemia is caused by: a) Lack of intrinsic factor; vitamin B12 deficiency. b) Bone marrow depression. c) Iron deficiency. d) Blood loss.

a Rationale: Intrinsic factor is required for vitamin B12 to be absorbed from the intestine. The most profound consequence of B12 deficiency is pernicious anemia, or megaloblastic anemia.

The client receiving filgrastim (Neupogen) should be monitored for common adverse effects, which include: a) Hypertension and skeletal pain. b) Elevated liver enzymes. c) Hypotension and hypoglycemia. d) Elevated BUN and creatinine.

a Rationale: The nurse should assess for both hypertension and skeletal pain, which are adverse effects of filgrastim therapy.

The nursing care plan for a client receiving epoetin alfa (Epogen, Procrit) should include careful monitoring for symptoms of: a) Angina, or a change in level of consciousness. b) Impaired liver function. c) Severe hypotension. d) Severe diarrhea.

a Rationale: This drug increases the risk of thromboembolic disease. The client should be monitored for early signs of stroke or heart attack.

The nurse administers filgrastim (Neupogen) to the client. The nurse explains that this drug is used in the treatment of: a) Acute lymphoblastic leukemia. b) Neutropenia, or neutropenia secondary to chemotherapy. c) Clients with Hodgkin's disease who are having bone marrow transplants. d) Hodgkin's lymphoma.

b Rationale: Filgrastim is a colony-stimulating factor used primarily for chronic neutropenia, or neutropenia secondary to chemotherapy.

The client receiving chemotherapy is prescribed oprelvekin (Neumega) as part of the treatment regimen. The nurse explains that the function of this drug is to: a) Reverse bone marrow suppression. b) Stimulate platelet production. c) Reduce excessive immature white cells. d) Stimulate white blood cell production.

b Rationale: Oprelvekin (Neumega) is a medication, produced through recombinant DNA technology, that stimulates the production of megakaryocytes and thrombopoietin. The drug is used to stimulate the production of platelets in clients who are at risk for thrombocytopenia caused by cancer chemotherapy.

Before administering sargramostim (Leukine), the nurse should assess: a) Blood pressure. b) CBC. c) Level of consciousness. d) Bowel sounds.

b Rationale: The CBC should be assessed prior to administration, because this drug is contraindicated when excessive leukemic myeloid blasts are present in blood or bone marrow.

The nurse teaches the client and caregivers to immediately report to the health care provider which of the following symptoms of adverse reaction to oprelvekin (Neumega)? a) Thirst b) Muscle pain c) Cough; difficulty breathing d) Nausea

c Rationale: Fluid retention is a common side effect of oprelvekin therapy. The client should be assessed for the symptoms of pleural effusion, HF, and dysrhythmias.

The nurse prepares nutritional teaching for a group of clients. The nurse recognizes that the client most at risk for ____________ anemia is the client diagnosed with insufficient dietary intake. a) Aplastic b) Hemolytic c) Folate-deficiency d) Sickle-cell

c Rationale: The most common cause of folate deficiency is insufficient dietary intake. This is most commonly observed with chronic alcoholism, although other absorption diseases of the small intestine can result in folate anemia.

A client with a diagnosis of cancer is receiving epoetin alfa (Epogen, Procrit) as part of the treatment regimen. The nurse evaluates the effectiveness of this drug by: a) Assessing the client's energy level. b) Monitoring the client's blood pressure. c) Monitoring the hematocrit and hemoglobin levels. d) Assessing the client's level of consciousness.

c Rationale: This medication does not cure the primary disease condition; however, it helps reduce the anemia that dramatically affects the client's ability to function. The hematocrit and hemoglobin levels will provide a reference for evaluating the drug's effectiveness.

Erythropoietin regulates the process of red blood cell formation. The nurse understands that this mechanism is activated by a reduction of oxygen reaching the: a) Lungs. b) Brain. c) Heart. d) Kidneys.

d Rationale: Secreted by the kidney, erythropoietin travels to the bone marrow, where it interacts with receptors on hematopoietic stem cells with the message to increase erythrocyte production. The primary signal for the increased secretion of erythropoietin is a reduction in oxygen reaching the kidneys.