Deck 39: Biologic Response Modifiers

Question 1

A client is receiving interferon. What should be the highest priority nursing intervention to prevent the client from experiencing rigors?

A) Pretreat with acetaminophen (Tylenol) and meperidine (Demerol).
B) Provide antiemetics before treatment and around the clock.
C) Infuse IV fluids as quickly as possible and assess urine output.
D) Provide analgesia every 4 hours and assess for pain.

Answer 1

Pretreat with acetaminophen (Tylenol) and meperidine (Demerol).

Question 2

What does appropriate client teaching for clients receiving biologic response modifiers (BRMs) include?

A) Report weight loss and signs of infection or bleeding.
B) Severe weakness and malaise are expected side effects.
C) BRM therapy has no teratogenic effects.
D) Most BRM side effects persist after therapy is discontinued.

Answer 2

Report weight loss and signs of infection or bleeding.

Question 3

The client is being treated with Epoetin Alfa. The nurse expect to see in the client's laboratory values a(n) _____ hematocrit and a(n) _____ plasma volume.

A) decreased; increased
B) increased; decreased
C) decreased; decreased
D) increased; increased

Answer 3

increased; decreased

Question 4

The nurse reviews a medication history for a client prescribed sargramostim (Leukine) for treatment of acute myelogenous leukemia (AML). The client is being treated with all of the following medications. Which one will require the nurse to contact the healthcare provider?

A) Diphenhydramine (Benadryl)
B) Furosemide (Lasix)
C) Lithium (Eskalith)
D) Risperidone (Risperdal)

Question 5

The client is scheduled to receive treatment with Leukine. She is currently receiving treatment with lithium. As a result of the interaction of the medications, the nurse anticipates that the client will experience a(n) _____ effect of the _____.

A) increased; Leukine
B) increased; lithium
C) decreased; Leukine
D) decreased; lithium

Question 6

The nurse is administering erythropoietin. The nurse anticipates that the client will experience which side effects of receiving the medication?

A) Orthostatic hypotension and dizziness
B) Shortness of breath and tachypnea
C) Bradycardia and agonal respirations
D) Headaches and hypertension

Question 7

A client with leukemia is receiving colony-stimulating factors (CSFs). The nurse anticipates that the client will be affected by the medication by exhibiting:

A) a decrease in the actual size of the tumor.
B) a decrease in length of posttreatment neutropenia.
C) an increase in fungus-destroying ability.
D) diminished bacterial infection.

Question 8

The client is being treated with Epoetin Alfa. The nurse notes that his blood pressure, which had a baseline reading of 114/82, has risen to stay consistently at 142/90 or higher. What is the highest priority action on the part of the nurse?

A) Contact the physician; this is indicative of an adverse reaction to the medication.
B) Contact the pharmacist; this is indicative of the drug being prepared in error.
C) Contact the pharmacist; this indicates the client is experiencing an anaphylactic reaction.
D) Contact the physician; this is an expected side effect of the medication.

Question 9

The highest priority nursing intervention to prevent the client from experiencing fatigue related to biologic response modifiers is to administer the drug:

A) with iron to prevent anemia.
B) with high-calorie foods to protect the stomach.
C) before bedtime to allow the patient to sleep.
D) with high-fat food to provide quick energy.

Question 10

A client is to receive oprelvekin (Neumega). The nurse confirms that the client is experiencing fluid retention related to the medication by monitoring the client for evidence of:

A) peripheral edema and exertional dyspnea.
B) bradycardia and hypotension.
C) restlessness and hypoxia.
D) hypothermia and ventricular dysrhythmias.

Question 11

A client is taking G-CSF, or filgrastim (Neupogen). Which nursing interventions are indicated for the most common side effect of this medication?

A) Stool softeners and a high-fiber diet for constipation
B) High fluid intake and vitamin C for alkaline urine
C) Acetaminophen (Tylenol) and assessment for fever
D) Nonnarcotic analgesia and comfort measures for pain

Question 12

A client is to receive filgrastim (Neupogen) as a granulocyte-stimulating factor. The nurse recognizes that this medication should not be given when the client has:

A) severe myelosuppression.
B) a history of hypertension.
C) received cytotoxic agents less than 24 hours before.
D) a neutrophil count lower than 500.