Deck 28: Drugs for Hematopoietic Disorders

Question 1

The client is receiving chemotherapy for cancer. The physician has prescribed oprelvekin (Neumega). The nurse has completed medication education and evaluates it as effective when the client makes which statement?

A) "This medication will help my chemotherapy work better."
B) "This medication will help increase my red blood cell count."
C) "This medication will help me regain the weight I have lost."
D) "This medication will help increase my platelet count."

Answer 1

"This medication will help increase my platelet count."

Question 2

The client receives epoetin alfa (Epogen) subcutaneously, and says to the nurse, "My doctor said I have anemia. Are there little red blood cells in that shot"? What is (are) the best response(s) by the nurse? Select all that apply.

A) "Your kidney makes more erythropoietin if it doesn't get enough oxygen."
B) "Erythropoietin also helps your body make hemoglobin."
C) "It is similar to a kidney hormone, erythropoietin, and helps your body make more red blood cells."
D) "This stimulates your kidney to make more red blood cells."
E) "Your kidney makes more erythropoietin when you have too much fluid in your body."

Answer 2

"Your kidney makes more erythropoietin if it doesn't get enough oxygen."
"Erythropoietin also helps your body make hemoglobin."
"It is similar to a kidney hormone, erythropoietin, and helps your body make more red blood cells."

Question 3

The nurse teaches a class on iron -deficiency anemia to a group of pregnant clients who are all taking ferrous sulfate (Novoferrosulpha). The nurse evaluates that additional learning is needed when the clients make which statement?

A) "We need extra iron because when our red blood cells die, all their iron is excreted from the body."
B) "Transferrin is a protein that transports iron to places in our bodies where it is needed."
C) "The most common cause of nutritional anemia is iron deficiency."
D) "Most iron in our bodies is stored on hemoglobin in the red blood cell."

Answer 3

"We need extra iron because when our red blood cells die, all their iron is excreted from the body."

Question 4

The client is pregnant and has been told by her physician that she needs cyanocobalamin (Anacobin). She asks the nurse, "Will this hurt my baby?" What is the best response by the nurse?

A) "No, this medication will not hurt your baby as long as you take it with ascorbic acid."
B) "No, this is safe as long as long as you take it in pill form; it is a Pregnancy Category A drug, which means it is safe for your baby."
C) "No, this medication will not hurt your baby as long as you take the pills only in the third trimester."
D) "No, this is safe in either pill or injectable form; it is a Pregnancy Category A drug which means it is safe for your baby."

Question 5

The client receives filgrastim (Neupogen). He asks the nurse "That is such a funny name; where do you suppose it comes from"? What is the best response by the nurse?

A) "It comes from the blood cell it stimulates; this one stimulates neutrophils."
B) "It comes from the interleukins it stimulates; this one stimulates neuocytes."
C) "It comes from the stem cells it stimulates, such as filgrastims."
D) "It is a complicated process; the drug companies are secretive about it."

Question 6

The client complains of constipation while receiving ferrous gluconate (Apo -Ferrous gluconate). What is the best plan by the nurse to assist the client in resolving this common side effect?

A) Plan to teach the client about which laxatives are the safest to use.
B) Plan to teach the client to increase fluids and high -fibre foods in the diet.
C) Plan to teach the client to increase exercise.
D) Plan to teach the client to self -administer Fleets enemas.

Question 7

The client calls the nurse and is very frantic. "I think something is wrong! My stools are black and they have never been this colour before!" The client is receiving ferrous fumarate (Palafer). What is the best response by the nurse?

A) "Do you have hemorrhoids? That could be the problem."
B) "This sounds serious; you may have started bleeding again."
C) "I will speak with your doctor and call you right back."
D) "This is an expected side effect of ferrous fumarate (Palafer); it is okay."

Question 8

The physician has prescribed epoetin alfa (Epogen) for the client. What is the priority assessment by the nurse?

A) the client's ability to use the proper injection techniques for self -administration
B) the client's report of a headache, indicating a stroke
C) the client's blood pressure
D) the client's hemoglobin and hematocrit levels

Question 9

The nurse is teaching a class on how red blood cell formation is regulated by the body to a group of clients who have AIDS. The nurse evaluates that learning has occurred when the clients make which statement(s)? Select all that apply.

A) "Red blood cell formation is regulated through messages from the hormone, secretin, which is located in the kidney."
B) "Red blood cell formation is regulated through specific liver enzymes and a process called hemochromatosis."
C) "Red blood cell formation is regulated through specific transporter proteins called apolipoprotein A and B."
D) "Red blood cell formation is regulated through messages from the hormone erythropoietin."
E) "Red blood cell formation is regulated through chemicals called colony -stimulating factors that come from white blood cells."

Question 10

The physician has ordered filgrastim (Neupogen) intravenously for the client. What is a priority plan by the nurse prior to administering this drug?

A) Plan to administer 6 lpm of oxygen during the infusion.
B) Plan to insert a Foley catheter and monitor urine output.
C) Plan to have a white blood cell (WBC) count drawn every 30 minutes.
D) Plan to monitor the client's ECG readings.

Question 11

The client has chronic alcoholism. He asks the nurse why his doctor put him on folic acid (Folvite) since he promised the doctor that he would stop drinking. What is the best response by the nurse?

A) "You should ask your doctor since you promised him that you would not drink anymore."
B) "You have been drinking instead of eating, and alcohol interferes with folate metabolism in your liver."
C) "You need folic acid because you have not been compliant with taking your vitamins and attending Alcoholics Anonymous (AA) meetings."
D) "You need folic acid to make up for the vitamin B12 deficiency that was caused by your alcoholism."

Question 12

The client is receiving ferrous sulfate (Novoferrosulpha) for the treatment of anemia. The nurse has taught the client about this drug and about anemia. The nurse evaluates that learning has occurred when the client makes which statement?

A) "My anemia was caused by blood loss from my ulcer, but there are other causes too."
B) "I think my anemia occurred when I started that vegetarian diet."
C) "My anemia was caused by drinking too many carbonated beverages with caffeine."
D) "There are many causes for anemia; mine was caused by heart failure and fluid overload."

Question 13

A small child has been diagnosed with iron deficiency anemia, and has a very low level of iron. What will the nurse most likely assess in this child?

A) sensitivity to certain fabrics and aggression.
B) difficulty in performing age -related psychomotor tasks.
C) hyperactivity and difficulty focusing on tasks.
D) depression and severe anxiety.

Question 14

The client receives chemotherapy as therapy for cancer. The physician orders epoetin alfa (Eprex) subcutaneously. The client asks the nurse if this drug is also chemotherapy. What is the best response by the nurse?

A) "No, this drug helps to counteract the nausea and vomiting caused by your chemotherapy."
B) "No, it will stimulate your immune system to help you battle the cancer."
C) "No, but it works with your chemotherapy to make it more effective."
D) "No, this drug will help prevent anemia that can be caused by your chemotherapy."

Question 15

The client had stomach cancer and a surgical removal of his stomach several years ago. The physician prescribed cyanocobalamin (Anacobin). The client stopped this drug several years ago. What will the nurse most likely assess in this client?

A) a gradual decrease in red blood cell counts
B) memory loss, numbness in the limbs, and depression
C) low hemoglobin and hematocrit counts
D) jaundice, and tarry stools