Deck 31: Drugs for Hematopoietic Disorders

Question 1

The physician has prescribed epoetin alfa (Epogen)for the client.What is the priority assessment by the nurse?
1)The client's blood pressure
2)The client's report of a headache,indicating a stroke
3)The client's ability to use the proper injection techniques for self-administration
4)The client's hemoglobin and hematocrit levels

Answer 1

1

Question 2

The client is pregnant and has been told by her physician that she needs cyanocobalamin (Nascobal).She asks the nurse,"Will this hurt my baby?" What is the best response by the nurse?
1)"No,this medication will not hurt your baby as long as you take it with ascorbic acid."
2)"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."
3)"No,this medication will not hurt your baby as long as you take the pills only in the third trimester."
4)"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."

Answer 2

2

Question 3

Colony-stimulating factors (CSFs)are named according to
1)type of blood cell stimulated.
2)type of hormone secreted.
3)type of homeostatic control.
4)type of stem cell stimulated.

Answer 3

1

Question 4

To decrease gastric irritation,anti-anemia medications,such as ferrous sulfate (Ferosol),should be taken with
1)milk.
2)other medications,such as calcium.
3)orange juice.
4)food.

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?
1)"It comes from the interleukins it stimulates;this one stimulates neuocytes."
2)"It comes from the blood cell it stimulates;this one stimulates neutrophils."
3)"It comes from the stem cells it stimulates,such as filgrastims."
4)"It is a complicated process;the drug companies are secretive about it."

Question 6

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 statements? Credit will be given only if all correct choices and no incorrect choices are selected.
1)"Red blood cell formation is regulated through chemicals called colony-stimulating factors that come from white blood cells."
2)"Red blood cell formation is regulated through messages from the hormone,secretin,which is located in the kidney."
3)"Red blood cell formation is regulated through specific liver enzymes and a process called hemochromatosis."
4)"Red blood cell formation is regulated through messages from the hormone erythropoietin."
5)"Red blood cell formation is regulated through specific transporter proteins called apolipoprotein A and B."

Question 7

Per classification of anemias,the morphology for pernicious anemia or folate-deficiency anemia results in
1)hematocytic-hematochromic erythrocytes.
2)microcytic-hypochromic erythrocytes.
3)macrocytic-normochromic erythrocytes.
4)normocytic-normochromic erythrocytes.

Question 8

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

Question 9

The client receives chemotherapy as therapy for cancer.The physician orders epoetin alfa (Procrit)subcutaneously.The client asks the nurse if this drug is also chemotherapy.What is the best response by the nurse?
1)"No,but it works with your chemotherapy to make it more effective."
2)"No,this drug helps to counteract the nausea and vomiting caused by your chemotherapy."
3)"No,it will stimulate your immune system to help you battle the cancer."
4)"No,this drug will help prevent anemia that can be caused by your chemotherapy."

Question 10

The nurse teaches a class on iron-deficiency anemia to a group of pregnant clients who are all taking ferrous sulfate (Feosol).The nurse evaluates that additional learning is needed when the clients make which statement?
1)"Most iron in our bodies is stored on hemoglobin in the red blood cell."
2)"Transferrin is a protein that transports iron to places in our bodies where it is needed."
3)"We need extra iron because when our red blood cells die,all their iron is excreted from the body."
4)"The most common cause of nutritional anemia is iron deficiency."

Question 11

The client is receiving ferrous sulfate (Feosol)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?
1)"My anemia was caused by blood loss from my ulcer,but there are other causes too."
2)"My anemia was caused by drinking too many carbonated beverages with caffeine."
3)"There are many causes for anemia;mine was caused by heart failure and fluid overload."
4)"I think my anemia occurred when I started that vegetarian diet."

Question 12

The physician has ordered filgrastim (Neupogen)intravenously for the client.What is a priority plan by the nurse prior to administering this drug?
1)Plan to monitor the client's ECG readings.
2)Plan to insert a Foley catheter and monitor urine output.
3)Plan to administer 10% oxygen during the infusion.
4)Plan to have a white blood cell (WBC)count drawn every 30 minutes.

Question 13

The client complains of constipation while receiving ferrous sulfate (Feosol).What is the best plan by the nurse to assist the client in resolving this common side effect?
1)Plan to teach the client about which laxatives are the safest to use.
2)Plan to teach the client to increase fluids and high-fiber foods in the diet.
3)Plan to teach the client to self-administer Fleets enemas.
4)Plan to teach the client to increase exercise.

Question 14

The client had stomach cancer and a surgical removal of his stomach several years ago.The physician prescribed cyanocobalamin (Crystamine).The client stopped this drug several months ago.What will the nurse most likely assess in this client?
1)Memory loss,numbness in the limbs,and depression
2)A gradual decrease in red blood cell counts
3)Jaundice,and tarry stools
4)Low hemoglobin and hematocrit counts

Question 15

The mechanism of action of colony-stimulating factors,such as filgrastim (Neupogen),is to
1)increase neutrophil production.
2)supplement iron in the body.
3)replace vitamin B₁₂ factor.
4)increase erythrocyte production.

Question 16

The process for regulating hematopoiesis occurs via
1)white bone marrow.
2)hematopoietic stem cell.
3)hormones.
4)essential vitamins and nutrients.

Question 17

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 are the best responses by the nurse? Credit will be given only if all correct choices and no incorrect choices are selected.
1)"Your kidney makes more erythropoietin if it doesn't get enough oxygen."
2)"Erythropoietin also helps your body make hemoglobin."
3)"This stimulates your kidney to make more red blood cells."
4)"It is similar to a kidney hormone,erythropoietin,and helps your body make more red blood cells."
5)"Your kidney makes more erythropoietin when you have too much fluid in your body."

Question 18

The client calls the nurse and is very frantic."I think something is wrong! My stools are black and they have never been this color before!" The client is receiving ferrous sulfate (Feosol).What is the best response by the nurse?
1)"This is an expected side effect of ferrous sulfate (Feosol);it is okay."
2)"This sounds serious;you may have started bleeding again."
3)"Do you have hemorrhoids? That could be the problem."
4)"I will speak with your doctor and call you right back."

Question 19

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?
1)"This medication will help my chemotherapy work better."
2)"This medication will help increase my platelet count."
3)"This medication will help me regain the weight I have lost."
4)"This medication will help increase my red blood cell count."

Question 20

In monitoring clients receiving hematopoietic agents,it is most important for the nurse to monitor for
1)thromboembolus.
2)TIA (transient ischemic attack).
3)MI (myocardial infarction).
4)stroke.

Question 21

A nurse is preparing to administer ferrous sulfate IM to a client with anemia.What should the nurse consider when giving this injection? Credit will be given only if all correct choices and no incorrect choices are selected.
1)Give the injection in the deltoid muscle.
2)Iron is best absorbed if given subcutaneously.
3)Iron is irritating to the tissues.
4)The z-track method should be used.
5)Iron preparations should be administered through a needle gauge 16 or larger.

Question 22

A client is scheduled to have chemotherapy Thursday at 9 a.m.Filgrastim (Neupogen)has also been ordered.The nurse should plan which dosing time for the Neupogen? Credit will be given only if all correct choices and no incorrect choices are selected.
1)No later than 9 a.m.on Wednesday
2)At the time of the chemotherapy infusion
3)Immediately following the chemotherapy
4)No earlier than 9 a.m.Friday
5)Immediately before the chemotherapy

Question 23

A client's blood work shows an anemia that was not present at the last clinic visit 6 months ago.Which s should the nurse ask this client? Credit will be given only if all correct choices and no incorrect choices are selected.
1)"Have you had a significant dietary change in the last 6 months?"
2)"Do you handle chemicals in your new job?"
3)"Have your stools changed in appearance?"
4)"Have you been eating more carbohydrates than usual?"
5)"Are your menstrual periods heavier than normal for you?"

Question 24

A client is to receive darbepoetin alfa (Aranesp)adjunctive medication during chemotherapy.The client says,"Not another drug.Why do I need this one?" How should the nurse respond? Credit will be given only if all correct choices and no incorrect choices are selected.
1)"I know you are tired of drugs,but this is just one more."
2)"This drug will help you grow red blood cells."
3)"This drug will help keep you from getting infections."
4)"This is an erythropoiesis-stimulating factor."
5)"This drug will help you get more oxygen around to your tissues so you feel better."

Question 25

A client has been treated with an erythropoiesis-stimulating factor.Which client assessment would the nurse interpret as indicating the goal of this treatment has been reached? Credit will be given only if all correct choices and no incorrect choices are selected.
1)The client's hemoglobin values have risen.
2)The client reports less shortness of breath on exertion.
3)The client has not had an episode of epistaxis in over three weeks.
4)The client reports enjoying a walk with family for the first time in months.
5)The client has not had a fever since treatment began.