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pharm 2 exam 3 > Questions on Hematopoietic and immunosuppressants > Flashcards

Questions on Hematopoietic and immunosuppressants Flashcards

1
Q

The nurse is monitoring a client who is receiving epoetin alfa (Epogen, Procrit) for adverse effects of the medication. Which finding indicates an adverse effect?

  1. Diarrhea
  2. Depression
  3. Bradycardia
  4. Hypertension
A
  1. Hypertension
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2
Q

The nurse is evaluating the results of laboratory studies for a client receiving epoetin alfa (Epogen, Procrit). When should the nurse expect to note a therapeutic effect of this medication?

  1. Immediately
  2. 3 days after therapy
  3. 2 weeks after therapy
  4. After 1 week of therapy
A
  1. 2 weeks after therapy
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3
Q

The nurse is preparing to administer filgrastim (Neupogen) to a client with a diagnosis of agranulocytosis. The client asks the nurse about the purpose of the medication. The nurse explains that this medication will have which action?

  1. Prevent bleeding.
  2. Prolong the clotting time.
  3. Increase the red blood cell count.
  4. Promote the growth of neutrophils.
A
  1. Promote the growth of neutrophils
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4
Q

A home care nurse is preparing to administer filgrastim (Neupogen) to a client. The nurse plans to administer the medication by which route?

  1. Oral
  2. Subcutaneous
  3. Intramuscular
  4. Intravenous bolus
A
  1. Subcutaneous
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5
Q

The nurse is reviewing the laboratory test results for a client who is receiving filgrastim (Neupogen). Which reported value would indicate an effective response to this medication?

  1. Hematocrit of 42%
  2. Blood glucose level of 120 mg/dL
  3. Platelet count of 150,000 cells/mm3
  4. Neutrophil count of 10,000 cells/mm3
A
  1. Neutrophil count of 10,000 cells/mm3
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6
Q

The nurse is preparing to administer filgrastim (Neupogen) by intravenous (IV) infusion. Which nursing action is appropriate for administering this medication?

  1. Shake the solution before drawing it up.
  2. Dilute the medication in normal (0.9%) saline.
  3. Discard the medication if it has been refrigerated.
  4. Dilute the medication in 5% dextrose in water (D5W).
A
  1. Dilute the medication in 5% dextrose in water (D5W).
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7
Q

A client with chronic kidney disease was started on epoetin alfa (Epogen, Procrit) 2 months earlier. In evaluating the therapeutic effectiveness of the medication, the nurse should expect the client to exhibit which finding?

  1. A decrease in blood pressure
  2. An increase in white blood cells
  3. An increase in serum hematocrit
  4. A decrease in serum creatinine levels
A
  1. An increase in serum hematocrit
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8
Q

Epoetin alfa (Epogen, Procrit) has been prescribed for a client with chronic kidney disease who is being cared for by a nursing student. The nursing instructor determines that the student understands the procedure for administering the medication when the student states that which route of administration is acceptable?

  1. Oral
  2. Z-track
  3. Intramuscular
  4. Subcutaneous
A
  1. Subcutaneous
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9
Q

Epoetin alfa (Epogen, Procrit) by the subcutaneous route is prescribed for a client. Which is the correct action for the nurse to implement?

  1. Shake the vial before use.
  2. Freeze the medication before use.
  3. Refrigerate the medication until used.
  4. Obtain syringes with 1½-inch needles from the pharmacy
A
  1. Refrigerate the medication until used.
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10
Q

The client in chronic kidney disease is receiving epoetin alfa (Epogen). The nurse should monitor this client for which adverse effect of this medication?

  1. Fever
  2. Depression
  3. Bradycardia
  4. Hypertension
A
  1. Hypertension
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11
Q

The nurse is caring for a patient with anemia related to chronic renal failure. Which agent below might be used to treat the anemia?

A. Filgrastim (Neupogen)
B. Sargramostim (Leukine)
C. Oprelvekin (Neumega)
D. Epoetin alfa (Procrit)

A

D. Epoetin alfa (Procrit)

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12
Q

The nurse is administering epoetin alfa (Procrit) to a patient receiving chemotherapy. Which adverse effect below is a potential risk with this drug?

A. Accelerated tumor progression
B. Hypotension
C. Easy bruising
D. Bone pain

A

A. Accelerated tumor progression

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13
Q

The nurse is caring for a patient undergoing cancer chemotherapy who presents with rash, bone pain, hypertension, and pedal edema. Which symptom is most likely an adverse reaction to the filgrastim (Neupogen) he is receiving?

A. Rash
B. Bone pain
C. Hypertension
D. Pedal edema

A

B. Bone pain

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14
Q

The nurse is evaluating the effectiveness of the drug oprelvekin (Neumega) in a patient undergoing cancer chemotherapy. Which finding below is the most indicative that this drug is having its intended effect?

A.   Platelet count = 150 × 103/mm3  
B.   Hemoglobin = 13.2 g/dL  
C.   White blood cells = 5500/mm3  
D.   Total lymphocyte count = 1000/mm3
A

A. Platelet count = 150 × 103/mm3

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15
Q

A transplant recipient patient is receiving cyclosporine (Sandimmune). Which of these responses should a nurse expect if the medication is having the desired effect?

A. Increased antibody response
B. Increased natural killer (NK) cellular activity
C. Suppression of T lymphocytes
D. Suppression of hepatic metabolism of steroids

A

C. Suppression of T lymphocytes

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16
Q

A patient who is receiving cyclosporine (Sandimmune) is also receiving ketoconazole (Nizoral). The nurse should expect which of these therapeutic outcomes from the combined medications?

A. Improved glomerular filtration rate
B. Inhibition of cyclosporine metabolism
C. Decreased risk of lymphoma occurrence
D. Decreased risk of bacterial and viral infections

A

B. Inhibition of cyclosporine metabolism

17
Q

The nurse is caring for a postrenal transplantation client taking cyclosporine (Sandimmune). The nurse notes an increase in one of the client’s vital signs and the client is complaining of a headache. What vital sign is most likely increased?

  1. Pulse
  2. Respirations
  3. Blood pressure
  4. Pulse oximetry
A

. Blood pressure

18
Q

Tacrolimus (Prograf) is prescribed to a client for prevention of organ rejection after renal transplantation. Which prescription should the nurse anticipate to be prescribed, along with the tacrolimus, for this client?

  1. Prednisone
  2. Phenytoin (Dilantin)
  3. Fluconazole (Diflucan)
  4. Erythromycin (Erythrocin)
A
  1. Prednisone
19
Q

Azathioprine (Imuran) is prescribed for a client to suppress rejection of a renal transplant. In planning for administration of the medication, the nurse understands that which description is the mechanism of action of this medication?

  1. It cross-links DNA.
  2. It blocks all T-cell functions.
  3. It inhibits the proliferation of B and T lymphocytes.
  4. It decreases the activity of thymus-derived lymphocytes.
A
  1. It inhibits the proliferation of B and T lymphocytes
20
Q

The nurse is providing discharge instructions to a client who will be taking tacrolimus (Prograf) daily following allogenic liver transplantation. The nurse instructs the client that which is a frequent side effect related to this medication?

  1. Diarrhea
  2. Confusion
  3. Loss of memory
  4. A decrease in urine output
A
  1. Diarrhea
21
Q

Cyclosporine (Sandimmune) is prescribed for a client who received a kidney transplant. The nurse would be most concerned if a review of the medical record revealed that the client currently is taking which prescribed medications?

  1. Prednisone
  2. Digoxin (Lanoxin)
  3. Propranolol (Inderal)
  4. Phenytoin (Dilantin)
A
  1. Phenytoin (Dilantin)
22
Q

Cyclosporine (Sandimmune) is prescribed to be administered by the intravenous (IV) route. Which option indicates an inappropriate action in regard to preparing and administering this medication?

  1. Mixing the solution and covering it with a paper bag
  2. Administering the medication over a period of 2 to 6 hours
  3. Mixing 1 mL of concentrate in 50 mL of 0.9% sodium chloride and administering by infusion
  4. Mixing 1 mL of concentrate in 10 mL of 0.9% sodium chloride and administering by bolus injection
A
  1. Mixing 1 mL of concentrate in 10 mL of 0.9% sodium chloride and administering by bolus injection
23
Q

The nurse is preparing to administer a prescribed dose of cyclosporine (Sandimmune) by intravenous (IV) administration. Which priority item would the nurse have available during administration of this medication?

  1. A code cart
  2. Oral airway
  3. A suction catheter
  4. Epinephrine (Adrenalin)
A
  1. Epinephrine (Adrenalin)
24
Q

A nurse provides instructions to a client who will be taking cyclosporine (Sandimmune) oral solution. Which action should nurse tell the client to do?

  1. Mix the concentrate with orange juice.
  2. Mix the concentrate with grapefruit juice.
  3. Avoid diluting the concentrate for administration.
  4. Dilute the concentrate in a Styrofoam cup before administration.
A
  1. Mix the concentrate with orange juice.
25
Q

A nurse is monitoring a client receiving cyclosporine (Sandimmune). Which sign or symptom should indicate to the nurse that the client is experiencing an adverse effect from this medication?

  1. Nausea
  2. Tremors
  3. Alopecia
  4. Hypotension
A
  1. Tremors
26
Q

A client with a severe allergic reaction is prescribed intravenous corticosteroids. The nurse should expect that which desired effect will be achieved?

  1. Decreased inflammation
  2. Increased serum glucose
  3. Enhanced immunity
  4. Pain relief
A
  1. Decreased inflammation
27
Q

A nurse reinforces medication instructions to a client who has received a kidney transplant about therapy with cyclosporine (Sandimmune). Which statement by the client would indicate a need for further instruction?

  1. “I need to obtain a yearly influenza vaccine.”
  2. “I need to have dental checkups every 3 months.”
  3. “I need to self-monitor my blood pressure at home.”
  4. “I need to call the health care provider if my urine volume decreases or it becomes cloudy.”
A
  1. “I need to obtain a yearly influenza vaccine.”
28
Q

A client who has received a kidney transplant is taking azathioprine (Imuran), and the nurse provides instructions about the medication. Which statement by the client would indicate a need for further instruction?

  1. “I need to watch for signs of infection.”
  2. “I need to discontinue the medication after 14 days of use.”
  3. “I can take the medication with meals to minimize nausea.”
  4. “I need to call the health care provider if more than one dose is missed.”
A
  1. “I need to discontinue the medication after 14 days of use.”
29
Q

A client who has undergone renal transplant is receiving ongoing therapy with cyclosporine (Sandimmune). The nurse would be sure to immediately report which abnormal finding?

  1. Decreased creatinine level
  2. Decreased hemoglobin level
  3. Decreased white blood cell (WBC) count
  4. Elevated blood urea nitrogen (BUN) level
A
  1. Elevated blood urea nitrogen (BUN) level
30
Q

A client is receiving tacrolimus (Prograf) to prevent organ rejection. Which is a nursing consideration associated with this medication?

  1. Assess for hypoglycemia.
  2. Give with grapefruit juice.
  3. Give with cyclosporine (Sandimmune).
  4. Assess platelet count for thrombocytopenia.
A
  1. Assess platelet count for thrombocytopenia.
31
Q

A nurse is collecting data from a client with a history of renal transplantation. The nurse understands that which medication is the medication of choice for preventing organ rejection?

  1. Probenecid
  2. Prednisone
  3. Indomethacin (Indocin)
  4. Cyclosporine (Sandimmune)
A
  1. Cyclosporine (Sandimmune)
32
Q

Cyclosporine (Sandimmune) is prescribed for the client following allogenic kidney transplantation. The nurse should provide which instruction to the client regarding the medication?

  1. There are no known adverse effects of the medication.
  2. The medication will need to be taken for a period of 6 months.
  3. Blood levels of the medication will need to be measured periodically.
  4. The medication is administered by the intravenous (IV) route on a monthly basis.
A
  1. Blood levels of the medication will need to be measured periodically.
33
Q

Blood work has been drawn on a client who has been taking cyclosporine (Sandimmune) following allogenic liver transplantation. The nurse should check the results of which test to determine the presence of an adverse effect related to this medication?

  1. Hematocrit level
  2. Cholesterol level
  3. Hemoglobin level
  4. Blood urea nitrogen (BUN) level
A
  1. Blood urea nitrogen (BUN) level
34
Q

The nurse is providing patient education for patients preparing to receive renal transplants. The nurse discusses the pros and cons of using cyclosporine (Sandimmune) to prevent allograft rejection. Which statement by one of the patients best demonstrates understanding of cyclosporine? “Cyclosporine does not

A. cause renal damage.”
B. increase the risk of infection.”
C. not suppress bone marrow.”
D. cause hypertension.”

A

D.

NOT SURPRESS BONE MARROW

35
Q

The nurse is caring for a patient taking tacrolimus (Prograf) on a renal telemetry unit. Which adverse effect associated with this medication would most concern the nurse?

a. Gingival hyperplasia
b. Blood glucose level of 120
c. Risk of infection
d. Tremors and insomnia

A

d. Tremors and insomnia

36
Q

The nurse is caring for a patient who received a transplant a few months ago. The patient has been taking azathioprine (Imuran) and comes to the clinic for laboratory work. Which laboratory test would the nurse anticipate for this patient?

a. Bilirubin
b. Blood urea nitrogen (BUN)
c. Serum azathioprine levels
d. Complete blood cell (CBC) count

A

d. Complete blood cell (CBC) count

37
Q

The nurse is caring for a patient who has been taking cyclosporine (Sandimmune). During a follow-up appointment, the patient starts making conversation. What comment by the patient would most concern the nurse?

a. “I have coffee every morning.”
b. “I enjoy tea in the afternoons.”
c. “I drink grapefruit juice with my breakfast.”
d. “I take aspirin for headaches.”

A

c. “I drink grapefruit juice with my breakfast.”

38
Q

The nurse is preparing to draw blood for measurement of a serum cyclosporine (Sandimmune) level. At what time should the serum cyclosporine level be drawn?

a. Two hours after the dose is administered
b. Just prior to the next dose
c. Six hours after the dose is administered
d. Timing of levels is irrelevant

A

b. Just prior to the next dose

pharm 2 exam 3 (7 decks)

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