Adams, Pharmacology for Nurse: A Pathophysiologic Approach, 4/E Chapter 31

Question 1 Type: MCMA 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!" "hat are the best responses by the nurse! Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: #elect all that apply 1. "$our %idney ma%es more erythropoietin if it doesn&t get enough o'ygen " 2. "Erythropoietin also helps your body ma%e hemoglobin " 3. "This stimulates your %idney to ma%e more red blood cells " 4. "It is similar to a %idney hormone, erythropoietin, and helps your body ma%e more red blood cells " 5. "$our %idney ma%es more erythropoietin (hen you have too much fluid in your body " Corre t Ans!er: ),*,+ "ationa#e 1, Erythropoiesis is regulated by the %idney hormone, erythropoietin The primary signal for increased secretion is a reduction in o'ygen reaching the %idney "ationa#e 2, This hormone reacts (ith receptors on hematopoietic stem cells to increase erythrocyte production It also stimulates production of hemoglobin "ationa#e 3, -ed blood cells are manufactured in the bone marro(, not in the %idney "ationa#e 4, Epoetin alfa is identical to the natural hormone erythropoietin and stimulates the production of red blood cells in the same manner "ationa#e 5, -educed o'ygen, not over.hydration is the stimulus for the %idney to produce additional erythropoietin $#o%a# "ationa#e: Co&niti'e (e'e#: Applying C#ient )eed: /hysiological Integrity C#ient )eed Su%: /hysiological Adaptation )ursin&/*nte&rated Con epts: 0ursing /rocess, Implementation (earnin& +ut ome: 1).)
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Question 2 Type: MCMA The nurse is teaching a class on ho( red blood cell formation is regulated by the body to a group of clients (ho have AI4# The nurse evaluates that learning has occurred (hen the clients ma%e (hich statements! Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: #elect all that apply 1. "-ed blood cell formation is regulated through chemicals called colony.stimulating factors that come from (hite blood cells " 2. "-ed blood cell formation is regulated through messages from the hormone, secretin, (hich is located in the %idney " 3. "-ed blood cell formation is regulated through specific liver en5ymes and a process called hemochromatosis " 4. "-ed blood cell formation is regulated through messages from the hormone erythropoietin " 5. "-ed blood cell formation is regulated through specific transporter proteins called apolipoprotein A and 6 " Corre t Ans!er: + "ationa#e 1, Colony.stimulating factors affect (hite blood cell production "ationa#e 2, #ecretin stimulates the pancreas to release a fluid that neutrali5es stomach acid and aids in digestion7 it has nothing to do (ith red blood cell formation "ationa#e 3, 8emochromatosis refers to e'cess iron accumulation in the body, not to red blood cell formation "ationa#e 4, -egulation of hematopoiesis occurs through messages from hormones such as erythropoietin "ationa#e 5, Apolipoprotein refers to a protein found in cholesterol particles7 it has nothing to do (ith red blood cell formation $#o%a# "ationa#e: Co&niti'e (e'e#: Applying C#ient )eed: /hysiological Integrity C#ient )eed Su%: /hysiological Adaptation )ursin&/*nte&rated Con epts: 0ursing /rocess, Evaluation (earnin& +ut ome: 1) * Question 3 Type: MC#A
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The client receives chemotherapy as therapy for cancer The physician orders epoetin alfa (/rocrit) subcutaneously The client as%s the nurse if this drug is also chemotherapy "hat is the best response by the nurse! 1. "0o, but it (or%s (ith your chemotherapy to ma%e it more effective " 2. "0o, this drug helps to counteract the nausea and vomiting caused by your chemotherapy " 3. "0o, it (ill stimulate your immune system to help you battle the cancer " 4. "0o, this drug (ill help prevent anemia that can be caused by your chemotherapy " Corre t Ans!er: + "ationa#e 1, Epoetin alfa (/rocrit) is prescribed to treat anemia associated (ith chemotherapy7 it does not ma%e the chemotherapy more effective "ationa#e 2, Epoetin alfa (/rocrit) is prescribed to treat anemia associated (ith chemotherapy7 it does not counteract nausea and vomiting "ationa#e 3, Epoetin alfa (/rocrit) is prescribed to treat anemia associated (ith chemotherapy7 it does not stimulate the immune system "ationa#e 4, Epoetin alfa (/rocrit) is given to clients undergoing cancer chemotherapy to counteract the anemia caused by antineoplastic agents $#o%a# "ationa#e: Co&niti'e (e'e#: Applying C#ient )eed: /hysiological Integrity C#ient )eed Su%: /harmacological and /arenteral Therapies )ursin&/*nte&rated Con epts: 0ursing /rocess, Implementation (earnin& +ut ome: 1).1 Question 4 Type: MC#A The client receives filgrastim (0eupogen) 8e as%s the nurse, "That is such a funny name7 (here do you suppose it comes from!" "hat is the best response by the nurse! 1. "It comes from the interleu%ins it stimulates7 this one stimulates neuocytes " 2. "It comes from the blood cell it stimulates7 this one stimulates neutrophils " 3. "It comes from the stem cells it stimulates, such as filgrastims " 4. "It is a complicated process7 the drug companies are secretive about it "
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Corre t Ans!er: * "ationa#e 1, There aren&t any interleu%ins named neuocytes "ationa#e 2, Colony.stimulating factors (C#9s) are named according to the types of blood cells that they stimulate :ranulocyte colony.stimulating factor (:.C#9) increases the production of neutrophils, the most common type of granulocyte "ationa#e 3, There aren&t any stem cells named filgrastims "ationa#e 4, 0aming of drugs is not a complicated process $#o%a# "ationa#e: Co&niti'e (e'e#: Applying C#ient )eed: /hysiological Integrity C#ient )eed Su%: /harmacological and /arenteral Therapies )ursin&/*nte&rated Con epts: 0ursing /rocess, Implementation (earnin& +ut ome: 1) + Question 5 Type: MC#A The client is receiving ferrous sulfate (9eosol) for the treatment of anemia The nurse has taught the client about this drug and about anemia The nurse evaluates that learning has occurred (hen the client ma%es (hich statement! 1. "My anemia (as caused by blood loss from my ulcer, but there are other causes too " 2. "My anemia (as caused by drin%ing too many carbonated beverages (ith caffeine " 3. "There are many causes for anemia7 mine (as caused by heart failure and fluid overload " 4. "I thin% my anemia occurred (hen I started that vegetarian diet " Corre t Ans!er: ) "ationa#e 1, The three categories of blood loss are hemorrhage, increased erythrocyte destruction, and impaired erythrocyte production "ationa#e 2, Anemia is not caused by too much caffeine "ationa#e 3, Anemia is not caused by heart failure or fluid overload "ationa#e 4, A (ell.balanced vegetarian diet (ill not result in anemia $#o%a# "ationa#e:
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Co&niti'e (e'e#: Applying C#ient )eed: /hysiological Integrity C#ient )eed Su%: /harmacological and /arenteral Therapies )ursin&/*nte&rated Con epts: 0ursing /rocess, Evaluation (earnin& +ut ome: 1).; Question , Type: MC#A 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 "hat (ill the nurse most li%ely assess in this client! 1. Memory loss, numbness in the limbs, and depression 2. A gradual decrease in red blood cell counts 3. <aundice, and tarry stools 4. =o( hemoglobin and hematocrit counts Corre t Ans!er: ) "ationa#e 1, The most common cause of vitamin 6)* deficiency (pernicious anemia) is absence of intrinsic factor, a protein secreted by stomach cells This protein is re>uired for vitamin 6)* to be absorbed from the intestine #ymptoms of pernicious anemia involve the nervous system, and include memory loss, confusion, tingling or numbness in the limbs, and mood disturbances "ationa#e 2, A decrease in red blood cells does not occur (ith pernicious anemia "ationa#e 3, <aundice and tarry stools do not occur (ith pernicious anemia "ationa#e 4, =o( hemoglobin and hematocrit counts do not occur (ith pernicious anemia A decrease in red blood cells does not occur (ith pernicious anemia $#o%a# "ationa#e: Co&niti'e (e'e#: Applying C#ient )eed: /hysiological Integrity C#ient )eed Su%: /harmacological and /arenteral Therapies )ursin&/*nte&rated Con epts: 0ursing /rocess, Assessment (earnin& +ut ome: 1).? Question Type: MC#A
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The client has chronic alcoholism 8e as%s the nurse (hy his doctor put him on folic acid (9olvite) since he promised the doctor that he (ould stop drin%ing "hat is the best response by the nurse! 1. "$ou should as% your doctor since you promised him that you (ould not drin% anymore " 2. "$ou have been drin%ing instead of eating, and alcohol interferes (ith folate metabolism in your liver " 3. "$ou need folic acid to ma%e up for the vitamin 6)* deficiency that (as caused by your alcoholism " 4. "$ou need folic acid because you have not been compliant (ith ta%ing your vitamins and attending Alcoholics Anonymous (AA) meetings " Corre t Ans!er: * "ationa#e 1, -eferring the client bac% to the physician is inappropriate7 the nurse can ans(er this >uestion "ationa#e 2, Insufficient folic acid can manifest itself as anemia This is often observed in chronic alcoholism, since alcoholics consume alcohol instead of eating nutritious foods Alcohol interferes (ith folate metabolism in the liver "ationa#e 3, 9olic acid anemia is not caused by a vitamin 6)* deficiency "ationa#e 4, The client needs folic acid because his liver cannot metaboli5e folate, not because he has missed his vitamins and Alcoholics Anonymous (AA) meetings $#o%a# "ationa#e: Co&niti'e (e'e#: Applying C#ient )eed: /hysiological Integrity C#ient )eed Su%: /harmacological and /arenteral Therapies )ursin&/*nte&rated Con epts: 0ursing /rocess, Implementation (earnin& +ut ome: 1).@ Question . Type: MC#A The nurse teaches a class on iron.deficiency anemia to a group of pregnant clients (ho are all ta%ing ferrous sulfate (9eosol) The nurse evaluates that additional learning is needed (hen the clients ma%e (hich 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 (here it is needed " 3. ""e need e'tra iron because (hen our red blood cells die, all their iron is e'creted from the body " 4. "The most common cause of nutritional anemia is iron deficiency "
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Corre t Ans!er: 1 "ationa#e 1, Most iron in our bodies is stored on hemoglobin in the red blood cell "ationa#e 2, Transferrin is a protein that transports iron to places in our bodies (here it is needed "ationa#e 3, After erythrocytes die, nearly all of the iron in their hemoglobin is incorporated into transferrin and recycled for later use "ationa#e 4, The most common cause of nutritional anemia is iron deficiency $#o%a# "ationa#e: Co&niti'e (e'e#: Applying C#ient )eed: /hysiological Integrity C#ient )eed Su%: /harmacological and /arenteral Therapies )ursin&/*nte&rated Con epts: 0ursing /rocess, Evaluation (earnin& +ut ome: 1).A Question / Type: MC#A The physician has prescribed epoetin alfa (Epogen) for the client "hat is the priority assessment by the nurse! 1. The client&s blood pressure 2. The client&s report of a headache, indicating a stro%e 3. The client&s ability to use the proper inBection techni>ues for self.administration 4. The client&s hemoglobin and hematocrit levels Corre t Ans!er: ) "ationa#e 1, The most serious adverse effect of epoetin alfa (Epogen) is hypertension, (hich can raise blood pressure to dangerous levels, and (hich occurs in as many as 13C of clients receiving the drug "ationa#e 2, Clients are at ris% for a stro%e, but this is a complication of uncontrolled hypertension7 blood pressure assessment is a priority "ationa#e 3, Assessment of hypertension ta%es precedence over inBection techni>ues "ationa#e 4, 8emoglobin and hematocrit levels should be assessed, but they are not as high a priority as blood pressure $#o%a# "ationa#e: Co&niti'e (e'e#: Applying
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C#ient )eed: /hysiological Integrity C#ient )eed Su%: /hysiological Adaptation )ursin&/*nte&rated Con epts: 0ursing /rocess, Assessment (earnin& +ut ome: 1).D Question 10 Type: MC#A The physician has ordered filgrastim (0eupogen) intravenously for the client "hat is a priority plan by the nurse prior to administering this drug! 1. /lan to monitor the client&s EC: readings 2. /lan to insert a 9oley catheter and monitor urine output 3. /lan to administer )3C o'ygen during the infusion 4. /lan to have a (hite blood cell ("6C) count dra(n every 13 minutes Corre t Ans!er: ) "ationa#e 1, 9ilgrastim (0eupogen) may cause abnormal #T.segment depression "ationa#e 2, There is no need to monitor urine output during the infusion "ationa#e 3, There is no need to administer o'ygen during the infusion "ationa#e 4, There is no need to have a (hite blood cell ("6C) count dra(n every 13 minutes $#o%a# "ationa#e: Co&niti'e (e'e#: Applying C#ient )eed: /hysiological Integrity C#ient )eed Su%: /harmacological and /arenteral Therapies )ursin&/*nte&rated Con epts: 0ursing /rocess, /lanning (earnin& +ut ome: 1).D Question 11 Type: MC#A The client is pregnant and has been told by her physician that she needs cyanocobalamin (0ascobal) #he as%s the nurse, ""ill this hurt my baby!" "hat is the best response by the nurse! 1. "0o, this medication (ill not hurt your baby as long as you ta%e it (ith ascorbic acid " 2. "0o, this is safe as long as long as you ta%e it in pill form7 it is a /regnancy Category A drug, (hich means it is safe for your baby "
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3. "0o, this medication (ill not hurt your baby as long as you ta%e the pills only in the third trimester " 4. "0o, this is safe in either pill or inBectable form7 it is a /regnancy Category A drug (hich means it is safe for your baby " Corre t Ans!er: * "ationa#e 1, Ascorbic acid affects the stability of cyanocobalamin (0ascobal), and should not be used concomitantly (ith cyanocobalamin "ationa#e 2, Cyanocobalamin (0ascobal), oral formulation, is a /regnancy Category A drug, but it is a /regnancy Category C (hen used parenterally "ationa#e 3, There is no evidence to support that oral cyanocobalamin (0ascobal) is teratogenic during the first or second trimesters "ationa#e 4, Cyanocobalamin (0ascobal) is a /regnancy Category C (hen used parenterally $#o%a# "ationa#e: Co&niti'e (e'e#: Applying C#ient )eed: /hysiological Integrity C#ient )eed Su%: /harmacological and /arenteral Therapies )ursin&/*nte&rated Con epts: 0ursing /rocess, Implementation (earnin& +ut ome: 1).D Question 12 Type: MC#A The client complains of constipation (hile receiving ferrous sulfate (9eosol) "hat is the best plan by the nurse to assist the client in resolving this common side effect! 1. /lan to teach the client about (hich la'atives are the safest to use 2. /lan to teach the client to increase fluids and high.fiber foods in the diet 3. /lan to teach the client to self.administer 9leets enemas 4. /lan to teach the client to increase e'ercise Corre t Ans!er: * "ationa#e 1, The use of la'atives (ill ma%e the bo(el la5y and contribute to constipation "ationa#e 2, Constipation is a common side effect of ferrous sulfate7 therefore, an increase in dietary fiber may be indicated "ationa#e 3, The use of 9leets enemas (ill ma%e the bo(el la5y and contribute to constipation
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"ationa#e 4, Increasing e'ercise (ill help relieve constipation, but is not as effective as other interventions $#o%a# "ationa#e: Co&niti'e (e'e#: Applying C#ient )eed: /hysiological Integrity C#ient )eed Su%: /harmacological and /arenteral Therapies )ursin&/*nte&rated Con epts: 0ursing /rocess, /lanning (earnin& +ut ome: 1).D Question 13 Type: MC#A The client is receiving chemotherapy for cancer The physician has prescribed oprelve%in (0eumega) The nurse has completed medication education and evaluates it as effective (hen the client ma%es (hich statement! 1. "This medication (ill help my chemotherapy (or% better " 2. "This medication (ill help increase my platelet count " 3. "This medication (ill help me regain the (eight I have lost " 4. "This medication (ill help increase my red blood cell count " Corre t Ans!er: * "ationa#e 1, Eprelve%in (0eumega) does not enhance the effectiveness of chemotherapy "ationa#e 2, Eprelve%in (0eumega) is used to stimulate the production of platelets in clients (ho are at ris% for thrombocytopenia caused by cancer chemotherapy "ationa#e 3, Eprelve%in (0eumega) does not promote (eight gain "ationa#e 4, Eprelve%in (0eumega) does not increase red blood cell count $#o%a# "ationa#e: Co&niti'e (e'e#: Analy5ing C#ient )eed: /hysiological Integrity C#ient )eed Su%: /harmacological and /arenteral Therapies )ursin&/*nte&rated Con epts: 0ursing /rocess, Evaluation (earnin& +ut ome: 1) D Question 14 Type: MC#A

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The client calls the nurse and is very frantic "I thin% something is (rongF My stools are blac% and they have never been this color beforeF" The client is receiving ferrous sulfate (9eosol) "hat is the best response by the nurse! 1. "This is an e'pected side effect of ferrous sulfate (9eosol)7 it is o%ay " 2. "This sounds serious7 you may have started bleeding again " 3. "4o you have hemorrhoids! That could be the problem " 4. "I (ill spea% (ith your doctor and call you right bac% " Corre t Ans!er: ) "ationa#e 1, 9errous sulfate (9eosol) (ill turn stools a harmless, dar% green or blac% color7 this is an e'pected side effect of the medication "ationa#e 2, To tell a client that this sounds serious is non.therapeutic, as the nurse should %no( that blac% stools are an e'pected side effect of the drug "ationa#e 3, 8emorrhoids are unli%ely the problem, they (ould cause bright red color in the stool "ationa#e 4, There is no need to call the physician7 this is an e'pected side effect of the drug $#o%a# "ationa#e: Co&niti'e (e'e#: Applying C#ient )eed: /hysiological Integrity C#ient )eed Su%: /harmacological and /arenteral Therapies )ursin&/*nte&rated Con epts: 0ursing /rocess, Implementation (earnin& +ut ome: 1).)3 Question 15 Type: MC#A The process for regulating hematopoiesis occurs via 1. (hite bone marro( 2. hematopoietic stem cell 3. hormones 4. essential vitamins and nutrients Corre t Ans!er: 1
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"ationa#e 1, 8ematopoiesis occurs primarily in red bone marro( "ationa#e 2, The process of hematopoiesis begins (ith a stem cell "ationa#e 3, -egulation of hematopoiesis occurs through messages from hormones "ationa#e 4, 8ematopoiesis occurs primarily in red bone marro(, and re>uires 6 vitamins, vitamin C, copper, iron, and other nutrients $#o%a# "ationa#e: Co&niti'e (e'e#: -emembering C#ient )eed: /hysiological Integrity C#ient )eed Su%: /hysiological Adaptation )ursin&/*nte&rated Con epts: 0ursing /rocess, Assessment (earnin& +ut ome: 1) ) Question 1, Type: MC#A Colony.stimulating factors (C#9s) 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 Corre t Ans!er: ) "ationa#e 1, C#9s are named according to types of blood cells stimulated "ationa#e 2, The type of hormone is responsible for hematopoiesis regulation "ationa#e 3, 8omeostatic control is influenced by hormones and gro(th factors "ationa#e 4, The type of stem cell stimulated is responsible for hematopoiesis $#o%a# "ationa#e: Co&niti'e (e'e#: -emembering C#ient )eed: /hysiological Integrity C#ient )eed Su%: /harmacological and /arenteral Therapies )ursin&/*nte&rated Con epts: 0ursing /rocess, Assessment (earnin& +ut ome: 1).+
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Question 1Type: MC#A In monitoring clients receiving hematopoietic agents, it is most important for the nurse to monitor for 1. thromboembolus 2. TIA (transient ischemic attac%) 3. MI (myocardial infarction) 4. stro%e Corre t Ans!er: ) "ationa#e 1, Clients are at greater ris% for thrombolitic disease, (hich can result in MI, stro%e, and TIA "ationa#e 2, Transient ischemic attac% can occur as a result of thromboembolic disease "ationa#e 3, Myocardial infarction can occur as a result of thromboembolic disease "ationa#e 4, #tro%e can occur as a result of thromboembolic disease $#o%a# "ationa#e: Co&niti'e (e'e#: Gnderstanding C#ient )eed: /hysiological Integrity C#ient )eed Su%: /harmacological and /arenteral Therapies )ursin&/*nte&rated Con epts: 0ursing /rocess, Assessment (earnin& +ut ome: 1).D Question 1. Type: MC#A To decrease gastric irritation, anti.anemia medications, such as ferrous sulfate (9erosol), should be ta%en (ith 1. mil% 2. other medications, such as calcium 3. orange Buice 4. food Corre t Ans!er: +
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"ationa#e 1, Ta%ing (ith mil% (ould decrease absorption "ationa#e 2, #everal medications can increase or decrease absorption "ationa#e 3, Ta%ing (ith orange Buice can increase gastric irritations "ationa#e 4, Ta%ing iron medications (ith food (ill decrease gastric irritation $#o%a# "ationa#e: Co&niti'e (e'e#: Gnderstanding C#ient )eed: 8ealth /romotion and Maintenance C#ient )eed Su%: )ursin&/*nte&rated Con epts: 0ursing /rocess, Implementation (earnin& +ut ome: 1).D Question 1/ Type: MC#A The mechanism of action of colony.stimulating factors, such as filgrastim (0eupogen), is to 1. increase neutrophil production 2. supplement iron in the body 3. replace vitamin 6)* factor 4. increase erythrocyte production Corre t Ans!er: ) "ationa#e 1, The primary mechanism of action is to increase neutrophil production and phagocytosis in chemotherapy clients "ationa#e 2, Anti.anemic iron supplements increase iron in the body "ationa#e 3, Anti.anemic vitamin supplements increase 6)* in the body "ationa#e 4, 8ematopoietic gro(th factors increase erythrocytes in the bone marro( $#o%a# "ationa#e: Co&niti'e (e'e#: -emembering C#ient )eed: /hysiological Integrity C#ient )eed Su%: )ursin&/*nte&rated Con epts: (earnin& +ut ome: 1).+
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Question 20 Type: MC#A /er classification of anemias, the morphology for pernicious anemia or folate.deficiency anemia results in 1. hematocyticHhematochromic erythrocytes 2. microcyticHhypochromic erythrocytes 3. macrocyticHnormochromic erythrocytes 4. normocyticHnormochromic erythrocytes Corre t Ans!er: 1 "ationa#e 1, 8ematocyticHhematochromic erythrocytes do not classify anemias "ationa#e 2, MicrocyticHhypochromic erythrocytes classify iron.deficiency anemia or thalassemia "ationa#e 3, MacrocyticHnormochromic erythrocytes classify pernicious and folate.deficiency anemia "ationa#e 4, 0ormocyticHnormochromic erythrocytes classify aplastic, hemorrhagic, sic%le.cell, and hemolytic anemia $#o%a# "ationa#e: Co&niti'e (e'e#: -emembering C#ient )eed: /hysiological Integrity C#ient )eed Su%: )ursin&/*nte&rated Con epts: (earnin& +ut ome: 1).; Question 21 Type: MCMA A client is to receive darbepoetin alfa (Aranesp) adBunctive medication during chemotherapy The client says, I0ot another drug "hy do I need this one!J 8o( should the nurse respond! Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: #elect all that apply 1. II %no( you are tired of drugs, but this is Bust one more J 2. IThis drug (ill help you gro( red blood cells J
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3. IThis drug (ill help %eep you from getting infections J 4. IThis is an erythropoiesis.stimulating factor J 5. IThis drug (ill help you get more o'ygen around to your tissues so you feel better J Corre t Ans!er: *,; "ationa#e 1, This response does not ans(er the clientKs >uestion "ationa#e 2, 4arbepoetin alfa (Aranesp) is an erythropoiesis.stimulating factor "ationa#e 3, 4arbepoetin alfa (Aranesp) does not increase immunity "ationa#e 4, The nurse should e'plain the medication in terms the client can understand "ationa#e 5, 4arbepoetin alfa (Aranesp) stimulates production of red blood cells (hich carry o'ygen :etting additional o'ygen to the tissues helps the client feel better $#o%a# "ationa#e: Co&niti'e (e'e#: Applying C#ient )eed: /hysiological Integrity C#ient )eed Su%: /harmacological and /arenteral Therapies )ursin&/*nte&rated Con epts: 0ursing /rocess, Implementation (earnin& +ut ome: 1) A Question 22 Type: MCMA A client has been treated (ith an erythropoiesis.stimulating factor "hich client assessment (ould the nurse interpret as indicating the goal of this treatment has been reached! Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: #elect all that apply 1. The clientKs hemoglobin values have risen 2. The client reports less shortness of breath on e'ertion 3. The client has not had an episode of epista'is in over three (ee%s 4. The client reports enBoying a (al% (ith family for the first time in months 5. The client has not had a fever since treatment began
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Corre t Ans!er: ),*,+ "ationa#e 1, The purpose of this therapy is to increase red blood cells (hich (ould increase hemoglobin "ationa#e 2, #ince the client has more -6Cs, more o'ygen can be carried to tissues "ationa#e 3, This drug supports -6C production, not platelet production "ationa#e 4, Increase in activity level indicates treatment success "ationa#e 5, This treatment supports red blood cell production, not (hite blood cell production $#o%a# "ationa#e: Co&niti'e (e'e#: Analy5ing C#ient )eed: /hysiological Integrity C#ient )eed Su%: /harmacological and /arenteral Therapies )ursin&/*nte&rated Con epts: 0ursing /rocess, Evaluation (earnin& +ut ome: 1) )3 Question 23 Type: MCMA A client is scheduled to have chemotherapy Thursday at D a m 9ilgrastim (0eupogen) has also been ordered The nurse should plan (hich dosing time for the 0eupogen! Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: #elect all that apply 1. 0o later than D a m on "ednesday 2. At the time of the chemotherapy infusion 3. Immediately follo(ing the chemotherapy 4. 0o earlier than D a m 9riday 5. Immediately before the chemotherapy Corre t Ans!er: ),+ "ationa#e 1, 0eupogen should be given at least *+ hours before chemotherapy "ationa#e 2, The effectiveness of the 0eupogen (ill be diminished by the chemotherapy "ationa#e 3, The effectiveness of the 0eupogen (ill be diminished by the chemotherapy
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"ationa#e 4, 0eupogen should be given no earlier than *+ hours after chemotherapy "ationa#e 5, The effectiveness of the 0eupogen (ill be diminished by the chemotherapy $#o%a# "ationa#e: Co&niti'e (e'e#: Analy5ing C#ient )eed: /hysiological Integrity C#ient )eed Su%: /harmacological and /arenteral Therapies )ursin&/*nte&rated Con epts: 0ursing /rocess, /lanning (earnin& +ut ome: 1) A Question 24 Type: MCMA A clientKs blood (or% sho(s an anemia that (as not present at the last clinic visit ? months ago "hich >uestions should the nurse as% this client! Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: #elect all that apply 1. I8ave you had a significant dietary change in the last ? months!J 2. I4o you handle chemicals in your ne( Bob!J 3. I8ave your stools changed in appearance!J 4. I8ave you been eating more carbohydrates than usual!J 5. IAre your menstrual periods heavier than normal for you!J Corre t Ans!er: ),*,1,; "ationa#e 1, 4ietary changes may significantly influence production of red blood cells "ationa#e 2, Chemicals can cause -6C destruction "ationa#e 3, Change to dar% tarry stool, red stools, or much looser stools could indicate blood loss "ationa#e 4, There is no connection bet(een carbohydrate ingestion and anemia "ationa#e 5, 8eavy menstrual flo( is a leading cause of blood loss anemia in (omen $#o%a# "ationa#e: Co&niti'e (e'e#: Applying
Adams, Pharmacology for Nurse: A Pathophysiologic Approach, +2E Copyright *3)+ by /earson Education, Inc

C#ient )eed: /hysiological Integrity C#ient )eed Su%: /hysiological Adaptation )ursin&/*nte&rated Con epts: 0ursing /rocess, Assessment (earnin& +ut ome: 1).; Question 25 Type: MCMA A nurse is preparing to administer ferrous sulfate IM to a client (ith anemia "hat should the nurse consider (hen giving this inBection! Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: #elect all that apply 1. :ive the inBection in the deltoid muscle 2. Iron is best absorbed if given subcutaneously 3. Iron is irritating to the tissues 4. The 5.trac% method should be used 5. Iron preparations should be administered through a needle gauge )? or larger Corre t Ans!er: 1,+ "ationa#e 1, The inBection should be given deep IM in a larger muscle "ationa#e 2, Iron should be given deep IM "ationa#e 3, Iron is irritating to tissues "ationa#e 4, L.trac% inBection reduces lea%age into the tissues and is the preferred method of IM inBection of iron "ationa#e 5, There is no indication of need to use a large diameter needle for inBection $#o%a# "ationa#e: Co&niti'e (e'e#: Applying C#ient )eed: /hysiological Integrity C#ient )eed Su%: /harmacological and /arenteral Therapies )ursin&/*nte&rated Con epts: 0ursing /rocess, Implementation (earnin& +ut ome: 1) A

Adams, Pharmacology for Nurse: A Pathophysiologic Approach, +2E Copyright *3)+ by /earson Education, Inc