A nurse is caring for a client who is receiving filgrastim. The nurse should monitor the client for which of the following adverse effects?

Hypertension

Fluid retention

Bone pain

Hypokalemia

Answer and Explanation

The Correct Answer is C

A. Hypertension. Filgrastim, a granulocyte colony-stimulating factor (G-CSF), primarily stimulates white blood cell production. While minor blood pressure fluctuations can occur, hypertension is not a common or significant adverse effect. Monitoring blood pressure is important, but sustained hypertension is not expected.

B. Fluid retention. Filgrastim does not typically cause significant fluid retention. Medications such as corticosteroids or certain chemotherapeutic agents are more likely to lead to fluid overload. While rare cases of capillary leak syndrome have been reported, general fluid retention is not a primary concern.

C. Bone pain. Bone pain is the most common adverse effect of filgrastim. The medication stimulates bone marrow activity, leading to increased production of neutrophils, which can cause discomfort in bones, particularly in long bones such as the femur and sternum. Pain is usually mild to moderate and can be managed with acetaminophen or NSAIDs if appropriate.

D. Hypokalemia. Filgrastim does not have a direct effect on potassium levels. Electrolyte imbalances are more commonly associated with diuretics, corticosteroids, or chemotherapy. Clients on filgrastim typically do not require routine potassium monitoring unless other risk factors are present.

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Correct Answer is D

Explanation

A. Alprazolam. Alprazolam, a benzodiazepine, is metabolized in the liver and can accumulate in clients with chronic liver disease, increasing the risk of sedation, confusion, and hepatic encephalopathy. Benzodiazepines should be used cautiously or avoided in clients with liver impairment.

B. Rotavirus vaccine. The rotavirus vaccine is a live, attenuated vaccine given to infants to prevent severe diarrhea caused by rotavirus infection. It is not recommended for adults, including those with chronic liver disease, as it is not indicated for their age group or condition.

C. Niacin. Niacin is used to lower cholesterol and treat vitamin B3 deficiency, but it can cause hepatotoxicity, especially in high doses. In clients with chronic liver disease, niacin may worsen liver function, making it an inappropriate choice unless absolutely necessary and closely monitored.

D. Hepatitis A vaccine. Clients with chronic liver disease are at higher risk of severe complications from hepatitis A infection. Vaccination provides protection against hepatitis A, which can cause acute liver failure in individuals with pre-existing liver disease. It is recommended to prevent further liver damage and protect overall health.

A. Client is short of breath B. intercostal retractions visible C. Wheezing auscultated throughout lung fields D. Diffuse, raised rash present on trunk E. Respiratory rate 30/min F. Blood pressure 90/55 mmHg G. Oxygen saturation 91% on room air H. Temperature 38.3°C (101°F) I. Client is alert and oriented to person, place, and time. J. Heart rate 110/min

Correct Answer is ["A","B","C","D","E","F","G"]

Explanation

Shortness of breath. The client is experiencing respiratory distress, which could indicate a severe allergic reaction (anaphylaxis). Immediate intervention is needed to prevent airway compromise and respiratory failure.
Intercostal retractions. Retractions occur when breathing is labored, suggesting airway obstruction or bronchoconstriction. This is a sign of worsening respiratory distress, requiring urgent medical attention.
Wheezing auscultated throughout lung fields. Wheezing suggests bronchospasm, which is common in anaphylaxis and asthma attacks. The presence of diffuse wheezing indicates that the airways are narrowing, making breathing more difficult.
Diffuse, raised rash present on trunk. A new-onset rash following antibiotic administration raises suspicion for anaphylaxis or a severe allergic reaction. Immediate treatment with antihistamines and corticosteroids may be required.
Respiratory rate 30/min. The increased respiratory rate indicates that the client is compensating for airway constriction and hypoxia. This is an early warning sign of impending respiratory failure if not treated promptly.
Blood pressure 90/55 mmHg. The drop in blood pressure suggests anaphylactic shock, where vasodilation and fluid leakage from capillaries lead to hypotension. Immediate administration of epinephrine is necessary to prevent cardiovascular collapse.
Oxygen saturation 91% on room air. A decrease in oxygen saturation indicates impaired gas exchange, likely due to airway swelling and bronchospasm. Supplemental oxygen therapy should be provided to prevent further desaturation.

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A nurse is caring for a client who is receiving filgrastim. The nurse should monitor the client for which of the following adverse effects?

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Naxlex Comprehensive Predictor Exams

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Correct Answer is D

Explanation

Correct Answer is ["A","B","C","D","E","F","G"]

Explanation

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