A nurse recently administered filgrastim intravenously to a client who has cancer and is receiving cytotoxic chemotherapy.
For which of the following data, discovered after the medication was administered, should the nurse file an incident report?

The client had chemotherapy 12 hr before the medication was administered.

The medication vial sat at room temperature for 2 hr before it was administered.

The client's absolute neutrophil count was 2,500/mm³ before the medication was administered.

The nurse flushed the client's IV line with dextrose 5% in water before and after the medication was administered.

Answer and Explanation

The Correct Answer is A

Choice A rationale: Administering filgrastim after chemotherapy is a standard practice to boost white blood cell count. However, filgrastim should not be given within 24 hours before or after chemotherapy, as it can affect the efficacy and increase the risk of side effects. Administering the medication 12 hours after chemotherapy falls within this contraindicated window, necessitating an incident report.

Choice B rationale: Filgrastim can be stored at room temperature for short periods, and 2 hours is generally within acceptable limits for stability.

Choice C rationale: An absolute neutrophil count of 2,500/mm³ is within the normal range, and there is no contraindication for administering filgrastim.

Choice D rationale: Flushing the client's IV line with dextrose 5% in water before and after administering filgrastim is not appropriate, as this medication is typically administered with saline solution. Using an incorrect flushing solution could affect the medication's efficacy or compatibility, necessitating an incident report.

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Correct Answer is C

Explanation

The correct answer is Choice C.

Choice A rationale:

This response is not appropriate because it is judgmental and may make the client feel defensive.
It is important for the nurse to respect the client's right to make their own decisions about their health care.
Telling the client what they should do can undermine their autonomy and potentially damage the nurse-client relationship.
It's crucial for the nurse to remain objective and avoid imposing their personal opinions or beliefs onto the client.

Choice B rationale:

This response is also not appropriate because it is using scare tactics to try to persuade the client to get the vaccine.
This approach can be counterproductive and may further alienate the client.
It's important to provide accurate information about the risks and benefits of the vaccine in a neutral and non-threatening manner.

Choice C rationale:

This is the most appropriate response because it acknowledges the client's right to refuse the vaccine while still encouraging them to get it.
It also demonstrates respect for the client's autonomy and validates their feelings.
This approach is more likely to foster a positive nurse-client relationship and keep the door open for future discussions about vaccination.

Choice D rationale:

This response is not accurate because the influenza vaccine is not mandatory for all clients before discharge.
It is important for the nurse to provide accurate information to the client.
Threatening the client with an against medical advice form is not appropriate and may be considered a form of coercion.

A. Review the adverse effects of the medication with the client. B. Compare the current and newly prescribed medications and note any discrepancies. C. Send a list of the prescribed medications to the client's pharmacy. D. Include the medications the client received during surgery on the client's medication list.

Correct Answer is B

Explanation

Compare the current and newly prescribed medications and note any discrepancies.

During medication reconciliation, the nurse should compare the client’s current medication orders with the medications that the client has been taking and note any discrepancies.

Choice A is wrong because Reviewing the adverse effects of the medication with the client, is not part of medication reconciliation.

Choice C is wrong because Sending a list of the prescribed medications to the client’s pharmacy, is not part of medication reconciliation.

Choice D is wrong because Including the medications the client received during surgery on the client’s medication list, is not part of medication reconciliation.

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A nurse recently administered filgrastim intravenously to a client who has cancer and is receiving cytotoxic chemotherapy. For which of the following data, discovered after the medication was administered, should the nurse file an incident report?

Nursing Test Bank

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Explanation

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Correct Answer is B

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A nurse recently administered filgrastim intravenously to a client who has cancer and is receiving cytotoxic chemotherapy.
For which of the following data, discovered after the medication was administered, should the nurse file an incident report?