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's absolute neutrophil count was 2.500/mm before the medication was administered

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

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

The client had chemotherapy 12 hr before the medication was administered

Answer and Explanation

The Correct Answer is C

A. The client's absolute neutrophil count was 2.500/mm before the medication was administered:
This information does not indicate an error in the administration process. The absolute neutrophil count being 2.500/mm before the medication was given is relevant to the client's condition but does not suggest an incident related to the administration of filgrastim.
B. The nurse flushed the client's IV line with dextrose 5% in water before and after the medication was administered:
Flushing the IV line with dextrose 5% in water is a standard practice before and after medication administration. This action helps ensure that the medication is effectively delivered and that the line remains patent. There is no indication of an error in this case.
C. The medication vial sat at room temperature for 2 hr before it was administered:
Filgrastim is a medication that typically requires refrigeration to maintain stability. Allowing it to sit at room temperature for an extended period can affect its efficacy and safety. This is a deviation from the recommended storage conditions and should be reported as an incident to assess potential consequences.
D. The client had chemotherapy 12 hr before the medication was administered:
This information does not necessarily suggest an incident related to the administration of filgrastim. The timing of chemotherapy is an essential consideration in cancer treatment protocols. Filgrastim is often administered to support recovery from the hematopoietic effects of chemotherapy.

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Correct Answer is ["B","C","D"]

Explanation

A. "Take the medication with an antacid if it upsets your stomach."
Explanation: Antacids may interfere with the absorption of iron. It is generally recommended to take iron supplements on an empty stomach or with vitamin C-containing foods to enhance absorption.
B. "Stop taking the medication if your stools become green or black."
Explanation: Ferrous sulfate can cause stools to become dark green or black, which is a normal and expected side effect. However, excessive black, tarry stools may indicate gastrointestinal bleeding and should be reported to the healthcare provider.
C. "Drink the elixir using a straw to prevent staining your teeth."
Explanation: Ferrous sulfate elixir can stain the teeth. Using a straw helps bypass direct contact with the teeth, reducing the risk of staining.
D. "Increase your fiber intake to prevent constipation."
Explanation: Iron supplements, including ferrous sulfate, can cause constipation. Increasing fiber intake can help alleviate constipation.
E. "Increase your intake of dairy products to increase the absorption of this medication."
Explanation: Calcium-containing foods, such as dairy products, can inhibit the absorption of iron. It is advisable to take iron supplements separately from calcium-containing foods.

A. INR 1.0 B. WBC count 8.000/mm² C. Sodium 141 mEq/L D. Potassium 25 MED/L

Correct Answer is D

Explanation

A. INR 1.0: The International Normalized Ratio (INR) is a measure of blood clotting. A value of 1.0 is within the normal range, so there is no immediate concern related to furosemide administration based on this INR value.
B. WBC count 8,000/mm³: The white blood cell count is not directly related to furosemide administration, and the value of 8,000/mm³ is within the normal range. There is no immediate concern based on this WBC count.
C. Sodium 141 mEq/L: The sodium level is within the normal range, and it is not a contraindication for furosemide administration.
D. Potassium 2.5 mEq/L: A potassium level of 2.5 mEq/L is significantly below the normal range. Furosemide is a loop diuretic that can lead to potassium loss, and administering it when the potassium level is already low can further decrease potassium levels, potentially leading to serious complications such as cardiac arrhythmias. Therefore, the nurse should withhold the medication and contact the provider to address the low potassium level before administering furosemide.

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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

Naxlex Comprehensive Predictor Exams

A nurse is teaching a client who is pregnant and has iron-deficiency anemia about taking ferrous sulfate elixir, Which of the following instructions should the nurse include in the teaching? (Select all that apply.)

Correct Answer is ["B","C","D"]

Explanation

A nurse is reviewing a client's laboratory results before administering furosemide 40 mg IV bolus. For which of the following values should the nurse withhold the medication and contact the provider?

Correct Answer is D

Explanation

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