The nurse is administering filgrastim (G-CSF) to a patient with colorectal cancer after finishing a cycle of chemotherapy.
Which SMART Outcome will this intervention help to achieve?

The patient will have one formed bowel movement by the end of the shift.

The patient's skin will be free of petechiae and purpura by discharge.

The patient will tolerate meals without reports of nausea by the end of the day.

The patient will be free from infection by discharge.

Answer and Explanation

The Correct Answer is D

Choice A rationale

Filgrastim (G-CSF) is used to stimulate the production of white blood cells to decrease the risk of infection. A formed bowel movement is unrelated to the specific outcomes of this medication.

Choice B rationale

While filgrastim can improve overall blood cell counts, its primary goal is to enhance neutrophil counts, rather than addressing skin petechiae or purpura, which may be related to platelet levels.

Choice C rationale

Filgrastim does not target gastrointestinal symptoms such as nausea. Instead, it is aimed at restoring neutrophil levels to reduce infection risk.

Choice D rationale

Filgrastim is specifically designed to increase neutrophil counts, thus helping the patient to be free from infections by discharge, which is a SMART goal.

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Correct Answer is C

Explanation

Choice A rationale

Wearing a dosimeter badge is essential for healthcare workers handling radioactive materials to monitor exposure, but it is not a standard practice for handling chemotherapy, which is typically not radioactive. Chemotherapy drugs are cytotoxic and require different safety measures, such as PPE.

Choice B rationale

While protecting patients during radiation therapy with a lead apron is necessary, it is not applicable for chemotherapy infusions. Chemotherapy involves the administration of cytotoxic drugs, not ionizing radiation, so protective measures focus on preventing exposure to these chemicals rather than shielding from radiation.

Choice C rationale

The nurse must wear personal protective equipment (PPE), including gloves and a gown, when handling chemotherapy to prevent exposure to these toxic drugs. PPE is crucial to protect healthcare workers from accidental spills, splashes, and skin contact with the chemotherapy agents, which can be harmful.

Choice D rationale

Disposal of chemotherapy waste should follow specific guidelines to prevent contamination and exposure. Sharps containers are for sharp objects like needles and blades, not for all chemotherapy waste. Chemotherapy waste should be disposed of in designated containers that comply with hazardous waste regulations to ensure safe handling and disposal.

A. Increase of 25 mmHg in the patient's systolic blood pressure. B. An increase in the serum potassium level from 3.5 to 5.6 mEq/dL. C. Patient complains of headache and is showing signs of restlessness. D. The patient has normal temperature with pallor to the skin.

Correct Answer is A

Explanation

Choice A rationale

An increase in systolic blood pressure by 25 mmHg indicates a positive response to therapy for Addisonian crisis. Addisonian crisis involves severe hypotension due to low levels of cortisol and aldosterone, which regulate blood pressure. Cortisol replacement therapy helps to increase blood pressure by enhancing the responsiveness of blood vessels to catecholamines and promoting sodium and water retention. This improvement is critical for stabilizing the patient and restoring hemodynamic balance.

Choice B rationale

An increase in serum potassium level from 3.5 to 5.6 mEq/dL suggests hyperkalemia, which is a sign of worsening condition, not improvement. Addisonian crisis is characterized by hyperkalemia due to aldosterone deficiency, which impairs potassium excretion. Effective treatment would normalize potassium levels rather than increase them.

Choice C rationale

Complaints of headache and signs of restlessness may indicate adverse effects or complications, rather than therapeutic efficacy. These symptoms could result from inadequate or excessive dosing of corticosteroids or other underlying issues. Monitoring patient response and adjusting treatment is essential.

Choice D rationale

Normal temperature with pallor to the skin does not indicate effective therapy for Addisonian crisis. Pallor may reflect ongoing hypoperfusion or anemia. The absence of fever is not a definitive marker of therapeutic success. Key indicators include hemodynamic stability and normalized electrolytes.

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The nurse is administering filgrastim (G-CSF) to a patient with colorectal cancer after finishing a cycle of chemotherapy.Which SMART Outcome will this intervention help to achieve?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is C

Explanation

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Correct Answer is A

Explanation

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The nurse is administering filgrastim (G-CSF) to a patient with colorectal cancer after finishing a cycle of chemotherapy.
Which SMART Outcome will this intervention help to achieve?