Ch 11 - Exam 4 NUR 3420 – Prep Test
Questions with Complete Answers.
A calendar to mark the days of the week the drug is to be administered
Explanation:
The nurse should provide the patient with a calendar of the days the drug is to be administered.
This will serve as a reminder that the patient has to get to the clinic or that the home health
nurse will be coming. This would encourage compliance by being at the clinic or being available
at home on the days of administration. An appointment card given to him each time he is to
have a dose would be easy to loose and would not help with compliance. More than likely the
patient will not be purchasing the drug himself. Therefore, the telephone number of the
pharmacy would not be helpful. If needed the information concerning community
transportation could be useful, but the patient would have to know the days he would need
transportation to the clinic. - Answer The nurse is working with a male client diagnosed with
chronic renal disease. To increase compliance with the drug regimen, what should the nurse
provide the patient who has been prescribed epoetin alfa?
Hematocrit and hemoglobin
Explanation:
Hematocrit and hemoglobin levels will indicate drug effectiveness and could be used to
determine dosage. Immature RBCs lose their nucleus and enter circulation as a reticulocyte. A
measure of RBCs would indicate the number of blood cells per cubic millimeter and does not
indicate iron or O2 content. The hemoglobin count represents the iron-containing pigment of
the RBC, which carries oxygen from the lungs to the tissue. The hematocrit represents the
volume of solids (iron) and plasma in the blood. These two measures indicate the basis for a
diagnosis of anemia. Aspartate transminase levels are associated with liver function and serum
creatinine levels are associated with renal function. - Answer Prior to administration of an
iron preparation, what should a nurse assess?
Produce erythropoietin
Explanation:
Persons with chronic renal failure often are anemic because of an inability of the kidneys to
produce erythropoietin. This anemia usually is managed by the administration of a recombinant
erythropoietin (epoetin alfa) produced through DNA technology, to stimulate erythropoiesis.
Options B, C, and D are incorrect - Answer The anemia that occurs with chronic renal failure
is caused by the kidneys themselves. What inability of the kidneys causes anemia in chronic
renal failure?
, Hypertension
Explanation:
All three of these drugs are contraindicated in the presence of uncontrolled hypertension,
because of the risk of even further hypertension when RBC numbers increase and the pressure
within the vascular system increases. There is no contraindication to the use of erythropoeisis-
stimulating agents for patients with asthma, irritable bowel syndrome, or shortness of breath -
Answer A patient has been prescribed epoetin alfa. In reviewing this patient's history, what
would the nurse know contraindicates the use of epoetin alfa?
A 62-year-old male with cancer
Explanation:
Older adults who have cancer and are receiving chemotherapy are especially vulnerable to the
adverse effects of anemia as a result of chemotherapy and would therefore be the most likely
candidates for epoetin alfa therapy. Young adults over age 18, pregnant women, and patients
with a high white blood cell count are not as vulnerable to anemia and would not require
epoetin alfa therapy - Answer Which patient will be at the greatest risk for anemia and be
the most likely candidate for epoetin alfa therapy?
500-10,000 mm3
Explanation:
Clients are at highest risk for infection when neutrophil counts fall below 500/mm3, and
immunostimulants should be stopped when neutrophil counts exceeds 10,000 mm3 - Answer
An immunostimulant has been ordered for a chemotherapy client. The client asks the nurse why
they need to take this drug. The nurse explains that the medication is given to increase the WBC
count to at least what level?
Iron supplement
Explanation:
Iron supplementation is used adjunctively with epoetin to increase RBCs. The nurse would not
expect a potassium supplement, sodium restriction or renal dialysis to be ordered. - Answer
The nurse is caring for a client who is receiving epoetin alfa. What adjunct treatment will the
nurse expect the health care provider to order for this client?
An iron supplement
Questions with Complete Answers.
A calendar to mark the days of the week the drug is to be administered
Explanation:
The nurse should provide the patient with a calendar of the days the drug is to be administered.
This will serve as a reminder that the patient has to get to the clinic or that the home health
nurse will be coming. This would encourage compliance by being at the clinic or being available
at home on the days of administration. An appointment card given to him each time he is to
have a dose would be easy to loose and would not help with compliance. More than likely the
patient will not be purchasing the drug himself. Therefore, the telephone number of the
pharmacy would not be helpful. If needed the information concerning community
transportation could be useful, but the patient would have to know the days he would need
transportation to the clinic. - Answer The nurse is working with a male client diagnosed with
chronic renal disease. To increase compliance with the drug regimen, what should the nurse
provide the patient who has been prescribed epoetin alfa?
Hematocrit and hemoglobin
Explanation:
Hematocrit and hemoglobin levels will indicate drug effectiveness and could be used to
determine dosage. Immature RBCs lose their nucleus and enter circulation as a reticulocyte. A
measure of RBCs would indicate the number of blood cells per cubic millimeter and does not
indicate iron or O2 content. The hemoglobin count represents the iron-containing pigment of
the RBC, which carries oxygen from the lungs to the tissue. The hematocrit represents the
volume of solids (iron) and plasma in the blood. These two measures indicate the basis for a
diagnosis of anemia. Aspartate transminase levels are associated with liver function and serum
creatinine levels are associated with renal function. - Answer Prior to administration of an
iron preparation, what should a nurse assess?
Produce erythropoietin
Explanation:
Persons with chronic renal failure often are anemic because of an inability of the kidneys to
produce erythropoietin. This anemia usually is managed by the administration of a recombinant
erythropoietin (epoetin alfa) produced through DNA technology, to stimulate erythropoiesis.
Options B, C, and D are incorrect - Answer The anemia that occurs with chronic renal failure
is caused by the kidneys themselves. What inability of the kidneys causes anemia in chronic
renal failure?
, Hypertension
Explanation:
All three of these drugs are contraindicated in the presence of uncontrolled hypertension,
because of the risk of even further hypertension when RBC numbers increase and the pressure
within the vascular system increases. There is no contraindication to the use of erythropoeisis-
stimulating agents for patients with asthma, irritable bowel syndrome, or shortness of breath -
Answer A patient has been prescribed epoetin alfa. In reviewing this patient's history, what
would the nurse know contraindicates the use of epoetin alfa?
A 62-year-old male with cancer
Explanation:
Older adults who have cancer and are receiving chemotherapy are especially vulnerable to the
adverse effects of anemia as a result of chemotherapy and would therefore be the most likely
candidates for epoetin alfa therapy. Young adults over age 18, pregnant women, and patients
with a high white blood cell count are not as vulnerable to anemia and would not require
epoetin alfa therapy - Answer Which patient will be at the greatest risk for anemia and be
the most likely candidate for epoetin alfa therapy?
500-10,000 mm3
Explanation:
Clients are at highest risk for infection when neutrophil counts fall below 500/mm3, and
immunostimulants should be stopped when neutrophil counts exceeds 10,000 mm3 - Answer
An immunostimulant has been ordered for a chemotherapy client. The client asks the nurse why
they need to take this drug. The nurse explains that the medication is given to increase the WBC
count to at least what level?
Iron supplement
Explanation:
Iron supplementation is used adjunctively with epoetin to increase RBCs. The nurse would not
expect a potassium supplement, sodium restriction or renal dialysis to be ordered. - Answer
The nurse is caring for a client who is receiving epoetin alfa. What adjunct treatment will the
nurse expect the health care provider to order for this client?
An iron supplement
