A nurse is reviewing the laboratory data of a client who is receiving filgrastim. Which of the following laboratory values should the nurse monitor to evaluate the effectiveness of the treatment?
INR
BUN
WBC count
Potassium level
The Correct Answer is C
Choice A Reason:
INR (International Normalized Ratio) is incorrect. INR is a measurement used to monitor the effects of anticoagulants like warfarin. It assesses the blood's ability to clot. Filgrastim does not directly affect INR levels, so monitoring INR would not provide information about the effectiveness of filgrastim in stimulating white blood cell production.
Choice B Reason:
BUN (Blood Urea Nitrogen) is incorrect. BUN levels primarily indicate kidney function and hydration status. They are not directly influenced by filgrastim treatment. Monitoring BUN is essential for assessing kidney function but does not reflect the effectiveness of filgrastim therapy in increasing white blood cell counts.
Choice C Reason:
WBC count is correct. Filgrastim is a medication that stimulates the production of white blood cells (WBCs), particularly neutrophils. Therefore, the key laboratory value to monitor for assessing the effectiveness of filgrastim therapy is the WBC count. An increase in the WBC count, particularly in the neutrophil count, signifies the intended therapeutic effect of filgrastim in boosting the immune system's response by increasing the production of these infection-fighting cells.
Choice D Reason:
Potassium level is incorrect. Potassium levels are crucial for heart and muscle function. While certain medications might affect potassium levels, filgrastim's primary action is on stimulating white blood cell production and does not directly impact potassium levels. Monitoring potassium levels is essential for overall health but does not specifically indicate the effectiveness of filgrastim treatment.

Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A Reason:
Sodium 141 mEq/L is incorrect. This value is within the normal range (usually around 135-145 mEq/L).
Choice B Reason:
Potassium 2.5 mEq/ is correct. Furosemide, a loop diuretic, can lead to potassium loss through increased urine output. If a client already has a low potassium level (hypokalemia), administering furosemide can further decrease potassium levels, potentially causing or worsening hypokalemia. Hypokalemia can lead to various complications, including cardiac arrhythmias.
Choice C Reason:
WBC count 8,000/mm3 is incorrect. This value falls within the normal range for white blood cell count.
Choice D Reason:
INR 1.0: An INR of 1.0 is within the normal range for a person not on anticoagulation therapy.

Correct Answer is B
Explanation
Choice A Reason:
Weight loss is incorrect. While weight loss can be a side effect of citalopram, it's not typically considered a severe or urgent adverse effect that requires immediate reporting to the provider. It's more often observed in some individuals as a common side effect of this medication.
Choice B Reason:
Confusion can indicate a severe or uncommon adverse reaction to citalopram, especially in the context of treating major depression. It could potentially signify a serious condition that requires immediate attention. Reporting confusion promptly allows the healthcare provider to assess the situation and make appropriate adjustments to the medication regimen or provide additional interventions if necessary.
Choice C Reason:
Insomnia is incorrect. Insomnia is another potential side effect of citalopram. While it can affect the individual's quality of life, it's not typically an adverse effect that would be considered an urgent concern requiring immediate reporting to the provider.
Choice D Reason:
Bruxism is incorrect. Bruxism, or teeth grinding, is a less common side effect of citalopram. While it can cause discomfort or dental issues, it's not typically considered a priority adverse effect that necessitates immediate reporting to the provider compared to confusion, which might indicate a more serious or severe reaction.
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