A nurse is reviewing the medical record of a client who just received a dose of IV filgrastim. The client has cancer and is receiving cytotoxic chemotherapy. For which of the following findings should the nurse complete an incident report?

The client had a decreased neutrophil count before the medication was administered.

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

The vial was out of the refrigerator for 2 hr before the medication was administered.

The client reported feeling nauseous after the medication was administered.

Answer and Explanation

The Correct Answer is C

A.   The client had a decreased neutrophil count before the medication was administered: This finding may be expected in a client undergoing cytotoxic chemotherapy and receiving filgrastim to stimulate neutrophil production. It is not an indication for an incident report.
B.   The client had chemotherapy 12 hr before the medication was administered: The timing of chemotherapy administration is not typically a reason to complete an incident report unless it conflicts with specific medication guidelines or protocols.
C.   The vial was out of the refrigerator for 2 hr before the medication was administered:

Filgrastim should be stored in the refrigerator and protected from light. Allowing the medication vial to be out of the refrigerator for an extended period may compromise its stability and effectiveness, potentially leading to adverse effects or reduced efficacy. Therefore, this finding warrants completion of an incident report.
D. The client reported feeling nauseous after the medication was administered: Nausea is a known side effect of filgrastim and is not typically an indication for completing an incident report unless it is severe or persistent and requires intervention.

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Correct Answer is B

Explanation

A. 0.45% sodium chloride: 0.45% sodium chloride solution, also known as half-normal saline, is a hypotonic solution used for rehydration and maintenance fluid therapy. However, in cases of
major burns where there is a significant loss of fluid and electrolytes, isotonic solutions are generally preferred.
B. Lactated Ringer's: Lactated Ringer's solution is an isotonic crystalloid solution that closely resembles the electrolyte composition of extracellular fluid. It is commonly used for fluid resuscitation in clients with major burns to replace lost fluids and electrolytes and restore
intravascular volume.

C. Dextrose 5% in water: Dextrose 5% in water is a hypotonic solution used primarily for hydration in clients with normal electrolyte levels or as a vehicle for administering medications.
It is not typically used for fluid resuscitation in clients with major burns, as it does not adequately replace lost electrolytes.
D. Dextrose 5% in 0.45% sodium chloride: This solution combines dextrose 5% and 0.45% sodium chloride and is used for maintenance fluid therapy and mild dehydration. However, in cases of major burns where there is significant fluid and electrolyte loss, isotonic solutions like lactated Ringer's or normal saline are preferred for fluid resuscitation.

A. “I should stay upright for at least 15 minutes after taking this medication." B. “I should take an antacid with this medication to prevent stomach upset." C. "I should take this medication with 8 ounces of milk." D. “I should notify my provider if my stools turn black."

Correct Answer is A

Explanation

A. “I should stay upright for at least 15 minutes after taking this medication.": This statement is correct as remianing upright reduces the risk of reflux that is common after taking the medication.
B. “I should take an antacid with this medication to prevent stomach upset.": Antacids can decrease the absorption of iron, so taking them with ferrous gluconate is not recommended.
C. "I should take this medication with 8 ounces of milk.": Milk can inhibit the absorption of iron, so taking ferrous gluconate with milk is not advised. It's better to take it with water or juice.
D. “I should notify my provider if my stools turn black.": This statement is incorrect as black stools are an expected side effect of the medication.

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A nurse is reviewing the medical record of a client who just received a dose of IV filgrastim. The client has cancer and is receiving cytotoxic chemotherapy. For which of the following findings should the nurse complete an incident report?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has major burns and is experiencing dehydration. The nurse should anticipate a prescription to infuse which of the following solutions?

Correct Answer is B

Explanation

A nurse is teaching a client who has a prescription for ferrous gluconate. Which of the following statements by the client indicates an understanding of the teaching?

Correct Answer is A

Explanation

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