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 had chemotherapy 12 hr before the medication was administered.
The medication vial sat at room temperature for 2 hr before it was administered.
The client's absolute neutrophil count was 2,500/mm³ before the medication was administered.
The nurse flushed the client's IV line with dextrose 5% in water before and after the medication was administered.
The Correct Answer is A
Choice A rationale: Administering filgrastim after chemotherapy is a standard practice to boost white blood cell count. However, filgrastim should not be given within 24 hours before or after chemotherapy, as it can affect the efficacy and increase the risk of side effects. Administering the medication 12 hours after chemotherapy falls within this contraindicated window, necessitating an incident report.
Choice B rationale: Filgrastim can be stored at room temperature for short periods, and 2 hours is generally within acceptable limits for stability.
Choice C rationale: An absolute neutrophil count of 2,500/mm³ is within the normal range, and there is no contraindication for administering filgrastim.
Choice D rationale: Flushing the client's IV line with dextrose 5% in water before and after administering filgrastim is not appropriate, as this medication is typically administered with saline solution. Using an incorrect flushing solution could affect the medication's efficacy or compatibility, necessitating an incident report.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
After a mastectomy, it is important to avoid placing a catheter in the arm on the same side as the surgery to prevent complications such as lymphedema.

Therefore, the nurse should place the catheter in the left arm.
Choice A is wrong because Most proximal site, is not the correct answer because it does not specify which arm to use and could result in placing the catheter on the same side as the mastectomy.
Choice C is wrong because Wrist, is not the correct answer because it does not specify which arm to use and could result in placing the catheter on the same side as the mastectomy.
Choice D is wrong because Cordlike vein, is not the correct answer because it does not specify which arm to use and could result in placing the catheter on the same side as the mastectomy.
Correct Answer is A
Explanation
This is because pioglitazone can cause fluid retention and edema.
Choice B is wrong because tinnitus (ringing in the ears) is not a common adverse effect of pioglitazone.
Choice C is wrong because insomnia (difficulty sleeping) is not a common adverse effect of pioglitazone.
Choice D is wrong because orthostatic hypotension (a drop in blood pressure when standing up) is not a common adverse effect of pioglitazone.
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