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 A
Explanation
The nurse should withhold the dose of propranolol and notify the provider.
Using propranolol together with albuterol may reduce the benefits of both medications, since they have opposing effects in the body.
In addition, propranolol can sometimes cause narrowing of the airways, which may worsen breathing problems or trigger severe asthmatic attacks.
Choice B is wrong because there is no known interaction between albuterol and isosorbide mononitrate.
Choice C is wrong because there is no known interaction between albuterol and pantoprazole.
Choice D is wrong because there is no known interaction between albuterol and montelukast.
Correct Answer is B
Explanation
Ranitidine is a histamine H2-receptor antagonist that blocks histamine-mediated gastric acid secretion.
Antacids can interfere with the absorption of ranitidine, so it is important to separate their administration by at least 1 hour.
Choice A is wrong because aspirin is a type of nonsteroidal anti-inflammatory drug (NSAID) which can increase the risk of peptic ulcers.
Choice C is wrong because fine hand tremors are not a known side effect of ranitidine.
Choice D is wrong because there is no need to avoid dairy products when taking ranitidine.
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