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

The medication vial sat at room temperature for 2 hr before it was administered

Answer and Explanation

The Correct Answer is D

A. The client's absolute neutrophil count was 2.500/mm³ before the medication was administered:
Incorrect Explanation: This is a normal data point that does not suggest an adverse event or error.
Explanation: An absolute neutrophil count of 2.500/mm³ is within the normal range, and there is no indication of a problem related to the administration of filgrastim based on this information.
B. The nurse flushed the client's IV line with dextrose 5% in water before and after the medication was administered:
Incorrect Explanation: Routine flushing of the IV line with appropriate solutions is a standard practice and not indicative of an incident.
Explanation: Flushing the IV line with dextrose 5% in water before and after medication administration is a routine procedure to maintain line patency and prevent interactions between medications.
C. The client had chemotherapy 12 hours before the medication was administered:
Incorrect Explanation: The timing of chemotherapy does not necessarily indicate an incident.
Explanation: Knowing the timing of chemotherapy is important for overall patient care, but it doesn't necessarily indicate an incident or error related to the administration of filgrastim.
D. The medication vial sat at room temperature for 2 hours before it was administered:
Correct Answer: This is the data point that should lead to filing an incident report.
Explanation: Many medications, including filgrastim, have specific storage requirements to ensure their effectiveness and safety. Allowing a medication vial to sit at room temperature for an extended period can compromise its stability and effectiveness. This situation should be reported as it involves a potential deviation from proper medication storage and handling procedures.

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Correct Answer is A

Explanation

A. Chronic kidney disease:
Correct Answer: This finding is a contraindication for receiving acetaminophen.
Explanation: Acetaminophen is metabolized in the liver, and its active metabolites can potentially be toxic to the liver in excessive amounts. However, if a person has chronic kidney disease, their impaired kidney function can affect the clearance of the drug and its metabolites, increasing the risk of adverse effects. Therefore, acetaminophen is used with caution or avoided in individuals with kidney disease.
B. Alcohol use disorder:
Incorrect Explanation: Alcohol use disorder is a cautionary consideration, but it's not a strict contraindication for acetaminophen use.
Explanation: Chronic excessive alcohol consumption can also affect liver function and the metabolism of acetaminophen. While alcohol use disorder is not a strict contraindication, it's important to consider potential interactions and the cumulative effect on the liver.
C. Hepatitis B vaccine within the last week:
Incorrect Explanation: Receiving the hepatitis B vaccine within the last week is not a contraindication for acetaminophen.
Explanation: Acetaminophen can be used to manage minor discomfort or fever that might be associated with vaccine administration. There is no direct contraindication related to receiving a hepatitis B vaccine within the last week.
D. Diabetes mellitus:
Incorrect Explanation: Diabetes mellitus is not a contraindication for acetaminophen.
Explanation: Diabetes mellitus does not directly impact the use of acetaminophen. However, individuals with diabetes should be mindful of their overall health and potential interactions with other medications they might be taking.

A. Bruxism B. Confusion C. Weight loss D. Insomnia

Correct Answer is A

Explanation

A. Bruxism:
Correct Answer: This adverse effect is a priority to report to the provider.
Explanation: Bruxism refers to teeth grinding or clenching, often unconsciously during sleep. It can be a potential side effect of citalopram and other selective serotonin reuptake inhibitors (SSRIs). Bruxism can lead to dental problems, jaw pain, and other discomforts. If this side effect occurs, it should be reported to the provider as it can impact the client's oral health and overall well-being.
B. Confusion:
Incorrect Explanation: While confusion is a concerning adverse effect, it's not typically associated with citalopram use.
Explanation: Confusion is more commonly associated with other medications or medical conditions. If a client experiences confusion, a thorough assessment is warranted, but it may not be directly attributed to citalopram.
C. Weight loss:
Incorrect Explanation: Weight loss can be a side effect of citalopram, but it's not the highest priority in this scenario.
Explanation: Weight loss is a possible side effect of many antidepressants, including citalopram. However, it is generally not as immediately concerning as other adverse effects that can impact a client's health and well-being.
D. Insomnia:
Incorrect Explanation: Insomnia is a common side effect of citalopram and other antidepressants, but it's not the highest priority in this context.
Explanation: Insomnia can be a transient side effect when starting an antidepressant-like citalopram. While it can affect the client's quality of life, it is not as urgent as potential dental issues caused by bruxism.

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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?

Nursing Test Bank

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Explanation

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