After administering five doses of filgrastim, the nurse observes that the patient’s white blood cell count has increased from 2,500/mm^3 to 5,000/mm^3.
What action should the nurse take?

Inform the patient that the medication has been effective.

Review the patient’s culture and sensitivity reports.

Implement neutropenic precautions.

Assess the patient’s vital signs.

Answer and Explanation

The Correct Answer is A

Choice A rationale

Filgrastim is a medication used to stimulate the growth of white blood cells, making patients less vulnerable to infections. If the patient’s white blood cell count has increased from 2,500/mm^3 to 5,000/mm^3 after administering five doses of filgrastim, it indicates that the medication has been effective.

Choice B rationale

Reviewing the patient’s culture and sensitivity reports is not directly related to the effect of filgrastim on white blood cell count.

Choice C rationale

Neutropenic precautions are typically implemented when a patient has a low white blood cell count. Since the patient’s white blood cell count has increased, implementing neutropenic precautions may not be necessary.

Choice D rationale

While it’s always important to monitor a patient’s vital signs, there’s no specific reason to do so just because the patient’s white blood cell count has increased after administering filgrastim.

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Correct Answer is D

Explanation

The correct answer is D. Immediately after completion of the IV dose and 30 minutes before the next administration of the medication.

Explanation:

Peak levels measure the highest concentration of the drug in the bloodstream and should be drawn immediately after the IV infusion is completed.
Trough levels measure the lowest concentration of the drug and should be drawn 30 minutes before the next scheduled dose. This helps ensure the drug remains within therapeutic levels and prevents toxicity.

Why the other options are incorrect:

A. One hour after completion of the IV dose and one hour before the next administration – Waiting one hour for the peak level is too long and may lead to an inaccurate measurement.
B. Two hours after completion of the IV dose and two hours before the next administration – Waiting two hours for both peak and trough levels is too late for effective monitoring.
C. Thirty minutes into the administration of the IV dose and 30 minutes before the next administration – The sample drawn mid-infusion does not represent peak levels, making this method ineffective.

Key takeaway:

Proper timing of vancomycin peak and trough monitoring ensures therapeutic drug levels while minimizing nephrotoxicity and ototoxicity.

A. Hypertension. B. Scratchy throat. C. Bradycardia. D. Pupillary constriction.

Correct Answer is B

Explanation

Choice A rationale

Hypertension, or high blood pressure, is not typically a side effect of piperacillin-tazobactam. While it’s important to monitor a client’s blood pressure during any infusion, hypertension alone would not typically be a reason to stop the infusion of piperacillin-tazobactam.

Choice B rationale

A scratchy throat could be a sign of an allergic reaction to piperacillin-tazobactam. Allergic reactions to medications can range from mild to severe, and can include symptoms such as hives, difficulty breathing, and swelling in the face or throat. If a client reports a scratchy throat shortly after starting an infusion of piperacillin-tazobactam, it would be prudent for the nurse to stop the infusion and assess the client for other signs of an allergic reaction.

Choice C rationale

Bradycardia, or a slow heart rate, is not typically a side effect of piperacillin-tazobactam. While it’s important to monitor a client’s heart rate during any infusion, bradycardia alone would not typically be a reason to stop the infusion of piperacillin-tazobactam.

Choice D rationale

Pupillary constriction is not typically a side effect of piperacillin-tazobactam. While it’s important to monitor a client’s pupils during any infusion, pupillary constriction alone would not typically be a reason to stop the infusion of piperacillin-tazobactam.

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After administering five doses of filgrastim, the nurse observes that the patient’s white blood cell count has increased from 2,500/mm^3 to 5,000/mm^3.What action should the nurse take?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client is receiving intravenous vancomycin, and the nurse plans to draw blood for a peak and trough to determine the serum level of the drug. Which collection times would provide the best determination of these levels?

Correct Answer is D

Explanation

Explanation:

Why the other options are incorrect:

Key takeaway:

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Correct Answer is B

Explanation

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After administering five doses of filgrastim, the nurse observes that the patient’s white blood cell count has increased from 2,500/mm^3 to 5,000/mm^3.
What action should the nurse take?