ATI Pharmacology The Hematologic System Test Flashcards


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1

Pt is about to begin taking folic acid to treat megaloblastic anemia. The HCP should monitor which of the following lab values?

Amylase level

Reticulocyte count

C-reactive protein

Creatinine clearance

Reticulocyte count

- A reticulocyte count measures the amount of immature RBCs. Folic acid, also called folate, is essential for erythropoiesis. Patients who have a folic acid deficiency require a baseline reticulocyte count, as well as a serum folate, Hgb, Hct, and RBC count and periodic monitoring during folic acid therapy to determine effectiveness.

2

HCP is preparing to admin filgrastim (Neupogen) to a pt. The pt lab results indicate that the pt has a WBC count of 12,000/mm 3. Which of the following actions should the HCP take?

Clarify the prescription with the provider

Administer the drug with analgesic

Limit venipunctures

Assess breath sounds

Clarify the prescription with the provider

- Leukocytosis can occur with filgrastim therapy. It is essential to monitor CBC twice per week and reduce the dosage or stop therapy for a WBC count above 10,000/mm3​. The health care professional should notify the provider of the patient’s current WBC count and clarify the prescription prior to administration.

3

Pt is about to begin iron dextran (INFeD). When administering the drug IM, the HCP should take which of the following actions? (4 actions)

Administer a test dose.

Monitor blood pressure.

Have epinephrine available.

Premedicate with atropine.

Use the Z-track technique.

Administer a test dose is correct. Iron dextran can cause a hypersensitivity reaction. It is essential to administer a test dose to determine hypersensitivity prior to giving the full dosage initially and to allow 1 hr for identifying any adverse reactions.

Monitor blood pressure is correct. Iron dextran can cause hypotension and hypersensitivity reactions, so it is important to monitor blood pressure.

Have epinephrine available is correct. Iron dextran can cause a hypersensitivity reaction. It is essential to have epinephrine and resuscitation equipment available and to monitor for skin rash, fever, and chills.

Premedicate with atropine is incorrect . Iron dextran is more likely to cause tachycardia than bradycardia. Therefore, it is unnecessary to premedicate with atropine.

Use the Z-track technique is correct. Health care professionals giving the drug IM should use the Z-track technique to make sure to deposit it deep into the buttocks. Superficial injection can cause abscesses and brown discoloration of the skin.

4

Pt about to take filgrastim (Neupogen) to treat neutropenia. The HCP should assess the pt for which of the following adverse effects?

Dusky nail beds

Petechiae

Enlarged spleen

Swollen calf

Enlarged spleen

-With long-term use, filgrastim, a leukopoietic growth factor, can cause an enlarged spleen. Health care professionals should tell patients taking the drug to monitor and report abdominal pain or fullness.

5

Pt is about to begin taking warfarin (Coumadin). The HCP should caution the pt about taking which of the following OTC drugs?

Diphenhydramine

Dimenhydrinate (Dramamine)

Calcium carbonate (Tums)

Ibuprofen (Motrin)

Ibuprofen (Motrin)

-NSAIDs, such as ibuprofen and especially aspirin, can increase the risk of bleeding for patients taking warfarin, an anticoagulant.

6

pt is about to begin therapy with recombinant factor XI (BeneFix) to treat hemophilia B. The pt asks the HCP about the risks of the disease with recombinant factor IX, as compared with plasma derived factor IX. The HCP should explain that recombinant factor IX eliminates the risk for which of the following?

HIV

Cytomegalovirus

Creutzfeldt-Jakob disease

Anaphylaxis

Creutzfeldt-Jakob disease

-Recombinant factor IX is safer than the plasma-derived formulation because of the risk of Creutzfeldt-Jakob disease, a prion-transmitted infection, from human sources. Plasma-derived products also carry a minimal risk of acquiring hepatitis A and parvovirus B19.

7

A health care professional should assess a pt who has megaloblastic anemia for indications of which of the following vitamin deficiencies?

Vitamin B12

Vitamin K

Vitamin C

Vitamin D

Vitamin B12

- Patients who have megaloblastic anemia have a deficiency of vitamin B12, folic acid, or both. Cyanocobalamin (Nascobal) treats moderate vitamin B12 deficiencies. Patients who have a severe vitamin B12 deficiency should take cyanocobalamin and folic acid.

8

pt is taking ferrous sulfate (Feosol) to treat iron-deficiency anemia develops severe nausea and vomiting due to iron toxicity. Which of the following drugs should the HCP use to treat this complication?

Flumazenil (Mazicon)

Acetylcysteine (Acetadote)

Naloxone

Deferoxamine (Desferal)

Deferoxamine (Desferal)

-Indications of iron toxicity include nausea, vomiting, and diarrhea. Iron toxicity can lead to acidosis and shock. A chelating agent, such as deferoxamine, binds to the iron to reduce toxicity.

9

pt about to begin altepase (Activase) therapy to treat pulmonary embolism. Which of the following drugs should the HCP have available in the event of a severe adverse reaction?

Vitamin K

Aminocaproic acid (Amicar)

Protamine

Deferoxamine (Desferal)

Aminocaproic acid (Amicar)

-Aminocaproic acid, a coagulator, inhibits fibrinolysis and stops fibrinolytic bleeding. For severe bleeding, patients often require blood replacement.

10

HCP caring for pt who is about to begin taking altepase (Activase) to treat acute myocardial infarction. The HCP should understand the drug is most effect when the pt receives it.

24 hr after clot formation.

after initiation of anticoagulation.

prior to clot formation.

within 3 hr of symptom onset.

within 3 hr of symptom onset.

-Alteplase, a thrombolytic drug, is most effective in treating acute myocardial infarction if the patient receives it as soon as possible after the onset of symptoms.

11

HCP is caring for a pt who is about to begin taking oprelvekin (Neumega) to treat thrombocytopenia. The HCP should tell the pt to report which indication of an adverse reaction?

Conjunctivitis

Tinnitus

Swollen ankles

Jaundice

Palpitations

Conjunctivitis is correct. Oprelvekin, a thrombopoietic growth factor, can cause conjunctivitis, blurred vision, and papilledema. Patients should report eye redness or blurred vision.

Tinnitus is incorrect. Oprelvekin, a thrombopoietic growth factor, is unlikely to cause tinnitus. Aspirin (Ecotrin) is a drug that can cause tinnitus.

Swollen ankles is correct. Oprelvekin, a thrombopoietic growth factor, can cause fluid retention. The health care professional should monitor I&O and patients should report edema or difficulty breathing.

Jaundice is incorrect. Oprelvekin, a thrombopoietic growth factor, is unlikely to cause jaundice. However, it can cause fever, rash, and hypotension.

Palpitations is correct. Oprelvekin, a thrombopoietic growth factor, can cause cardiac dysrhythmias. Patients should report palpitations or dizziness.

12

A HCP is caring for a pt who is about to begin taking epoetin alfa (Epogen). Which of the following laboratory values should increase with effective therapy?

PT

WBC

Hgb

Platelets

Hgb

Epoetin alfa, an erythropoietic growth factor, increases the production of RBCs for patients who have anemia due to chronic renal failure or chemotherapy. Hgb and Hct should increase with effective therapy.

13

Pt has a known sensitivity to Escherichia coli-derived proteins. This sensitivity is a contraindication for which of the following drugs?

Epoetin alfa (Erythropoietin)

Oprelvekin (Neumega)

Filgrastim (Neupogen)

Alteplase (Activase)

Filgrastim (Neupogen)

-Patients who are sensitive to Escherichia coli-derived proteins or have acute respiratory distress syndrome should not receive filgrastim, a leukopoietic growth factor.

14

pt undergoing bone marrow transplant following high-dose chemotherapy. which of the following drugs should the health care professional expect the primary care provider to prescribe to reduce the patients risk of infection?

Epoetin alfa (Erythropoietin)

Oprelvekin (Neumega)

Filgrastim (Neupogen)

Alteplase (Activase)

Filgrastim (Neupogen)

-Filgrastim, a leukopoietic growth factor, stimulates production of neutrophils in the bone marrow. It helps reduce the risk for infection due to bone marrow transplantation, severe chronic neutropenia, and myelosuppressive chemotherapy.

15

Pt is about ot begin taking oprelvekin (Neumega). The HCP should explain to the pt tha the drug has which of the following effects?

Stimulates leukocyte maturation

Causes myelosuppression

Increases platelet production

Destroys blood clots

Increases platelet production

-Oprelvekin, a thrombopoietic growth factor, increases platelet production. It treats thrombocytopenia that is associated with myelosuppression.

16

HCP administers eopoetin alfa (Epogen) subcutaneously to a pt who has renal failure. The HCP should monitor the pt for which of the following adverse effects?

Hypertension

Muscle pain

Edema

Dry mouth

Hypertension

-Epoetin alfa, an erythropoietic growth factor, can cause hypertension. The health care professional should monitor blood pressure and regulate it prior to initiating epoetin alfa therapy, then monitor it during therapy. For elevations, recommend a reduced dosage or antihypertensive drug therapy.

17

pt is taking warfarin (Coumadin) arrives at the ER dept and reports rectal bleeding. which of the following drugs should the HCP have available?

Filgrastim (Neupogen)

Deferoxamine (Desferal)

Protamine

Vitamin K

Vitamin K

-Vitamin K reverses the effects of warfarin by promoting the synthesis of coagulation factors VI, IX, X, and prothrombin.

18

Pt is about to begin taking clopidogrel (Plavix) to prevent thrombus formation. HCP should question the use of clopidogrel by a pt who has which of the following?

Myocardial infarction

Peptic ulcer disease

Pancreatitis

Myasthenia gravis

Peptic ulcer disease

-Patients who have peptic ulcer disease should not take clopidogrel because it can cause gastric bleeding.

19

pt is about to begin factor VII (Advate) therapy to treat hemophilla A. When administering factor VII, which of the following actions should the HCP take?

Have emergency equipment ready.

Premedicate with aspirin (Ecotrin).

Administer via rapid IV bolus.

Administer the powdered form orally.

Have emergency equipment ready.

-Factor VIII can cause a hypersensitive reaction and anaphylaxis. The health care professional should monitor for hives, fever, wheezing, and difficulty breathing, and have emergency equipment and drugs readily available.

20

HCP is caring for a pt who is about to begin taking ferrous sulfate (Feosol) to treat iron-deficiency anemia. When taking with the pt about the drug, the HCP should include which of the following instructions? (4 instructions)

Eat iron-enriched foods.

Spread the dosage across each day.

Take the drug on an empty stomach.

Report dark green or black stools.

Increase dietary fiber intake.

Eat iron-enriched foods is correct. Patients who have iron-deficiency anemia should increase iron intake with foods such as egg yolks, wheat germ, meat, and fish to supplement ferrous sulfate.

Spread the dosage across each day is correct. Spreading out the iron intake throughout patients' waking hours allows the bone marrow to maximize the production of RBCs.

Take the drug on an empty stomach is correct. Food reduces the absorption of ferrous sulfate. Patients should take the drug on an empty stomach to increase drug absorption. If GI effects are troublesome, patients can take the drug with food.

Report dark green or black stools is incorrect. Health care professionals should tell patients to expect dark green or black stools. It is not necessary to report this effect.

Increase dietary fiber intake is correct. Ferrous sulfate can cause constipation. Patients should increase fiber and fluid intake and exercise more often or more intensely.

21

HCP is caring for a pt who has mild hemophilia A and is about to begin taking a desmopressin (DDAVP) to prevent bleeding. The HCP should monitor for which of the following adverse reaction?

Weight loss

Edema

Polyuria

Tachycardia

Edema

-Desmopressin, an antidiuretic hormone, can cause fluid retention and edema. Health care professionals should monitor fluid intake and output for patients receiving the drug therapy.

22

pt is about to begin taking clopidogrel (Plavix) to prevent stent stenosis. The HCP should monitor the pt for which of the following adverse reactions?

Thrombocytopenia

Hyponatremia

Lymphocytopenia

Uricemia

Thrombocytopenia

-Clopidogrel, an antiplatelet drug, can cause thrombotic thrombocytopenic purpura. The health care professional should monitor platelet count, bruising, bleeding gums, and petechiae.

23

HCP is caring for a pt who is about to begin altepase (Activase) therapy. The HCP should monitor the pt for which of the following indications of a possible adverse effect?

Hives

Headache

Edema

Hypertension

Headache

-Alteplase, a thrombolytic drug, can cause intracranial bleeding. Monitor patients receiving the drug for changes in level of consciousness, headache, one-sided weakness, and other indications of intracranial bleeding.

24

HCP is caring for a pt who is about to begin taking aspirin (Ecotrin) to reduce the risk of a cardiovascular event. The HCP should understand that the drug inhibits platelet aggregation by which of the following mechanisms?

Activating thromboxane A2

Blocking adenosine diphosphate receptor agonists

Suppressing specific clotting factors

Inhibiting cyclooxygenase action in platelets

Inhibiting cyclooxygenase action in platelets

-Salicylates, such as aspirin, work by inhibiting platelet aggregation. They do this by blocking the action of cyclooxygenase on platelets. As a result, activation of thromboxane A2 does not occur.

25

HCP administering epoetin alfa (Epogen) subcutaneously to a pt who has renal failure. The HCP should take which of the following actions?

Shake the vial before using.

Insert the needle into the vial once.

Dilute the drug first with normal saline.

Save the used vial for the next dose.

Insert the needle into the vial once.

-Instructions for administering the drug include inserting the needle into the vial only once. Health care professionals should also examine the solution and discard it if it is cloudy or discolored.