Chapter 55: Hematopoietic Growth Factors

Chapter 55: Hematopoietic Growth Factors

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

1. The nurse is providing patient education for a group of nurses on the topic of chronic renal failure (CRF). To evaluate the group’s understanding, the nurse asks, “What is the greatest benefit of treatment with epoetin alfa in patients in renal failure?” The best response would be that the drug

a.	replaces erythropoietin no longer produced in the proximal tubules of the kidney because of CRF.
b.	neutralizes the kidneys’ waste products, which destroy circulating RBCs.
c.	metabolizes the hormone that interferes with RBC production.
d.	increases the kidneys’ excretion of substances that interfere with RBC production.

 

 

ANS:   A

Erythropoietin is produced by peritubular cells in the proximal tubules of the kidney. Epoetin alfa replaces erythropoietin that is no longer produced because of CRF.

Epoetin alfa does not neutralize the kidneys’ waste products.

Epoetin alfa does not metabolize the hormone that interferes with RBC production.

Epoetin alfa does not increase the kidneys’ excretion of substances that interfere with RBC production.

 

DIF:    Cognitive Level: Application             REF:    pp. 647-648

TOP:    Nursing Process: Evaluation

MSC:   NCLEX Client Needs Category: Physiological Integrity: Pharmacological and Parenteral Therapies

 

2. A nurse is evaluating a patient with HIV who takes zidovudine (AZT) for possible treatment with epoetin alfa. The nurse notices that the laboratory report shows endogenous erythropoietin levels of 550 milliunits/mL. To keep the treatment optimal and at a therapeutic level, what would be the most appropriate nursing action?

a.	Administer the epoetin alfa as ordered.
b.	Contact the prescriber to determine whether the dosage should be reduced.
c.	Contact the prescriber to see whether the dosage should be increased.
d.	Confer with the prescriber to see whether the order should be discontinued.

 

 

ANS:   A

If endogenous levels of erythropoietin are at or above 500 milliunits/mL, raising them further with epoetin alfa is unlikely to help so the nurse needs to discuss the lab result and what the lowered dose should be with the prescriber.

The patient’s erythropoietin level is too high so the nurse needs to discuss what dose would be best with the prescriber before giving more erythropoietin.

This is incorrect since the lab result is too high so the patient needs a lower dose of erythropoietin.

Since anemia is a side effect of Zidovudine, it is likely he will need some dose of erythropoietin to maintain hemoglobin levels. Treatment with erythropoietin can maintain or elevate erythrocyte counts and reduce the need for transfusions.

 

DIF:    Cognitive Level: Application             REF:    p. 648

TOP:    Nursing Process: Implementation

MSC:   NCLEX Client Needs Category: Physiological Integrity: Pharmacological and Parenteral Therapies

 

3. The nurse practitioner is debating whether to prescribe darbepoetin alfa (ARAN esp) or epoetin alfa. The nurse practitioner decides to write the order for darbepoetin alfa (ARAM esp), because it has the advantage over erythropoietin that it

a.	is less painful to inject.
b.	can be administered less frequently.
c.	has a shorter half-life.
d.	is less likely to exacerbate hypertension.

 

 

ANS:   B

Darbepoetin alfa is cleared more slowly than epoetin alfa and has a longer half-life. It therefore can be administered less often and is more convenient.

Darbepoetin alfa is not less painful to inject and is not less likely to exacerbate hypertension.

Darbepoetin alfa has a longer half life than epoetin alfa.

 

DIF:    Cognitive Level: Comprehension      REF:    p. 649

TOP:    Nursing Process: Evaluation

MSC:   NCLEX Client Needs Category: Physiological Integrity: Reduction of Risk Potential