The nurse is administering prescribed epoetin alfa (Epogen) to a client. What finding would indicate that the treatment is having the intended effect.

Choice A rationale Epoetin alfa is a recombinant form of erythropoietin, a hormone that stimulates red blood cell (RBC) production in the bone marrow. It is not intended to affect the number of white blood cells (WBCs), which are typically in the range of 4,500 to 11,000 cells/mm. An elevated WBC count would suggest an infection, inflammation, or another hematologic condition, and is not a sign of the intended therapeutic effect of epoetin alfa. Choice B rationale PTT (Partial Thromboplastin Time) measures the function of the intrinsic and common pathways of the coagulation cascade, with a normal range typically around 25 to 35 seconds. Epoetin alfa primarily affects erythropoiesis and has no direct or intended effect on the coagulation factors or PTT level. A decreased PTT level would indicate a hypercoagulable state or potential laboratory error, which is unrelated to the medication's therapeutic goal. Choice C rationale Epoetin alfa stimulates the production of red blood cells. It does not directly target or reduce the platelet count, which is normally 150,000 to 450,000 platelets/mm and is involved in hemostasis. A reduced platelet count (thrombocytopenia) would be an unintended and potentially harmful side effect or an indication of an underlying problem, not a sign of the intended therapeutic benefit for anemia. Choice D rationale Epoetin alfa is prescribed to treat anemia by stimulating the bone marrow to produce red blood cells (RBCs), thereby increasing the hematocrit and hemoglobin levels. An increased red blood cell count, along with a rise in hemoglobin (normal: 12 to 17.5 g/dL) and hematocrit (normal: 36.