# A client receiving talquetamab reports altered taste and difficulty swallowing. Review the trend and select the best interpretation and plan.

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=522596&lang=en  
> language: en  
> subject: Adverse Effects/Contraindications/Interactions  
> category: PPT

## Question

A client receiving talquetamab reports altered taste and difficulty swallowing. Review the trend and select the best interpretation and plan.

| Time | Data |
| --- | --- |
| Before therapy | Weight 72 kg; normal taste, saliva, and swallowing |
| Week 3 | Food tastes metallic; dry mouth; weight 69 kg |
| Current visit | Weight 64 kg; coughs with liquids; eats less than half of meals; painful oral mucosa |

Q1. How should the current trend be interpreted?

Expected harmless taste preference
Clinically significant oral toxicity with nutritional and swallowing risk
Evidence that the malignancy is cured

Q2. Which plan is appropriate?

Promptly evaluate swallowing and nutrition and obtain treatment-withholding review
Encourage fasting until taste returns
Continue without reporting because oral effects never require intervention

## Explanation

Progressive dysgeusia, dry mouth, dysphagia, and more than 10% weight loss indicate clinically significant talquetamab oral toxicity and nutritional compromise that requires prompt evaluation and treatment review.

## In-depth explanation

Quick answer
Trend oral toxicity together with weight and intake.

Why this is correct
Talquetamab can cause persistent oral toxicity and weight loss. Weight must be monitored regularly, clinically significant loss evaluated, and treatment withheld or discontinued according to severity.

Easy analogy or mental picture
Use a closed medication-safety loop: identify the immune or cytotoxic exposure, connect the new findings, interrupt further harm, stabilize the client, and verify the response over time.

Memory hook
Exposure, immune effect, organ toxicity, infection risk, immediate action, and serial reassessment.

NCLEX decision rule
Choose the action that reduces the most immediate medication-related risk while preserving diagnostic evaluation and authorized treatment.

Why the other choices are wrong
Options that continue the exposure, treat only one symptom, or delay reassessment leave the toxic or infectious process active.References
1DailyMed: TALVEY (talquetamab)Oral toxicity, dysgeusia, dysphagia, clinically significant weight loss, nutrition support, and treatment withholding

## Clinical scenario

Oncology, transplant, and biologic safety review
Verify the indication, immune status, infection screen, interacting medicines, current organ findings, authorized action, and measurable follow-up.

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