Final answer:
The medication of most concern for a patient with shortness of breath and bilateral + pitting edema is Epoetin alfa (EPO), as it affects red blood cell production and oxygen delivery which could worsen symptoms related to edema and respiratory distress. Therefore, the correct option is A.
Step-by-step explanation:
A patient who complains of shortness of breath and presents with bilateral + pitting edema is most concerning if they are taking Epoetin alfa (EPO). EPO is a glycoprotein hormone that is secreted by the kidneys in response to low oxygen levels and promotes the production of erythrocytes (red blood cells). While it can be used therapeutically for the treatment of certain anemias to boost RBC counts and improve oxygen delivery to tissues, it may also exacerbate conditions such as hypertension and contribute to thrombotic events, which could lead to symptoms such as shortness of breath and edema. The other medications listed, Filgrastim (granulocyte colony-stimulating factor), Oprelvekin (interleukin-11), and Sargramostim (granulocyte-macrophage colony-stimulating factor), are cytokines that primarily affect leukocyte and platelet counts rather than red blood cell volume or oxygen transport, making them less likely to be directly implicated in the patient's respiratory symptoms and edema.