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Guidelines recommend primary G-CSF prophylaxis when the regimen’s baseline febrile neutropenia (FN) risk is ≥20% or when intermediate risk (10–20%) is compounded by patient-specific factors such as age >65, comorbidities, prior FN, poor nutrition, or open wounds. Docetaxel/cyclophosphamide can approach the high-risk threshold, and this patient’s age and comorbidities increase risk, warranting prophylaxis to maintain dose intensity and reduce hospitalizations. Pegfilgrastim administered ≥24 hours after chemotherapy (or daily filgrastim for several days) lowers FN incidence; patients need counseling on bone pain management, when to call, and access to same-day evaluation. Empiric dose reduction at cycle 1 (Option C) may compromise efficacy in curative-intent therapy. Routine prophylactic oral antibiotics (Option D) are not a substitute for G-CSF and may promote resistance. Waiting for FN to occur (Option A) increases morbidity. APRNs operationalize standing orders for timely growth factor delivery, reinforce fever pathways, and reassess the need for prophylaxis as tolerance becomes evident.