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A nurse is reviewing the laboratory results of a client who is taking amitriptyline. Which of the following laboratory values should the nurse report to the provider?
- A. Total bilirubin 1.5 mg/dL
- B. Potassium 4.2 mEq/L
- C. Hct 0.44%
- D. WBC count 5
Correct Answer: A
Rationale: The correct answer is A. Total bilirubin levels should be reported because amitriptyline can cause hepatotoxicity. Elevated bilirubin could indicate liver damage. Option B, potassium level, is not typically affected by amitriptyline. Option C, hematocrit, and option D, WBC count, are not directly related to amitriptyline use. Options E, F, and G are not provided. In summary, the nurse should report elevated total bilirubin levels due to potential hepatotoxicity from amitriptyline.
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A nurse is reviewing the medical record of a client who has sinusitis and a new prescription for cefuroxime. Which of the following client information is the priority for the nurse to report to the provider?
- A. The client has a BUN of 18 mg/dL
- B. The client takes an aspirin daily
- C. The client has a history of a severe penicillin allergy
- D. The client reports a history of nausea with cefuroxime
Correct Answer: C
Rationale: The correct answer is C: The client has a history of a severe penicillin allergy. This is the priority for the nurse to report because cefuroxime belongs to the cephalosporin class of antibiotics, which has a cross-reactivity with penicillins. Individuals with a history of severe penicillin allergy are at an increased risk of also being allergic to cephalosporins like cefuroxime. This can lead to potentially life-threatening allergic reactions. Reporting this information to the provider is crucial to avoid prescribing a medication that could harm the client.
Choice A (BUN of 18 mg/dL) is not directly related to the prescription of cefuroxime for sinusitis. Choice B (client takes an aspirin daily) is important but not as critical as the potential allergic reaction to cefuroxime. Choice D (client reports a history of nausea with cefuroxime) is relevant but does not pose an
A nurse is assessing a client after administering phenytoin IV bolus for a seizure. Which of the following should the nurse identify as an adverse effect of this medication?
- A. Hypoglycemia
- B. Bradycardia
- C. Red man syndrome
- D. Hypotension
Correct Answer: D
Rationale: The correct answer is D: Hypotension. Phenytoin can cause hypotension as an adverse effect due to its vasodilatory properties. The drug can cause a decrease in blood pressure, leading to symptoms such as dizziness and lightheadedness. This adverse effect is important for the nurse to recognize as it can potentially lead to complications such as falls in the client.
A: Hypoglycemia is not a common adverse effect of phenytoin.
B: Bradycardia is not a typical adverse effect of phenytoin.
C: Red man syndrome is associated with vancomycin, not phenytoin.
Summary: Phenytoin is more likely to cause hypotension as an adverse effect, rather than hypoglycemia, bradycardia, or red man syndrome.
A nurse is assessing for allergies with a client who is scheduled to receive the influenza vaccine. Which of the following allergies should the nurse report to the provider as a possible contraindication to receiving the vaccine?
- A. Eggs
- B. Shellfish
- C. Peanuts
- D. Milk
Correct Answer: A
Rationale: The correct answer is A: Eggs. Influenza vaccines are typically produced using eggs, so individuals with egg allergies may have an allergic reaction to the vaccine. Reporting this allergy to the provider is crucial to avoid potential adverse reactions. Shellfish, peanuts, and milk allergies are not contraindications for receiving the influenza vaccine. Summary: Eggs are the correct answer due to the vaccine production method; shellfish, peanuts, and milk allergies are not relevant in this context.
A nurse is preparing to administer Igrasm 5mcg/kg/day subcutaneous to a client who weighs 143 lb. How many mcg should the nurse administer per day?
Correct Answer: 325 mcg
Rationale: The correct answer is 325 mcg. First, convert the client's weight from lb to kg: 143 lb ÷ 2.2 = 65 kg. Next, calculate the daily dose: 5 mcg/kg/day x 65 kg = 325 mcg/day. Therefore, the nurse should administer 325 mcg per day.
Other choices are incorrect because they do not follow the correct conversion of weight to kg and do not calculate the dose accurately based on the weight and prescribed dosage.
A nurse is monitoring laboratory values for a client who has chronic heart failure and is receiving digoxin. Which of the following values should the nurse report to the provider?
- A. Sodium 1.38 mEq/dL
- B. Magnesium 1.5 mEq/L
- C. BUN level 10 mg/dL
- D. Potassium 2.9 mEq/L
Correct Answer: D
Rationale: The correct answer is D: Potassium 2.9 mEq/L. Low potassium levels can predispose the client to digoxin toxicity, leading to potentially life-threatening arrhythmias. Hypokalemia increases the risk of digoxin binding to cardiac tissue, enhancing its toxic effects. The nurse should report this value to the provider immediately for prompt intervention to prevent complications.
Incorrect Choices:
A: Sodium 1.38 mEq/dL - Low sodium levels are not directly related to digoxin toxicity.
B: Magnesium 1.5 mEq/L - While magnesium levels are important for cardiac function, they are not as directly linked to digoxin toxicity as potassium.
C: BUN level 10 mg/dL - BUN levels are not specific indicators of digoxin toxicity.
Summary: Potassium levels are crucial to monitor in clients taking digoxin due to the risk of toxicity. Sodium, magnesium, and BUN levels are important but not as