A client has a new prescription for Metformin to treat type 2 diabetes. Which of the following laboratory results should be monitored?
- A. Hemoglobin A1C
- B. Liver function tests
- C. Electrolyte levels
- D. Kidney function
Correct Answer: D
Rationale: Metformin is excreted by the kidneys, and impaired kidney function can lead to an increased risk of lactic acidosis, a serious side effect. Therefore, it is important to monitor kidney function regularly while a client is on Metformin. Hemoglobin A1C is used to monitor long-term glucose control, but kidney function is the priority for monitoring Metformin therapy.
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A client asks the nurse how Rituximab works, which the client is receiving to treat Non-Hodgkin's Leukemia. Which of the following should the nurse include?
- A. Blocks hormone receptors
- B. Increases immune response
- C. Binds with specific antigens on tumor cells
- D. Stops DNA replication during cell division
Correct Answer: C
Rationale: Rituximab is a monoclonal antibody that binds with specific antigens on B-lymphocytes, leading to the destruction of cancer cells. In the context of Non-Hodgkin's Leukemia, Rituximab targets and destroys cancerous B-lymphocytes, which helps in treating the disease. Choices A, B, and D are incorrect. Rituximab does not block hormone receptors, increase immune response, or stop DNA replication during cell division. The primary mode of action of Rituximab is its binding with specific antigens on tumor cells, specifically B-lymphocytes, to elicit an immune response against cancerous cells.
A client has a Cerebrospinal fluid infection with gram-negative bacteria. Which of the following Cephalosporin antibiotics should be administered IV to treat this infection?
- A. Cefaclor
- B. Cefazolin
- C. Cefepime
- D. Cephalexin
Correct Answer: C
Rationale: In treating a Cerebrospinal fluid infection caused by gram-negative bacteria, Cefepime, a fourth-generation cephalosporin, is the most suitable choice due to its enhanced efficacy against gram-negative organisms in such infections. Cefaclor (Choice A) is a second-generation cephalosporin more commonly used for respiratory tract infections. Cefazolin (Choice B) is a first-generation cephalosporin often used for skin and soft tissue infections. Cephalexin (Choice D) is a first-generation cephalosporin indicated for skin and urinary tract infections, but not the optimal choice for a Cerebrospinal fluid infection with gram-negative bacteria.
In which patient could the drug Senna potentially be indicated?
- A. A patient with an eating disorder
- B. A patient who has not passed stool in 5 days
- C. A patient with anal fissures
- D. A patient with a history of hemorrhoids
Correct Answer: B
Rationale: Senna is a stimulant laxative commonly used to treat constipation by stimulating bowel movements. It is typically indicated for patients who have not passed stool in several days, thereby helping to relieve constipation. Patients with eating disorders may require different treatments related to their condition. Patients with anal fissures or a history of hemorrhoids may need treatments targeted at those specific issues, which may not involve Senna.
A client has a fungal infection and a new prescription for amphotericin B. Which of the following laboratory values should the nurse report to the provider before initiating the medication?
- A. Sodium 140 mEq/L
- B. Potassium 4.5 mEq/L
- C. BUN 55 mg/dL
- D. Glucose 120 mg/dL
Correct Answer: C
Rationale: An elevated BUN level of 55 mg/dL should be reported before starting amphotericin B due to its nephrotoxic effects. Amphotericin B can cause kidney damage, and an elevated BUN indicates impaired kidney function, increasing the risk of further renal damage with this medication. Sodium, potassium, and glucose levels are not directly associated with the nephrotoxic effects of amphotericin B, making choices A, B, and D incorrect.
A healthcare professional is reviewing the medication list of a client who has a new prescription for Metformin to treat type 2 diabetes. Which of the following medications should the healthcare professional identify as placing the client at risk for lactic acidosis?
- A. Metformin
- B. Metoprolol
- C. Lisinopril
- D. Insulin
Correct Answer: A
Rationale: Metformin is known to have a risk of causing lactic acidosis, particularly in clients with renal impairment or predisposing conditions. Lactic acidosis is a rare but serious adverse effect of metformin use that can be life-threatening. Metoprolol, Lisinopril, and Insulin do not have a known association with lactic acidosis. Healthcare professionals should monitor clients prescribed metformin carefully, especially those with risk factors, to detect and manage lactic acidosis promptly.