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A healthcare professional is reviewing the laboratory results of a client who is taking Lithium for Bipolar Disorder. Which of the following findings should the healthcare professional report to the provider immediately?
- A. Lithium level of 1.0 mEq/L
- B. Potassium level of 3.5 mEq/L
- C. Sodium level of 140 mEq/L
- D. Creatinine level of 1.0 mg/dL
Correct Answer: D
Rationale: A creatinine level of 1.0 mg/dL should be reported to the provider immediately. While a lithium level of 1.0 mEq/L falls within the therapeutic range, a creatinine level of 1.0 mg/dL could suggest early signs of kidney dysfunction, especially concerning in a client on long-term lithium therapy. It is crucial to monitor kidney function closely because lithium can be nephrotoxic over time. Elevated creatinine levels may indicate impaired kidney function and should prompt immediate reporting to the healthcare provider. Potassium and sodium levels within normal range are not immediate concerns when compared to potential kidney issues.
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A client is receiving warfarin therapy. Which of the following findings should the nurse identify as an adverse effect of warfarin?
- A. Nausea
- B. Epistaxis
- C. Diarrhea
- D. Dyspepsia
Correct Answer: B
Rationale: Epistaxis, or nosebleeds, can be an indication of excessive anticoagulation while on warfarin therapy. Warfarin is a blood thinner that helps prevent blood clots. Epistaxis can occur as a result of the blood-thinning effects of warfarin, leading to increased bleeding tendencies, including nosebleeds. Nausea, diarrhea, and dyspepsia are not typically associated with warfarin therapy; therefore, they are not the adverse effects the nurse should identify in a client receiving warfarin.
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.
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.
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 client has a new prescription for Methotrexate. Which of the following instructions should be included in the teaching?
- A. Avoid drinking alcohol while taking this medication.
- B. Take the medication with a high-fat meal.
- C. Expect increased hair growth.
- D. You should never stop taking the medication without consulting your healthcare provider.
Correct Answer: A
Rationale: The correct instruction for a client taking Methotrexate is to avoid drinking alcohol. Methotrexate can cause liver toxicity, and alcohol consumption can increase this risk. It is important to emphasize the avoidance of alcohol while on this medication to prevent adverse effects and ensure treatment effectiveness. The other options are incorrect: Taking Methotrexate with a high-fat meal is not necessary as it can be taken with or without food. Increased hair growth is not an expected effect of Methotrexate; in fact, hair loss is a potential side effect. Stopping the medication without consulting a healthcare provider can be dangerous and may lead to worsening of symptoms or relapse, making option D incorrect.