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 administering 4 mg of hydromorphone to a client by mouth every 4 hr. The medication is provided as hydromorphone 8 mg per tablet. Which of the following actions is appropriate for the nurse to take?
- A. Return the remaining medication to the facility's pharmacy.
- B. Store the remaining half of the pill in the automated medication dispensing system.
- C. Place the remaining half of the pill in the unit dose package.
- D. Dispose of the remaining medication while another nurse observes.
Correct Answer: D
Rationale: The correct answer is D: Dispose of the remaining medication while another nurse observes. This is the appropriate action because hydromorphone is a controlled substance with high abuse potential. The nurse should follow proper medication disposal protocols to prevent diversion or misuse. Returning the medication to the pharmacy (choice A) may not ensure proper disposal. Storing the remaining half of the pill in the automated medication dispensing system (choice B) or placing it in the unit dose package (choice C) could lead to unauthorized access. Disposing of the medication while another nurse observes (choice D) ensures accountability and adherence to safety measures.
A nurse is providing teaching to a client who has a new prescription for enoxaparin. Which of the following medications for pain relief should the nurse include in the teaching that can be taken concurrently with enoxaparin?
- A. Ibuprofen
- B. Naproxen sodium
- C. Acetaminophen
- D. Aspirin
Correct Answer: C
Rationale: Rationale: Acetaminophen is the correct choice because it does not have an antiplatelet effect like aspirin, ibuprofen, and naproxen sodium. Enoxaparin is an anticoagulant that works by preventing blood clots, so it is safer to take acetaminophen for pain relief as it does not increase the risk of bleeding. Aspirin, ibuprofen, and naproxen sodium can increase the risk of bleeding when taken with enoxaparin due to their antiplatelet effects. Therefore, acetaminophen is the safest option for pain relief while on enoxaparin therapy.
A nurse is reviewing the laboratory values of a client who is taking atorvastatin. Which of the following laboratory values indicates the treatment has been effective?
- A. BUN 15 mg/dL
- B. Blood glucose 90 mg/dL
- C. Urine specific gravity 1.020
- D. LDL 120 mg/dL
Correct Answer: D
Rationale: The correct answer is D: LDL 120 mg/dL. Atorvastatin is a medication used to lower LDL cholesterol levels. A decrease in LDL levels indicates the effectiveness of the treatment in reducing the risk of cardiovascular events. BUN, blood glucose, and urine specific gravity are not directly related to the effectiveness of atorvastatin in lowering cholesterol levels. BUN reflects kidney function, blood glucose monitors glucose levels, and urine specific gravity indicates hydration status. Therefore, D is the best indicator of treatment effectiveness.
A nurse is preparing to initiate IV therapy for a client. Which of the following sites should the nurse use to place the peripheral IV catheter?
- A. Nondominant dorsal venous arch
- B. Dominant distal dorsal vein
- C. Nondominant forearm basilic vein
- D. Dominant antecubital vein
Correct Answer: A
Rationale: The correct answer is A: Nondominant dorsal venous arch. This site is preferred for peripheral IV catheter placement due to the larger vein diameter, ease of access, and reduced risk of complications like nerve damage or infiltration. The nondominant side is chosen to prevent disruption of daily activities. The dorsal venous arch is a superficial vein that is easily visible and palpable, making it suitable for successful cannulation. It also allows for optimal flow rate and minimizes the risk of phlebitis. Choices B, C, and D are not ideal for various reasons such as smaller vein size, increased risk of nerve damage, and difficulty in accessing or securing the catheter.
A nurse manager is planning an in-service about pain management with opioids for clients who have cancer. Which of the following information should the nurse manager include?
- A. IM administration is recommended if PO opioids are ineffective
- B. Respiratory depression decreases as opioid tolerance develops
- C. Meperidine is the opioid of choice for treating chronic pain
- D. Withhold PRN pain medication for the client who is receiving opioids every 6 hr
Correct Answer: B
Rationale: The correct answer is B because respiratory depression decreases as opioid tolerance develops. Opioid tolerance occurs with prolonged use, leading to a decrease in the side effect of respiratory depression. This information is crucial for healthcare providers managing cancer pain with opioids. Choice A is incorrect because oral administration is preferred over intramuscular for better absorption and convenience. Choice C is incorrect as meperidine is not recommended for chronic pain due to its toxic metabolite. Choice D is incorrect as PRN pain medication should not be withheld for clients on scheduled opioid doses to ensure adequate pain control.