Nokea
In a client with chronic renal failure receiving epoetin alfa (Epogen, Procrit), which laboratory result would indicate a therapeutic effect of the medication?
- A. Hematocrit of 32%
- B. Platelet count of 400,000 cells/mm³
- C. White blood cell count of 6000 cells/mm³
- D. Blood urea nitrogen (BUN) level of 15 mg/dL
Correct Answer: A
Rationale: A hematocrit of 32% indicates a therapeutic effect of epoetin alfa in a client with chronic renal failure. Epoetin alfa is used to treat anemia in these patients by stimulating red blood cell production, leading to an increase in the hematocrit level. Monitoring the hematocrit is essential to assess the response to epoetin alfa therapy.
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A client is being educated about the use of sertraline (Zoloft) for depression. Which statement by the client indicates a need for further teaching?
- A. I should take the medication with a high-protein meal.
- B. I may experience dizziness when getting up quickly.
- C. I might notice a decrease in my sex drive.
- D. I should report any thoughts of self-harm to my healthcare provider.
Correct Answer: A
Rationale: The statement 'I should take the medication with a high-protein meal' indicates a need for further teaching as sertraline (Zoloft) should not be taken with a high-protein meal due to potential interference with medication absorption. Choices B, C, and D are correct statements associated with the use of sertraline for depression. It is common to experience dizziness when quickly getting up, notice a decrease in sex drive, and important to report any thoughts of self-harm to the healthcare provider while on this medication.
A nurse reinforces discharge instructions to a postoperative client who is taking warfarin sodium (Coumadin). Which statement, if made by the client, reflects the need for further teaching?
- A. I will take my pills every day at the same time.
- B. I will be certain to avoid alcohol consumption.
- C. I have already called my family to pick up a Medic-Alert bracelet.
- D. I will take Ecotrin (enteric-coated aspirin) for my headaches because it is coated.
Correct Answer: D
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
A client has been prescribed cyclosporine (Sandimmune). Which food item should the client avoid based on the medication's interaction?
- A. Red meats
- B. Orange juice
- C. Grapefruit juice
- D. Green, leafy vegetables
Correct Answer: C
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
A client who has begun taking fosinopril (Monopril) is very distressed, telling the nurse that he cannot taste food normally since beginning the medication 2 weeks ago. The nurse provides the best support to the client by:
- A. Telling the client not to take the medication with food
- B. Suggesting that the client taper the dose until taste returns to normal
- C. Informing the client that impaired taste is expected and generally disappears in 2 to 3 months
- D. Requesting that the health care provider (HCP) change the prescription to another brand of angiotensin-converting enzyme (ACE) inhibitor
Correct Answer: C
Rationale: The correct answer is to inform the client that impaired taste is an expected side effect of ACE inhibitors like fosinopril, such as Monopril, and typically resolves within 2 to 3 months. It is essential for the nurse to offer reassurance and education to the client about this common side effect to alleviate distress and encourage compliance with the medication regimen.
A client is prescribed calcium gluconate after thyroidectomy. The medication is most likely prescribed to:
- A. Treat thyroid storm.
- B. Prevent cardiac irritability.
- C. Treat hypocalcemic tetany.
- D. Stimulate the release of parathyroid hormone.
Correct Answer: C
Rationale: After a thyroidectomy, the parathyroid glands can be inadvertently removed or damaged, leading to a decrease in calcium levels and potentially causing hypocalcemic tetany. Calcium gluconate is given to supplement calcium levels and prevent or treat hypocalcemia-related symptoms, such as muscle spasms and tetany.