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In a patient with chronic kidney disease (CKD) receiving erythropoietin therapy, what laboratory result should the nurse monitor to evaluate the effectiveness of this therapy?
- A. Serum creatinine
- B. White blood cell count
- C. Hemoglobin level
- D. Serum potassium
Correct Answer: C
Rationale: Rationale: The correct answer is C, hemoglobin level. Erythropoietin therapy is used to stimulate red blood cell production in CKD patients with anemia. Monitoring hemoglobin levels helps assess the effectiveness of the therapy in improving anemia. If hemoglobin levels increase, it indicates the therapy is working.
Summary of incorrect choices:
A: Serum creatinine - This measures kidney function, not the effectiveness of erythropoietin therapy for anemia in CKD patients.
B: White blood cell count - Monitors immune function, not related to erythropoietin therapy for anemia.
D: Serum potassium - Important for monitoring electrolyte balance in CKD patients but not specific to assessing erythropoietin therapy effectiveness.
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A patient with anemia is prescribed ferrous sulfate. What advice should the nurse give regarding the administration of this medication?
- A. Take with dairy products to increase absorption.
- B. Take on an empty stomach for best absorption.
- C. Avoid vitamin C while taking this medication.
- D. Take before bedtime.
Correct Answer: B
Rationale: The correct answer is B: Take on an empty stomach for best absorption. Ferrous sulfate is best absorbed on an empty stomach to maximize its effectiveness. When taken with food or dairy products (Choice A), the absorption of iron is reduced. Vitamin C actually enhances the absorption of iron, so avoiding it (Choice C) is not recommended. Taking the medication before bedtime (Choice D) may lead to gastrointestinal side effects and is not optimal for absorption.
A patient with hyperlipidemia is prescribed atorvastatin. What lab test should be monitored periodically to assess for adverse effects?
- A. Liver function tests
- B. Complete blood count
- C. Blood glucose levels
- D. Serum potassium
Correct Answer: A
Rationale: Step-by-step rationale:
1. Atorvastatin is a statin medication commonly known to potentially cause liver damage.
2. Monitoring liver function tests periodically helps assess for any liver abnormalities.
3. Elevated liver enzymes may indicate liver injury from atorvastatin.
4. Monitoring liver function tests allows for early detection and management of adverse effects.
Summary:
A: Monitoring liver function tests is crucial due to atorvastatin's potential hepatotoxicity.
B: Complete blood count is not typically affected by atorvastatin.
C: Blood glucose levels are not directly related to atorvastatin use.
D: Serum potassium is not specifically monitored for atorvastatin-related adverse effects.
A patient with rheumatoid arthritis is prescribed methotrexate. What should the nurse include in the patient teaching?
- A. Take folic acid supplements as prescribed.
- B. Avoid alcohol completely.
- C. Expect to see immediate results.
- D. Limit fluid intake to 1 liter per day.
Correct Answer: A
Rationale: The correct answer is A: Take folic acid supplements as prescribed. Methotrexate can lead to folic acid deficiency, so supplementing with folic acid helps prevent side effects. It is important for the nurse to educate the patient on the importance of taking folic acid to maintain overall health.
Choice B is incorrect. While it is generally recommended to limit alcohol consumption with methotrexate, avoiding it completely may not be necessary for all patients.
Choice C is incorrect. Methotrexate takes time to work, often several weeks to months, so immediate results should not be expected.
Choice D is incorrect. Limiting fluid intake to 1 liter per day is not a standard recommendation for patients taking methotrexate. Adequate hydration is important for overall health.
What side effect should be monitored for in a patient with chronic heart failure taking spironolactone?
- A. Hypokalemia
- B. Hyperkalemia
- C. Hyponatremia
- D. Hypernatremia
Correct Answer: B
Rationale: The correct answer is B: Hyperkalemia. Spironolactone is a potassium-sparing diuretic commonly used in patients with heart failure. It works by blocking the aldosterone receptor, leading to potassium retention and potential hyperkalemia. Monitoring potassium levels is crucial as hyperkalemia can increase the risk of arrhythmias and other cardiac complications in heart failure patients.
A: Hypokalemia is incorrect because spironolactone typically causes potassium retention.
C: Hyponatremia and D: Hypernatremia are incorrect as spironolactone does not directly affect sodium levels.
In summary, monitoring for hyperkalemia is essential in patients with heart failure taking spironolactone to prevent adverse cardiac events.
In a client with liver cirrhosis experiencing confusion and disorientation, what condition is most likely causing these symptoms?
- A. Hepatic encephalopathy
- B. Hypoglycemia
- C. Electrolyte imbalance
- D. Dehydration
Correct Answer: A
Rationale: The correct answer is A: Hepatic encephalopathy. In liver cirrhosis, the liver's ability to detoxify ammonia is impaired, leading to elevated ammonia levels in the blood. This excess ammonia crosses the blood-brain barrier, causing neurological symptoms like confusion and disorientation. Hypoglycemia (B), electrolyte imbalance (C), and dehydration (D) can also contribute to altered mental status, but in a cirrhotic patient, hepatic encephalopathy is the most likely cause due to impaired ammonia metabolism.