Nokea
The client with CRF is receiving epoetin alfa. Which finding should indicate to the nurse that the action of the medication has been effective?
- A. Urine output increased to 30 mL per hour
- B. Hemoglobin 12 g/dL and hematocrit 36%
- C. BP 110/70 mm Hg and heart rate 68 bpm
- D. Reports an increased energy level and less fatigue
Correct Answer: B
Rationale: A: Epoetin alfa does not have an effect on urine output or BP. B: Epoetin alfa stimulates erythropoiesis, or the production of RBCs. It is used in treating anemias associated with decreased RBC production, such as in renal failure. Hgb and Hct are used to evaluate the medication's effectiveness. The target Hgb for the client with CRF is 12 g/dL. C: Epoetin alfa does not have an effect on BP or HR. D: The client may report increased energy and less fatigue because of the increased Hgb levels, but these findings are not used to evaluate the medication's action.
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The LPN is caring for a client admitted for acute pancreatitis. Which of these medications would be least appropriate for pain management?
- A. Tylenol
- B. Tramadol
- C. Codeine
- D. Morphine
Correct Answer: D
Rationale: Morphine is contraindicated for pain management in pancreatitis because it causes spasms in the Sphincter of Oddi.
The child with CF is prescribed vitamin A supplements. Which finding by the clinic nurse indicates that the vitamin has been effective?
- A. Skin is supple and healthy.
- B. Viscosity of secretions is decreased.
- C. Number of bleeding episodes is reduced.
- D. Pancreatic enzyme absorption is increased.
Correct Answer: A
Rationale: A: A water-miscible form of vitamin A is given in children diagnosed with CF because the uptake of the fat-soluble vitamins is decreased. One of the functions of vitamin A is to keep epithelial tissue healthy by aiding the differentiation of specialty cells. B: Other treatments for CF, such as bronchodilators and recombinant human deoxyribonuclease dornase alfa (Pulmozyme), decrease the viscosity of secretions. C: Vitamin K, another fat-soluble vitamin administered in CF, increases coagulation. D: Vitamin A has no effect on pancreatic enzyme absorption.
The test used to differentiate sickle cell trait from sickle cell disease is:
- A. sickle cell preparation
- B. peripheral smear
- C. sickledex
- D. hemoglobin electrophoresis
Correct Answer: D
Rationale: Hemoglobin electrophoresis identifies the specific hemoglobin types, distinguishing sickle cell trait (HbAS) from sickle cell disease (HbSS).
Oral terbutaline is prescribed for the client with bronchitis. Which comorbidity most warrants the nurse's close monitoring of the client following administration of terbutaline?
- A. Strabismus
- B. Hypertension
- C. Diabetes insipidus
- D. Hypothyroidism
Correct Answer: B
Rationale: A: Terbutaline should be used with caution in clients with glaucoma (not strabismus). B: The client's history of hypertension warrants the nurse's close monitoring of the client when terbutaline (Brethine) is administered. It should be used with caution in clients with hypertension because it can precipitate a hypertensive episode. C: Terbutaline should be used with caution in clients with DM (not DI). D: Terbutaline should be used with caution in clients with hyperthyroidism (not hypothyroidism).
Nursing care for a client undergoing chemotherapy includes assessment for signs of bone marrow depression. Which finding accounts for some of the symptoms related to bone marrow depression?
- A. erythrocytosis
- B. leukocytosis
- C. polycythemia
- D. thrombocytopenia
Correct Answer: D
Rationale: Thrombocytopenia is an abnormal decrease in the number of platelets, which results in bleeding tendencies. Erythrocytosis is an abnormal increase in the number of circulating red blood cells. Leukocytosis is an increase in the number of white blood cells in the blood. Polycythemia is also an excess of red blood cells and is a synonym for erythrocytosis. With chemotherapy there is a decrease in red and white blood cells, not an increase.