Nokea
The healthcare provider is analyzing the laboratory results of a client with leukemia who has received a regimen of chemotherapy. Which laboratory value would the healthcare provider specifically note as a result of the massive cell destruction that occurred from the chemotherapy?
- A. Anemia
- B. Decreased platelets
- C. Increased uric acid level
- D. Decreased leukocyte count
Correct Answer: C
Rationale: Following chemotherapy for leukemias and lymphomas, hyperuricemia is common due to the massive cell kill. Chemotherapy leads to the rapid destruction of cancer cells, releasing large amounts of nucleic acids, which are broken down into uric acid. Monitoring and managing uric acid levels are crucial to prevent complications such as renal damage and gout.
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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.
What instruction should be included in the client's teaching plan when prescribed montelukast (Singulair) for asthma?
- A. Take the medication as needed for asthma attacks.
- B. Take the medication in the evening.
- C. Increase fluid intake while taking this medication.
- D. Use the medication before exercise.
Correct Answer: B
Rationale: The correct instruction to include in the teaching plan for a client prescribed montelukast (Singulair) is to take the medication in the evening. Montelukast is most effective when taken in the evening to provide optimal control of asthma symptoms. It is not intended for use as a rescue medication for asthma attacks. There is no specific recommendation to increase fluid intake or use the medication before exercise in relation to montelukast therapy.
Before administering Methylergonovine (Methergine) to a client with postpartum hemorrhage caused by uterine atony, the nurse checks which of the following as the important client parameter?
- A. Temperature
- B. Lochial flow
- C. Urine output
- D. Blood pressure
Correct Answer: D
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
A healthcare provider is preparing to administer a prescribed dose of digoxin (Lanoxin) to a client. Before administering the medication, the healthcare provider should:
- A. Measure the client's blood pressure.
- B. Check the client's heart rate.
- C. Assess the client's respiratory rate.
- D. Check the client's oxygen saturation level.
Correct Answer: B
Rationale: Before administering digoxin (Lanoxin), the healthcare provider should check the client's heart rate. Monitoring the heart rate is crucial because if it is below 60 beats per minute, the medication should be withheld, and the healthcare provider must be informed. While blood pressure, respiratory rate, and oxygen saturation are essential assessments, they are not the primary focus before administering digoxin.
A client with diabetes mellitus visits a health care clinic. The client's diabetes mellitus was previously well controlled with daily glyburide (DiaBeta). However, the fasting blood glucose level has recently been in the range of 180 to 200 mg/dL. Which medication, if added to the client's regimen, may have contributed to the hyperglycemia?
- A. Prednisone
- B. Phenelzine (Nardil)
- C. Atenolol (Tenormin)
- D. Allopurinol (Zyloprim)
Correct Answer: A
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.