Nokea
The nurse is caring for a client with epilepsy who is being treated with carbamazepine (Tegretol). Which laboratory value might indicate a serious side effect of this drug?
- A. Uric acid of 5 mg/dL
- B. Hematocrit of 33%
- C. WBC 2000 per cubic millimeter
- D. Platelets 150,000 per cubic millimeter
Correct Answer: C
Rationale: A WBC of 2000 indicates leukopenia, a serious side effect of carbamazepine that increases infection risk.
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A client with chronic kidney disease (CKD) is being evaluated by the transplant team. The client's glomerular filtration rate (GFR) is 14 mL/min. This places the client in which stage of CKD?
- A. stage 1
- B. stage 5
- C. stage 4
- D. stage 2
Correct Answer: B
Rationale: GFR <15 mL/min indicates stage 5 CKD (end-stage renal disease), often requiring dialysis or transplant.
The nurse is assessing elderly clients at a community center. Which of the following findings would be the most cause for concern?
- A. Complaint of dry mouth
- B. Loss of 1 inch of height in the last year
- C. Stiffened joints
- D. Rales bilaterally on chest auscultation
Correct Answer: D
Rationale: Rales bilaterally on chest auscultation suggest fluid in the lungs, which could indicate serious conditions like heart failure or pneumonia, requiring immediate attention. Dry mouth, height loss, and stiffened joints are common in aging but less urgent.
A client with a history of phenylketonuria is seen at the local family planning clinic. After completing the client's intake history, the nurse provides literature for a healthy pregnancy. Which statement indicates that the client needs further teaching?
- A. I can help control my weight by switching from sugar to Nutrasweet.
- B. I need to resume my old diet before becoming pregnant.
- C. Fresh fruits and raw vegetables will make excellent betweenmeal snacks.
- D. I need to eliminate most sources of phenylalanine from my diet.
Correct Answer: A
Rationale: Nutrasweet (aspartame) contains phenylalanine, which must be avoided in phenylketonuria, indicating a need for further teaching.
A client is admitted with suspected Hodgkin's lymphoma. The diagnosis is confirmed by the:
- A. Overproliferation of immature white cells
- B. Presence of Reed-Sternberg cells
- C. Increased incidence of microcytosis
- D. Reduction in the number of platelets
Correct Answer: B
Rationale: Hodgkin's lymphoma is diagnosed by the presence of Reed-Sternberg cells, large abnormal cells found in lymph node biopsies.
A client with cancer is to undergo an intravenous pyelogram. The nurse should:
- A. Force fluids 24 hours before the procedure
- B. Ask the client to void immediately before the study
- C. Hold medication that affects the central nervous system for 12 hours pre- and post-test
- D. Cover the client's reproductive organs with an x-ray shield.
Correct Answer: B
Rationale: Voiding immediately before an IVP ensures the bladder is empty, improving visualization of the urinary tract.