When reviewing laboratory results for a client receiving tacrolimus (Prograf), which laboratory result would indicate to the nurse that the client is experiencing an adverse effect of the medication?
- A. Blood glucose of 200 mg/dL
- B. Potassium level of 3.8 mEq/L
- C. Platelet count of 300,000 cells/mm³
- D. White blood cell count of 6000 cells/mm³
Correct Answer: A
Rationale: An elevated blood glucose level of 200 mg/dL indicates an adverse effect of tacrolimus. This finding suggests hyperglycemia, which is a known adverse effect of the medication. Other potential adverse effects of tacrolimus include neurotoxicity and hypertension. Monitoring blood glucose levels is crucial to detect and manage this adverse effect promptly.
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A nurse preparing a client for surgery reviews the client's medication record. The client is to be nothing per mouth (NPO) after midnight. Which of the following medications, if noted on the client's record, should the nurse question?
- A. Cyclobenzaprine (Flexeril)
- B. Alendronate (Fosamax)
- C. Allopurinol (Zyloprim)
- D. Prednisone
Correct Answer: D
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
A client receives a prescription for methocarbamol (Robaxin), and the nurse reinforces instructions to the client regarding the medication. Which client statement would indicate a need for further instructions?
- A. My urine may turn brown or green.
- B. This medication is prescribed to help relieve my muscle spasms.
- C. If my vision becomes blurred, I don't need to be concerned about it.
- D. I need to call my doctor if I experience nasal congestion from this medication.
Correct Answer: C
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
A client is prescribed nitroglycerin (Nitro-Dur) transdermal patch for angina. Which instruction should the nurse include in the client's teaching plan?
- A. Apply the patch to a hairless area of skin.
- B. Leave the patch on for 24 hours.
- C. Apply the patch at the same time each day.
- D. You can keep the patch on while taking a shower.
Correct Answer: C
Rationale: The nurse should instruct the client to apply the nitroglycerin (Nitro-Dur) transdermal patch at the same time each day to ensure consistent blood levels. It is essential to apply the patch to a hairless area of the skin for proper absorption. The patch can generally be left on during a shower. The patch is usually worn for 12-14 hours to allow for a nitrate-free period, which helps reduce tolerance to the medication.
Before initiating a client with tuberculosis on anti-tuberculosis therapy with isoniazid (INH), a nurse ensures that which of the following baseline studies has been completed?
- A. Electrolyte levels
- B. Coagulation times
- C. Liver enzyme levels
- D. Serum creatinine level
Correct Answer: C
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
Heparin sodium is prescribed for the client. The nurse expects that the healthcare provider will prescribe which of the following to monitor for a therapeutic effect of the medication?
- A. Hematocrit level
- B. Hemoglobin level
- C. Prothrombin time (PT)
- D. Activated partial thromboplastin time (aPTT)
Correct Answer: D
Rationale: The activated partial thromboplastin time (aPTT) is used to monitor the therapeutic effect of heparin sodium. Heparin affects the intrinsic pathway of coagulation, and monitoring aPTT helps ensure the medication is within the therapeutic range to prevent clot formation. Hematocrit and hemoglobin levels assess red blood cell concentrations, while prothrombin time (PT) is used to monitor the therapeutic effect of warfarin sodium, a different anticoagulant that affects the extrinsic pathway of coagulation.
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