A client who had a kidney transplant last week is receiving cyclosporine. This morning the client reports experiencing a headache and blurred vision. Based on which assessment finding should the nurse withhold the medication until the healthcare provider (HCP) is notified?

Temperature of 100.8° F (38.2° C).

Elevated blood urea nitrogen (BUN).

Renal output of 120 mL/hour.

Blood pressure 180/98 mm Hg.

Answer and Explanation

The Correct Answer is D

A. Temperature of 100.8° F (38.2° C): A mildly elevated temperature in a post-transplant client may suggest infection or early rejection, both of which warrant monitoring. However, this is not a direct reason to withhold cyclosporine, which is essential for preventing organ rejection.

B. Elevated blood urea nitrogen (BUN): Elevated BUN could indicate impaired renal function, which should be monitored during cyclosporine therapy. However, this alone is not an urgent reason to withhold the medication without further evaluation of kidney function trends and symptoms.

C. Renal output of 120 mL/hour: This is a healthy urine output and suggests good renal perfusion and function. It does not present any contraindication to continuing cyclosporine and supports that the transplanted kidney is functioning well.

D. Blood pressure 180/98 mm Hg: Hypertension is a known side effect of cyclosporine and can become severe. A blood pressure this high, especially when accompanied by headache and blurred vision, suggests possible cyclosporine-induced hypertensive crisis or toxicity, and warrants immediate withholding of the medication and notification of the HCP.

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Correct Answer is A

Explanation

A. Caution when changing from a sitting to a standing position: Carbidopa-levodopa can cause orthostatic hypotension, leading to dizziness and falls. Teaching the client to rise slowly and carefully helps prevent sudden drops in blood pressure and significantly reduces the risk of injury.

B. Ambulate using a four point cane or a walker with wheels: Assistive devices can help with mobility in Parkinson’s disease, but their use should be based on a physical therapist’s evaluation. Not every client will immediately require a walker or cane upon starting treatment.

C. Place small rugs on smooth surfaces such as tile or wood floors: Small rugs actually increase the risk of tripping and falling, especially for clients with Parkinson’s disease, who already have gait instability. It is safer to remove rugs rather than add them.

D. Obtain a hospital bed with side rails and an over bed trapeze: A hospital bed with side rails and an overbed trapeze might be necessary for clients with advanced Parkinson's disease who have significant mobility limitations or require assistance with repositioning in bed. However, for a newly diagnosed client, this level of equipment is likely unnecessary and could foster dependence.

A. Acetaminophen. B. Prednisone. C. Captopril. D. Omeprazole.

Correct Answer is A

Explanation

A. Acetaminophen: Acetaminophen is metabolized by the liver, and excessive or chronic use can lead to hepatotoxicity, which presents with signs such as jaundice. Observing jaundice in a client taking acetaminophen requires prompt notification of the healthcare provider to assess for potential liver damage.

B. Prednisone: Prednisone can have many systemic effects, including fluid retention and immune suppression, but it is not typically associated with liver toxicity or jaundice as a primary adverse effect.

C. Captopril: Captopril is used to manage hypertension and can cause renal dysfunction, but it is not commonly linked to liver dysfunction or jaundice. Liver-related side effects are rare with ACE inhibitors.

D. Omeprazole: Omeprazole is a proton pump inhibitor used for gastroesophageal reflux and has minimal hepatic side effects. It is not commonly associated with jaundice in clinical practice.

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A client who had a kidney transplant last week is receiving cyclosporine. This morning the client reports experiencing a headache and blurred vision. Based on which assessment finding should the nurse withhold the medication until the healthcare provider (HCP) is notified?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client recently diagnosed with Parkinson's disease receives a new prescription for carbidopa-levodopa. To reduce the client's risk for injury, which instruction should the nurse provide?

Correct Answer is A

Explanation

Correct Answer is A

Explanation

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