A newly admitted client has been prescribed sulfamethoxazole/trimethoprim. The nurse understands that this medication is contraindicated based on which lab result?

Serum fasting glucose 101 mg/dL

platelets 160,000 uL

Serum creatinine 2.5 mg/dL

Hemoglobin 13.6 g/dL

Answer and Explanation

The Correct Answer is C

A.   A serum fasting glucose level of 101 mg/dL indicates a mild elevation but is not significantly high enough to contraindicate the use of TMP-SMX. It does not directly relate to the medication’s safety.
B.   A platelet count of 160,000 µL is within normal limits (normal range is typically 150,000-450,000 µL). This result does not indicate any contraindication for using TMP-SMX.

C.   A serum creatinine level of 2.5 mg/dL indicates impaired kidney function (normal range is typically 0.6-1.2 mg/dL). TMP-SMX can be contraindicated in patients with significant renal impairment due to the potential for drug accumulation and toxicity, particularly affecting renal function.
D.   A hemoglobin level of 13.6 g/dL is within normal limits (normal range is approximately 13.5-17.5 g/dL for males and 12.0-15.5 g/dL for females). This result does not indicate a contraindication for using TMP- SMX.

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Correct Answer is D

Explanation

A. An INR of 5.0 indicates that the blood is significantly thinner than the therapeutic range (typically 2.0 to 3.0 for DVT treatment). Increasing the dose of warfarin would further increase the risk of bleeding.
B. Continuing with the prescribed dose of 2.5 mg is not appropriate at this time. The INR is above the safe therapeutic range, indicating a need for adjustment, not maintenance of the current dose.
C. While reducing the dose may be necessary, cutting it in half may not adequately address the high INR. The more appropriate action would involve holding the dose or significantly adjusting it based on the INR and clinical guidelines.
D. An INR of 5.0 is a critical value that suggests the client is at an increased risk of bleeding. The appropriate action in this case is to hold the warfarin dose and notify the healthcare provider for further evaluation and management. Depending on clinical protocols, the provider may recommend administering vitamin K to reverse the effects of warfarin, especially if there are signs of bleeding or if the INR is critically high.

A. Prone with arms elevated B. Supine with the stump flat on the bed C. Supine with the stump supported on pillows D. Reverse Trendelenburg

Correct Answer is C

Explanation

A. While positioning a patient prone can help with certain surgical recovery situations, it is not typically used immediately after an above-the-knee amputation. Additionally, elevating the arms may not provide any benefit and could cause discomfort.
B. This position can increase the risk of contractures in the residual limb, especially with an above-the- knee amputation. Keeping the stump flat may also lead to swelling and discomfort.
C. This position allows for proper elevation of the stump, which can help reduce swelling and promote healing. Supporting the stump on pillows prevents the risk of contractures and maintains the limb in a neutral position. It provides comfort and stability while facilitating blood flow.
D. While this position can help with venous return and reduce the risk of complications such as orthostatic hypotension, it is not specifically beneficial for an above-the-knee amputation recovery. It may not adequately address the need for proper stump support and elevation.

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A newly admitted client has been prescribed sulfamethoxazole/trimethoprim. The nurse understands that this medication is contraindicated based on which lab result?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client with a deep vein thrombosis has been receiving warfarin sodium 2.5 mg PO daily. The client's International Normalized Ratio (INR) is 5.0. The nurse is aware that the medication dose needs to be:

Correct Answer is D

Explanation

The nurse is caring for a client who has returned to the nursing unit from the post anesthesia care unit (PACU) 40 minutes ago following an above the knee amputation (AKA) of the right leg. In which position should the nurse place the client at this time?

Correct Answer is C

Explanation

A client with Type 2 diabetes is brought into the emergency room in an unresponsive state. A diagnosis of Hyperosmolar Hyperglycemic Syndrome (HHS) is made. The nurse prepares for the administration of which initial therapy?

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The nurse is providing teaching to a client who is being discharged with a prescription for warfarin. Which information should be included in the teaching for this medication? (SELECT ALL THAT APPLY)

The client is receiving a trimethoprim-sulfamethoxazole. What information should the nurse include in the teaching about this medication?

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