A newly admitted client has been prescribed trimethoprim-sulfamethoxazole.
The nurse understands that this medication is contraindicated based on which lab result?
Serum fasting glucose of 101 mg/dL.
Platelets of 160,000 uL.
Hemoglobin of 13.6 g/dL.
Serum creatinine of 2.5 mg/dL.
The Correct Answer is D
Choice A rationale
A serum fasting glucose of 101 mg/dL is slightly above the normal range (70-100 mg/dL), indicating a possible prediabetes condition. However, it is not a contraindication for trimethoprim-sulfamethoxazole.
Choice B rationale
A platelet count of 160,000 uL is within the normal range (150,000-450,000 uL). Therefore, it is not a contraindication for trimethoprim-sulfamethoxazole.
Choice C rationale
A hemoglobin level of 13.6 g/dL is within the normal range for both men (13.5-17.5 g/dL) and women (12.0-15.5 g/dL). Thus, it is not a contraindication for trimethoprim-sulfamethoxazole.
Choice D rationale
A serum creatinine level of 2.5 mg/dL is above the normal range (0.6-1.2 mg/dL for men, 0.5- 1.1 mg/dL for women), indicating impaired kidney function. Trimethoprim-sulfamethoxazole is contraindicated in patients with severe renal insufficiency.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale
Drawing the peak level at 0930, which is 30 minutes after the start of the infusion, would be too early. The medication would not have had enough time to reach its peak level in the blood.
Choice B rationale
The peak level of gentamicin is typically evaluated 30 minutes after the completion of the infusion. Since the infusion is administered over 1 hour, the peak level would be expected to be drawn at 10001.
Choice C rationale
Drawing the peak level at 2030, which is 12 hours after the start of the infusion, would not provide an accurate representation of the peak level of gentamicin. This is because the medication would have been metabolized and excreted over this period.
Choice D rationale
Drawing the peak level at 2100, which is 12.5 hours after the start of the infusion, would not provide an accurate representation of the peak level of gentamicin. This is because the medication would have been metabolized and excreted over this period.
Correct Answer is C
Explanation
Choice A rationale
While a past medical history of myocardial infarction does increase the risk of deep vein thrombosis (DVT), it is not the highest risk factor among the options provided. Other factors such as immobility, surgery, and certain medical conditions can pose a higher risk.
Choice B rationale
Postoperative patients, such as those who have had a laparoscopic knee replacement, are at an increased risk for DVT due to periods of immobility and changes in blood flow and clotting.
However, the risk is not as high as in patients who have undergone major open abdominal surgery.
Choice C rationale
Patients who have undergone major open abdominal surgery are at the highest risk for the development of DVT among the options provided. The surgery itself, along with the postoperative period of immobility, significantly increases the risk of DVT34567.
Choice D rationale
While peptic ulcers can be associated with certain risk factors for DVT, such as age and immobility due to pain, they do not pose as high a risk as major open abdominal surgery.
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