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
Pseudomembranous colitis and crystalluria are not typically associated with gentamicin use.
Choice B rationale
Gentamicin can cause ototoxicity, which can manifest as tinnitus (ringing in the ears), vertigo (a sensation of spinning), and hearing loss. Headaches can also occur as a side effect of gentamicin.
Choice C rationale
While gentamicin can cause nephrotoxicity (kidney damage), which could potentially affect electrolyte levels, a potassium level of 3.5 mg/dL is within the normal range. Therefore, this would not typically be assessed as a toxic effect of gentamicin.
Choice D rationale
Hypoglycemia and cardiac dysrhythmias are not typically associated with gentamicin use.
Correct Answer is C
Explanation
Choice A rationale
The client’s fasting blood glucose level, postprandial blood glucose level, and hemoglobin A1c level are all within the target range for good blood glucose control in diabetes. Therefore, the client is not at an increased risk for developing hypoglycemia.
Choice B rationale
Insulin resistance is a characteristic of type 2 diabetes, not type 1 diabetes. The client’s blood glucose levels are well controlled, which suggests that the client’s insulin regimen is effective, not that the client is demonstrating signs of insulin resistance.
Choice C rationale
The client’s fasting blood glucose level, postprandial blood glucose level, and hemoglobin A1c level are all within the target range for good blood glucose control in diabetes. Therefore, the client is demonstrating good control of blood glucose.
Choice D rationale
The client’s fasting blood glucose level, postprandial blood glucose level, and hemoglobin A1c level are all within the target range for good blood glucose control in diabetes. Therefore, the client is not at an increased risk for developing hyperglycemia.
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