A nurse is caring for a client who is taking azathioprine to treat rheumatoid arthritis. Which of the following laboratory values indicates an adverse effect of this medication?

BUN 15 mg/dL

WBC 3,000/mm²

Het 45W

Platelets 250.000/mm²

Answer and Explanation

The Correct Answer is B

A. BUN 15 mg/dL (Blood Urea Nitrogen):
BUN is a measure of kidney function, and an elevated BUN may suggest impaired kidney function. However, it is not a specific marker for azathioprine adverse effects.
B. WBC 3,000/mm² (White Blood Cell count):
This is the correct answer. Azathioprine can suppress bone marrow function, leading to leukopenia (low white blood cell count). A WBC count of 3,000/mm² indicates a lower-than-normal white blood cell count, which can increase the risk of infection.
C. Hct 45% (Hematocrit):
Hematocrit measures the percentage of red blood cells in the blood. While it can be affected by various factors, it is not a specific marker for azathioprine adverse effects.
D. Platelets 250,000/mm²:
Platelets are involved in blood clotting, and a platelet count of 250,000/mm² is within the normal range. Azathioprine is not typically associated with adverse effects on platelet counts.

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Correct Answer is B

Explanation

A. Simvastatin 40 mg PO at bedtime: This prescription is clear and specifies the medication (Simvastatin), the dose (40 mg), route (PO – oral), and timing (at bedtime). There is no need for clarification.
B. Morphine 4 mg IV every 4 hr PRN for pain: The need for clarification arises here because "PRN" (pro re nata) means "as needed," and prescribing an IV medication on an as-needed basis might need further clarification regarding the specific indications and circumstances for administering the medication.
C. Levothyroxine 100 mcg PO every morning: This prescription is clear and specifies the medication (Levothyroxine), the dose (100 mcg), route (PO – oral), and timing (every morning). There is no need for clarification.
D. Acetaminophen 500 mg every 4 hr PRN for fever: Similar to option B, there might be a need for clarification regarding the specific indications and circumstances for administering acetaminophen on an as-needed basis. However, in many cases, PRN for fever is reasonable, so it may not be as critical as in the case of an IV pain medication.

A. Urticaria B. Distended jugular vein C. Bounding pulse D. Confusion

Correct Answer is A

Explanation

A. Urticaria (hives): Urticaria is a manifestation of an allergic reaction, which can occur during a transfusion reaction. If the client develops urticaria, it suggests an allergic response, and epinephrine may be administered to manage severe allergic reactions.
B. Distended jugular vein: Distended jugular veins may be associated with fluid overload or cardiovascular issues, but it is not a typical indication for administering epinephrine during a blood transfusion reaction.
C. Bounding pulse: A bounding pulse may be associated with increased cardiac output but is not typically an indication for epinephrine administration during a blood transfusion reaction.
D. Confusion: Confusion is a neurological symptom and is not a typical indication for administering epinephrine during a blood transfusion reaction. Neurological symptoms may suggest other complications that need appropriate interventions.

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A nurse is caring for a client who is taking azathioprine to treat rheumatoid arthritis. Which of the following laboratory values indicates an adverse effect of this medication?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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