A nurse is caring for a male client who has a new prescription for cyclosporine following a kidney transplant. Which of the following findings should the nurse identify as an adverse effect of this therapy?

Fasting blood glucose 65 mg/dL (70 to 110 mg/dL)

RBC count 6.3/μL (4.7 to 6.1/μL)

BUN 24 mg/dL (10 to 20 mg/dL)

Alkaline Phosphatase (ALP) 25 units/L (30 to 120 units/L)

Answer and Explanation

The Correct Answer is C

Rationale:
A. Fasting blood glucose 65 mg/dL (70 to 110 mg/dL): While slightly below the normal range, this mild hypoglycemia is not a typical adverse effect of cyclosporine. Cyclosporine is more commonly associated with nephrotoxicity, hypertension, and increased infection risk rather than altering glucose levels significantly.

B. RBC count 6.3/μL (4.7 to 6.1/μL): This value is slightly elevated but not clinically concerning and is not a known adverse effect of cyclosporine. The medication typically affects white blood cells and kidney function more than red cell production.

C. BUN 24 mg/dL (10 to 20 mg/dL): An elevated BUN level may indicate reduced kidney function, which is a common adverse effect of cyclosporine. This immunosuppressant is nephrotoxic and requires close monitoring of renal function through BUN and creatinine levels.

D. Alkaline Phosphatase (ALP) 25 units/L (30 to 120 units/L): This ALP level is slightly below normal but not typically associated with cyclosporine use. Cyclosporine does not usually cause significant changes in ALP unless there is liver involvement, which is less common than kidney-related complications.

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Correct Answer is A

Explanation

Rationale:
A. Place monitoring cords and tubes in a stockinette: Clients with latex allergies are at risk for serious reactions from contact with latex-containing equipment. Covering cords and tubing with a stockinette helps prevent direct skin exposure to latex, reducing the risk of an allergic reaction.

B. Schedule the client for the last surgery of the day: Clients with latex allergies should be scheduled as the first surgery of the day to minimize their exposure to airborne latex particles and reduce contamination from previously used equipment or surfaces.

C. Choose rubber injection ports for fluid administration: Rubber injection ports often contain latex, which can trigger severe allergic reactions. For clients with latex allergies, non-latex or latex-free alternatives must be used for all fluid and medication administration.

D. Have phenytoin IV readily available: Phenytoin is an anticonvulsant used to manage seizures and is not specifically indicated for treating allergic reactions. Epinephrine, antihistamines, and corticosteroids should be available in case of an anaphylactic reaction.

A. Decreased calcium levels B. Decreased somatotropin levels C. Increased glucose levels D. Increased T4 levels

Correct Answer is D

Explanation

Rationale:
A. Decreased calcium levels: Hypocalcemia may cause neuromuscular symptoms such as tetany or tingling but is not associated with exophthalmos (protruding eyes). Calcium imbalance does not typically cause changes in eye appearance.

B. Decreased somatotropin levels: Somatotropin (growth hormone) deficiency may lead to growth delay or reduced muscle mass, but it is not associated with changes in orbital appearance. Protruding eyes are unrelated to growth hormone levels.

C. Increased glucose levels: Elevated glucose is characteristic of diabetes mellitus and may lead to complications like neuropathy or retinopathy, but it does not cause eye protrusion.

D. Increased T4 levels: Elevated thyroxine (T4) is seen in hyperthyroidism, particularly in Graves' disease, which is strongly associated with exophthalmos. The protrusion results from inflammation and edema of orbital tissues, a hallmark of this thyroid disorder.

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A nurse is caring for a male client who has a new prescription for cyclosporine following a kidney transplant. Which of the following findings should the nurse identify as an adverse effect of this therapy?

Nursing Test Bank

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