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. Contact the provider who will be performing the procedure: It is the provider’s legal and ethical responsibility to explain the procedure, including its purpose, risks, benefits, and alternatives. If the client does not understand, the nurse must contact the provider to clarify and ensure informed consent is valid.

B. Instruct the client's spouse to sign the consent form: A spouse may only sign the form if the client is legally unable to do so. If the client is competent but lacks understanding, they should not sign until they receive adequate information from the provider.

C. Read the consent form to the client using words the client will understand: While the nurse can clarify terms, reading or paraphrasing the consent form does not replace the provider’s obligation to explain the procedure fully and answer questions.

D. Provide teaching about the surgical procedure for the client: Nurses may reinforce information, but only the provider can give the detailed explanation required for informed consent. Providing full procedural teaching falls outside the nurse’s scope for consent purposes.

A. Close the pinch clamp on the CVC. B. Obtain a prescription for stat ABGs. C. Place the client in left Trendelenburg position. D. Check the tubing for placement of a locking adaptor.

Correct Answer is C

Explanation

Rationale:
A. Close the pinch clamp on the CVC: Clamping the catheter is important to stop further air entry, but placing the client in the proper position takes priority to trap the air and prevent it from reaching the pulmonary circulation.

B. Obtain a prescription for stat ABGs: ABGs may help assess respiratory compromise, but they are not the immediate action. This diagnostic step should follow emergency interventions that prevent further complications from an air embolism.

C. Place the client in left Trendelenburg position: This is the priority action because it helps trap any air in the right atrium and prevents it from entering the pulmonary arteries, reducing the risk of a fatal air embolism. Positioning the client correctly is a critical first step in managing suspected air embolism.

D. Check the tubing for placement of a locking adaptor: Verifying equipment setup is important for preventing future incidents, but it does not address the client’s current critical condition. Immediate positioning takes precedence.

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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

Naxlex Comprehensive Predictor Exams

A nurse is assessing a client's understanding of a surgical procedure prior to witnessing their signature on the informed consent form. The nurse determines that the client does not understand what the procedure will involve. Which of the following actions should the nurse take?

Correct Answer is A

Explanation

Correct Answer is C

Explanation

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