A nurse is reviewing laboratory reports for a client who is taking NSAIDs for rheumatoid arthritis. Which of the following results should the nurse recognize as a possible adverse effect of NSAID therapy?

Increased erythrocyte sedimentation rate

Elevated creatinine clearance

Increased serum potassium

Positive fecal occult blood test

Answer and Explanation

The Correct Answer is D

Choice A Reason

Increased erythrocyte sedimentation rate (ESR) is a marker of inflammation and is commonly elevated in conditions like rheumatoid arthritis. However, it is not a direct adverse effect of NSAID therapy. NSAIDs are more likely to cause gastrointestinal issues, such as bleeding, which would be detected by a fecal occult blood test.

Choice B Reason

Elevated creatinine clearance is not typically associated with NSAID use. In fact, NSAIDs can potentially reduce kidney function, leading to decreased creatinine clearance. Therefore, this option is incorrect.

Choice C Reason

Increased serum potassium levels can occur with NSAID use, especially in patients with compromised kidney function. However, this is less common compared to gastrointestinal bleeding, which is a more direct and frequent adverse effect of NSAID therapy.

Choice D Reason

Positive fecal occult blood test is the correct answer. NSAIDs can cause gastrointestinal bleeding, which can be detected through a fecal occult blood test. This is a well-documented adverse effect of NSAID therapy and is a significant concern for patients on long-term NSAID treatment.

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Correct Answer is D

Explanation

Choice A Reason:

Respiratory therapy is not typically required for clients with chronic kidney disease unless they have concurrent respiratory issues. CKD primarily affects the kidneys and related systems, so respiratory therapy is not a standard referral for these patients.

Choice B Reason:

Hospice care is generally reserved for clients with terminal illnesses who are nearing the end of life. While CKD can be a serious condition, many clients manage it with appropriate treatment and lifestyle changes. Therefore, hospice care is not a standard referral for newly diagnosed CKD patients.

Choice C Reason:

Occupational therapy may be beneficial for clients with CKD who experience difficulties with daily activities due to fatigue or other symptoms. However, it is not the most immediate or essential referral upon initial diagnosis.

Choice D Reason:

Dietary services are crucial for clients with chronic kidney disease. Proper nutrition can help manage symptoms, slow disease progression, and improve overall health. A dietitian can provide personalized dietary plans to ensure the client avoids foods that may exacerbate their condition and includes those that support kidney health.

A. The dressing was changed 7 days ago. B. The circumference of the client’s upper arm has increased by 10%. C. The catheter has not been used in 8 hours. D. The catheter has been flushed with 10 mL of sterile saline after medication use.

Correct Answer is B

Explanation

Choice A Reason:

The dressing for a PICC line should be changed every 7 days or sooner if it becomes wet, soiled, or loose. Therefore, a dressing change 7 days ago is within the recommended guidelines and does not necessarily require immediate notification of the provider.

Choice B Reason:

An increase in the circumference of the client’s upper arm by 10% can indicate swelling, which may be a sign of complications such as infection, thrombosis, or infiltration. This finding should be promptly reported to the provider for further evaluation and intervention.

Choice C Reason:

The catheter not being used for 8 hours is not typically a cause for concern as long as it is properly flushed and maintained. PICC lines can remain in place for extended periods without use, provided they are flushed regularly to prevent occlusion.

Choice D Reason:

Flushing the catheter with 10 mL of sterile saline after medication use is a standard practice to maintain patency and prevent blockage This action does not require notification of the provider unless there are other associated complications.

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A nurse is reviewing laboratory reports for a client who is taking NSAIDs for rheumatoid arthritis. Which of the following results should the nurse recognize as a possible adverse effect of NSAID therapy?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is preparing to discharge a client who has a new diagnosis of chronic kidney disease (CKD). Which of the following referrals should the nurse plan to initiate?

Correct Answer is D

Explanation

A nurse is caring for a client who has a peripherally inserted central catheter (PICC). For which of the following findings should the nurse notify the provider?

Correct Answer is B

Explanation

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