A patient with gout has been treated with allopurinol (Zyloprim) for 2 months. The nurse will monitor laboratory results for which therapeutic effect?
Decreased white blood cell count
Increased hemoglobin and hematocrit levels
Decreased prothrombin time
Decreased uric acid levels
The Correct Answer is D
A. Decreased white blood cell count: A drop in WBC is not the expected therapeutic effect of allopurinol.
B. Increased hemoglobin and hematocrit levels: Allopurinol does not typically affect Hgb/Hct as its primary therapeutic outcome.
C. Decreased prothrombin time: Prothrombin time is unrelated to allopurinol therapy.
D. Decreased uric acid levels: Allopurinol inhibits xanthine oxidase and reduces uric acid production; the desired therapeutic effect is lower serum uric acid concentration.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. Heparin: Heparin is an anticoagulant (would increase bleeding risk) and is not used to reverse warfarin-induced prolonged PT.
B. Ferrous sulfate: Iron treats iron-deficiency anemia and does not correct an elevated prothrombin time from warfarin.
C. Prednisone: A corticosteroid does not reverse warfarin’s effect on clotting factors.
D. Vitamin K: Vitamin K (phytonadione) is the antidote/reversal agent for warfarin and will help normalize an elevated PT/INR.
Correct Answer is A
Explanation
A. Administer sodium bicarbonate: Metabolic acidosis reflects a deficit of bicarbonate; in severe, life-threatening acidosis (and after addressing the underlying cause), sodium bicarbonate may be given to raise serum bicarbonate and pH.
B. Increase fluid intake: Fluids may be supportive but do not correct the acid–base disturbance itself.
C. Encourage deep breathing exercises: Deep breathing increases CO₂ (if slow) and affects respiratory compensation; respiratory maneuvers are not the primary treatment for metabolic (vs respiratory) acidosis.
D. Administer insulin: Insulin is the primary treatment for diabetic ketoacidosis (a specific cause of metabolic acidosis), but it is not the universal primary treatment for all causes of metabolic acidosis.
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