A patient with hepatic encephalopathy is receiving lactulose.
Which assessment provides the nurse with the best information to evaluate the patient’s therapeutic response to the drug?

Stool color and character.

Fingerstick glucose.

Serum electrolytes and ammonia.

Serum hepatic enzymes.

Answer and Explanation

The Correct Answer is C

Choice A rationale

While changes in stool color and character can be indicative of various health conditions, they are not the best indicators of a patient’s therapeutic response to lactulose in the context of hepatic encephalopathy.

Choice B rationale

Fingerstick glucose monitoring is important in managing conditions like diabetes, but it does not provide the best information to evaluate a patient’s therapeutic response to lactulose in the context of hepatic encephalopathy.

Choice C rationale

Lactulose is used in the management of hepatic encephalopathy, a condition that can occur in patients with severe liver disease. It works by reducing the absorption of ammonia in the gut, which is a toxin that can accumulate in the blood in patients with liver dysfunction. Therefore, monitoring serum electrolytes and ammonia levels can help evaluate the effectiveness of lactulose therapy.

Choice D rationale

While monitoring serum hepatic enzymes can provide valuable information about liver function, it does not provide the best information to evaluate a patient’s therapeutic response to lactulose in the context of hepatic encephalopathy.

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Correct Answer is A

Explanation

Choice A rationale

Filgrastim is a medication used to stimulate the growth of white blood cells, making patients less vulnerable to infections. If the patient’s white blood cell count has increased from 2,500/mm^3 to 5,000/mm^3 after administering five doses of filgrastim, it indicates that the medication has been effective.

Choice B rationale

Reviewing the patient’s culture and sensitivity reports is not directly related to the effect of filgrastim on white blood cell count.

Choice C rationale

Neutropenic precautions are typically implemented when a patient has a low white blood cell count. Since the patient’s white blood cell count has increased, implementing neutropenic precautions may not be necessary.

Choice D rationale

While it’s always important to monitor a patient’s vital signs, there’s no specific reason to do so just because the patient’s white blood cell count has increased after administering filgrastim.

A. The client primes the inhaler with 7 pumps. B. The client stores the medication at room temperature. C. The client rinses their mouth after each use. D. The client attaches a spacer device to the inhaler.

Correct Answer is A

Explanation

Choice A rationale

Ipratropium is a bronchodilator used to prevent bronchospasm in people with chronic obstructive pulmonary disease (COPD)3. The inhaler needs to be primed before use to ensure the right amount of medicine is delivered. However, priming the inhaler with 7 pumps is not recommended. Therefore, if the client primes the inhaler with 7 pumps, it indicates that additional teaching is needed.

Choice B rationale

Storing the medication at room temperature is the correct way to store ipratropium. Therefore, this action does not indicate that additional teaching is needed.

Choice C rationale

Rinsing the mouth after each use of the inhaler is a recommended practice. This helps to prevent dry mouth and throat irritation caused by the medication. Therefore, this action does not indicate that additional teaching is needed.

Choice D rationale

Attaching a spacer device to the inhaler can help improve the delivery of the medication. Therefore, this action does not indicate that additional teaching is needed.

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A patient with hepatic encephalopathy is receiving lactulose.Which assessment provides the nurse with the best information to evaluate the patient’s therapeutic response to the drug?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

After administering five doses of filgrastim, the nurse observes that the patient’s white blood cell count has increased from 2,500/mm^3 to 5,000/mm^3.What action should the nurse take?

Correct Answer is A

Explanation

A client with a history of chronic obstructive pulmonary disease (COPD) has been prescribed a new ipratropium inhaler.Which action indicates to the nurse that additional teaching is needed?

Correct Answer is A

Explanation

A patient with hepatic encephalopathy is receiving lactulose.Which assessment provides the nurse with the best information to evaluate the patient’s therapeutic response to the drug?

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A patient with hepatic encephalopathy is receiving lactulose.
Which assessment provides the nurse with the best information to evaluate the patient’s therapeutic response to the drug?