An older female client comes to the clinic for a regular check-up. The client tells the nurse that she has increased her daily doses of acetaminophen for the past month to control joint pain. Based on this patient's comment, which previous laboratory results should the nurse compare with today's laboratory report?

Determine if there is a decrease in serum potassium due to renal compromise

Expect to find an increase in today's activated partial thromboplastin time (APTT) as compared to last quarter's due to bleeding.

Look at last quarter's hemoglobin and hematocrit, expecting an increase today due to dehydration.

Look for an increase in today's lactic dehydrogenase (LDH) compared to the previous one to assess for possible liver damage.

Answer and Explanation

The Correct Answer is D

A. Determine if there is a decrease in serum potassium due to renal compromise: Acetaminophen is not commonly associated with significant renal impairment or changes in serum potassium levels, making this a less relevant consideration.
B. Expect to find an increase in today's activated partial thromboplastin time (APTT) as compared to last quarter's due to bleeding: Acetaminophen does not significantly affect APTT or bleeding risk, so changes in APTT would not be expected due to acetaminophen use.
C. Look at last quarter's hemoglobin and hematocrit, expecting an increase today due to dehydration: Acetaminophen is not known to cause changes in hemoglobin and hematocrit levels or dehydration-related increases in these values.
D. Look for an increase in today's lactic dehydrogenase (LDH) compared to the previous one to assess for possible liver damage: Acetaminophen overdose or chronic high use can lead to liver damage, which would be indicated by elevated LDH levels. Monitoring LDH is appropriate to assess for potential liver damage related to acetaminophen use.

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Free Nursing Study Resources

Correct Answer is B

Explanation

A. Assess the client for other indications of adverse effects of corticosteroid use: While important, this action does not address the immediate issue of stopping the medication safely.
B. Advise the client that the medication should be stopped gradually rather than abruptly: Corticosteroids should not be stopped suddenly due to the risk of adrenal insufficiency and withdrawal symptoms. Gradual tapering is necessary to safely discontinue the medication.
C. Encourage the client to take the medication with food to decrease GI distress: This can help manage GI symptoms but does not address the issue of safely discontinuing the medication.
D. Review the client's dosing schedule to ensure he is taking the prescribed amount: This is useful but does not resolve the problem of safely stopping the medication.

A. Hypokalemia. B. Hyponatremia C. Hyperphosphatemia. D. Hypermagnesemia.

Correct Answer is A

Explanation

A. Hypokalemia: Hydrochlorothiazide is a thiazide diuretic that can cause potassium loss through increased urine production. A common side effect of thiazide diuretics is hypokalemia, which can lead to symptoms such as palpitations or the sensation of the heart skipping beats. Therefore, it is crucial to check the client’s potassium levels to determine if hypokalemia is contributing to the client's symptoms.
B. Hyponatremia: While thiazide diuretics can affect sodium levels, hypokalemia is more directly associated with the symptoms described. Hyponatremia (low sodium levels) might also occur but is less commonly linked to the symptom of a skipped heartbeat compared to hypokalemia.
C. Hyperphosphatemia: Hydrochlorothiazide is not known to cause significant changes in phosphate levels, and hyperphosphatemia is not typically associated with the sensation of skipped heartbeats.
D. Hypermagnesemia: This condition, which involves elevated magnesium levels, is not a common side effect of hydrochlorothiazide. Hypokalemia is a more relevant concern for the symptoms described.

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Naxlex Comprehensive Predictor Exams

A male client reports to the nurse that he is experiencing gastrointestinal (GI) distress from a high dose of a corticosteroid and is planning to stop taking the medication. In response to the client's statement, which nursing action is most important for the nurse to Implement?

Correct Answer is B

Explanation

During a home visit, a client informs the nurse about feeling like the heart is skipping beats. When reviewing the client's record, the nurse notes that the client is taking hydrochlorothiazide. Based on these assessment data, the nurse plans to obtain a blood sample to check for which condition?

Correct Answer is A

Explanation

A client with chronic kidney disease (CKD) is receiving calcium acetate 667 mg PO. A decrease in which blood value indicates to the nurse that the medication is having the desired effect?

A client with a history of angina reports the onset of chest pain. The nurse determines that the heart rate is 104 beats/minute and the blood pressure is 138/86 mm Hg. A transdermal nitroglycerin patch was applied 30 minutes ago to the right upper chest. Which action should the nurse take?

A client is receiving IV vancomycin and the nurse plans to draw blood for a peak and trough to determine the serum level of the medication. Which collection times provide the best determination of these levels?

A client who is a vegetarian has a new prescription for warfarin. The client reports eating leafy green vegetables every day. How should the nurse respond?

A male client with dementia is admitted to the emergency department (ED) because he accidentally self-administered several doses of diltiazem. Which intervention is most important for the nurse to implement?

Prior to administration of the initial dose of the gastrointestinal (GI) agent misoprostol, which information should the nurse obtain from the patient?

A client who has dysphagia after a cerebral vascular accident (CVA) receives a new prescription for lansoprazole capsules via nasogastric tube (NGT). Which action should the nurse implement prior to administering the medication?