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.
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A) 40-year-old female with frequent vaginal infections: Simvastatin is a medication used primarily to manage cholesterol levels and reduce the risk of cardiovascular diseases. Frequent vaginal infections are not directly related to cholesterol levels or cardiovascular risk. Therefore, this client is unlikely to benefit from education about simvastatin.
B) A 50-year-old male with a history of angina: Simvastatin is a statin medication prescribed to lower cholesterol levels and reduce the risk of cardiovascular events, such as heart attacks and strokes. Since angina is a symptom of coronary artery disease, a condition often related to high cholesterol levels, this client would benefit from education about simvastatin, which can help manage cholesterol and potentially reduce cardiovascular risk.
C) An 18-year-old pregnant female with type 1 diabetes mellitus: Statins, including simvastatin, are generally contraindicated during pregnancy due to potential risks to the developing fetus. Additionally, this client’s primary condition of type 1 diabetes mellitus would not typically be managed with simvastatin alone. Therefore, this client is not the target for simvastatin education.
D) A 75-year-old male with bone cancer: While simvastatin is used for managing cholesterol and preventing cardiovascular events, bone cancer is not directly related to cholesterol levels. The primary focus for this client would be managing cancer-related symptoms and treatments rather than cholesterol levels. Thus, this client would not benefit from education about simvastatin.
Correct Answer is D
Explanation
A. Fingerstick glucose: While important in managing diabetes or hypoglycemia, it is not directly related to evaluating the effectiveness of lactulose in treating hepatic encephalopathy.
B. Stool color and character: Lactulose acts as a laxative, and its effectiveness can affect stool characteristics. However, stool color and character are less direct indicators of therapeutic response compared to serum ammonia levels.
C. Serum hepatic enzymes: While liver enzyme levels can provide information about liver function, they do not directly measure the effectiveness of lactulose in managing hepatic encephalopathy. Serum ammonia levels are more specific for this purpose.
D. Serum electrolytes and ammonia: Lactulose is used to treat hepatic encephalopathy by reducing blood ammonia levels. Monitoring serum ammonia levels provides direct feedback on the effectiveness of the medication in treating hepatic encephalopathy. Additionally, serum electrolytes should be monitored because lactulose can lead to electrolyte imbalances due to its laxative effect.
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