The nurse is administering subcutaneous enoxaparin to a client following knee replacement surgery to prevent a deep vein thrombosis. Which laboratory result requires immediate action by the nurse?

Reference Range:

Hematocrit [42% to 52% (0.42 to 0.52 volume fraction)]

Platelets [150,000 to 400,000/mm (150 to 400 x 10L)

Creatinine (0.5 to 1.1 mg/dL (44 to 97 μmol/L)]

Blood Urea Nitrogen (BUN) [10 to 20 mg/dl (3.6 to 7.1 mmol/L)]

Serum creatinine 1.0 mg/dL (88.4 μmol/L)

Platelet count of 100,000/mm3 (100 x 10°/L).

Hematocrit 459% (0.45 volume fraction).

Blood urea nitrogen (BUN) 20 mg/dL (7.1 mmol/L)

Answer and Explanation

The Correct Answer is B

A) A serum creatinine level of 1.0 mg/dL falls within the reference range (0.5 to 1.1 mg/dL) and does not indicate immediate action by the nurse. Creatinine levels within the reference range suggest normal kidney function.

B) A platelet count of 100,000/mm3 (100 x 10^9/L) is below the lower limit of the reference range (150,000 to 400,000/mm3). Thrombocytopenia, or low platelet count, increases the risk of bleeding complications, especially when administering anticoagulants like enoxaparin. Therefore, a platelet count of 100,000/mm3 requires immediate action by the nurse to assess for bleeding and notify the healthcare provider.

C) A hematocrit of 45% (0.45 volume fraction) falls within the reference range (42% to 52%) and does not indicate immediate action by the nurse.

D) A blood urea nitrogen (BUN) level of 20 mg/dL (7.1 mmol/L) falls within the reference range (10 to 20 mg/dl) and does not indicate immediate action by the nurse.

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Correct Answer is B

Explanation

A) Cheese, milk, and yogurt: These foods are high in calcium and may not be the best choice for a client taking furosemide, as they can contribute to calcium levels and potentially exacerbate hypercalcemia, which is a risk with loop diuretic use.

B) Bananas, oranges, and peaches: This is the correct response. These fruits are rich in potassium, which is often depleted in clients taking loop diuretics like furosemide. Encouraging foods high in potassium can help replenish electrolytes and prevent hypokalemia.

C) Pasta, cereal, and bread: While these foods are generally well-tolerated and can provide carbohydrates for energy, they do not specifically address the electrolyte imbalances associated with loop diuretic use.

D) Liver, beef, and chicken: These foods are good sources of protein but do not directly address the electrolyte imbalances associated with loop diuretic use.

Therefore, encouraging the client to consume foods rich in potassium, such as bananas, oranges, and peaches, can help offset the potassium loss caused by furosemide and mitigate the risk of hypokalemia.

A. Acetaminophen. B. Prednisone. C. Captopril. D. Omeprazole.

Correct Answer is A

Explanation

A) Acetaminophen is metabolized by the liver, and jaundice can indicate liver dysfunction or impairment. Therefore, the nurse should notify the healthcare provider about the scheduled acetaminophen to ensure appropriate monitoring of liver function and to consider alternative pain management options.

B) Prednisone is a corticosteroid that primarily affects the immune system and inflammation and is not directly metabolized by the liver. While prednisone can have side effects related to liver function, such as hepatotoxicity, jaundice is not a common manifestation.

C) Captopril is an angiotensin-converting enzyme (ACE) inhibitor used to treat hypertension and heart failure. While it can affect renal function, jaundice is not a typical side effect of captopril.

D) Omeprazole is a proton pump inhibitor (PPI) used to reduce gastric acid production and treat conditions such as gastroesophageal reflux disease (GERD). It is primarily metabolized in the liver, but jaundice is not a common side effect associated with its use.

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Naxlex Comprehensive Predictor Exams

The loop diuretic furosemide is prescribed for a client with a history of heart failure (HF). Which foods should the nurse encourage this client to eat?

Correct Answer is B

Explanation

Correct Answer is A

Explanation

The nurse is providing discharge instructions for a client with metastatic cancer who is proscribed morphine for bone pain. Which information from the client indicates to the nurse an understanding of the medication?

A client with multiple sclerosis starts a new prescription, baclofen, to control muscle spasticity. Three days later, the client calls the clinic nurse and reports feeling fatigued and dizzy. Which instruction should the nurse provide?

A client who is receiving pregabalin for fibromyalgia reports experiencing tremors in the hands. Which action should the nurse implement?

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 with a history of smoking cigarettes for many years arrives to the clinic and expresses a desire to stop smoking. The client receives a prescription for bupropion to reduce nicotine cravings. Which information should the nurse include in the discharge teaching?