Which data should the nurse assess for the client with a seizure disorder who is taking valproate (Depakote)?
Creatinine and BUN.
White blood cell count.
Red blood cell count.
Liver enzymes.
The Correct Answer is D
Choice A rationale
Creatinine (normal range: 0.6-1.2 mg/dL) and Blood Urea Nitrogen (BUN) (normal range: 7-20 mg/dL) are indicators of kidney function. While kidney function is important, valproate is primarily metabolized by the liver, making liver function monitoring more critical than routine renal function assessment for this medication.
Choice B rationale
White blood cell count (normal range: 4,000-11,000 cells/µL) measures components of the immune system. Although some anticonvulsants can affect blood counts, valproate's primary adverse effect profile does not typically involve significant or common alterations in white blood cell count requiring routine monitoring.
Choice C rationale
Red blood cell count (normal range: 4.2-5.4 million cells/µL for women; 4.7-6.1 million cells/µL for men) measures oxygen-carrying capacity. While certain medications can cause anemia, valproate is not commonly associated with significant hematological toxicities involving red blood cells that necessitate routine monitoring.
Choice D rationale
Liver enzymes, such as ALT (normal range: 7-56 U/L) and AST (normal range: 10-40 U/L), are crucial to assess for a client taking valproate. This medication is hepatically metabolized and can cause dose-related transient elevations or, rarely, severe, potentially fatal hepatotoxicity, necessitating regular monitoring of liver function.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale
Dementia is a neurodegenerative disorder characterized by a progressive and irreversible decline in cognitive function, including memory, thinking, and reasoning. This deterioration is due to widespread neuronal loss and brain atrophy, leading to increasing dependence over time as the disease advances.
Choice B rationale
Dementia is not characterized by a sudden onset of confusion. Instead, its onset is typically insidious, with a gradual decline in cognitive abilities over months to years. A sudden onset of confusion is more indicative of delirium, which is an acute and often reversible state.
Choice C rationale
An altered level of consciousness is not typically associated with dementia. Clients with dementia generally maintain a clear level of consciousness, although they may experience confusion, disorientation, or difficulty with attention. Altered consciousness is a hallmark feature of delirium.
Choice D rationale
While high fever or dehydration can exacerbate cognitive impairment in individuals with underlying dementia, they do not trigger the development of dementia itself. These factors are more commonly associated with delirium, which is an acute confusional state, rather than the chronic progressive nature of dementia.
Correct Answer is ["0.5"]
Explanation
Step 1 is: Convert mcg to mg. 125 mcg = 0.125 mg.
Step 2 is: Calculate the number of tablets. 0.125 mg ÷ (0.25 mg/tablet) = 0.5 tablets. The nurse should administer 0.5 tablets per dose.
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