A client has been taking glipizide for 6 months and reports to the nurse that their urine has become darker since starting the medication.
What should be the nurse’s initial action?
Review the results of liver function studies.
Instruct the client to increase their water intake.
Check the client’s weight.
Test a sample of urine for the presence of occult blood.
The Correct Answer is A
Choice A rationale
Dark urine can be a sign of liver dysfunction, which can be a side effect of glipizide. Therefore, reviewing the results of liver function studies would be an appropriate initial action to determine if the medication is affecting the client’s liver function.
Choice B rationale
While increasing water intake can sometimes help with certain side effects of medications, it would not address the potential issue of liver dysfunction indicated by the dark urine.
Choice C rationale
Checking the client’s weight would not provide information related to the cause of the dark urine.
Choice D rationale
Testing a sample of urine for the presence of occult blood could be useful if there was a suspicion of bleeding, but it would not address the potential issue of liver dysfunction indicated by the dark urine.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","B","D","E"]
Explanation
Choice A rationale
Assess for Red Man Syndrome. Vancomycin can cause a reaction known as Red Man Syndrome, which is characterized by flushing and/or an erythematous rash that affects the face, neck, and upper torso. This is not an allergic reaction, but rather a direct histamine-release effect of the drug.
Choice B rationale
Assess the client’s hearing. Ototoxicity, which can manifest as hearing loss, is a potential side effect of vancomycin. Therefore, it’s important to monitor the client’s hearing during treatment.
Choice C rationale
Obtain an arterial blood gas (ABG). This is not typically required when administering vancomycin. ABGs are usually drawn to assess a patient’s acid-base balance and oxygenation status, not as a routine part of vancomycin administration.
Choice D rationale
Infuse the drug over 1-2 hours. Vancomycin should be administered over at least 60 minutes to avoid skin irritation. Infusing the drug too quickly can also increase the risk of Red Man Syndrome.
Choice E rationale
Obtain an ordered trough level prior to next scheduled dose. Monitoring vancomycin trough levels is important to ensure therapeutic efficacy and to avoid toxicity. Trough levels are typically drawn just before the next dose is due.
Correct Answer is C
Explanation
Choice A rationale
A fasting blood glucose level of 135 mg/dL is above the diagnostic threshold for diabetes. However, it is not the exact threshold value.
Choice B rationale
A fasting blood glucose level of 140 mg/dL is significantly above the diagnostic threshold for diabetes.
Choice C rationale
A fasting blood glucose level of 126 mg/dL or higher on two separate tests indicates diabetes.
Choice D rationale
A fasting blood glucose level of 145 mg/dL is significantly above the diagnostic threshold for diabetes.
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