A client who had a kidney transplant last week is receiving cyclosporine. This morning the client reports experiencing a headache and blurred vision. Based on which assessment finding should the nurse withhold the medication until the healthcare provider (HCP) is notified?

Temperature of 100.8° F (38.2° C).

Elevated blood urea nitrogen (BUN).

Renal output of 120 mL/hour.

Blood pressure 180/98 mm Hg.

Answer and Explanation

The Correct Answer is D

A. Temperature of 100.8° F (38.2° C): A mildly elevated temperature in a post-transplant client may suggest infection or early rejection, both of which warrant monitoring. However, this is not a direct reason to withhold cyclosporine, which is essential for preventing organ rejection.

B. Elevated blood urea nitrogen (BUN): Elevated BUN could indicate impaired renal function, which should be monitored during cyclosporine therapy. However, this alone is not an urgent reason to withhold the medication without further evaluation of kidney function trends and symptoms.

C. Renal output of 120 mL/hour: This is a healthy urine output and suggests good renal perfusion and function. It does not present any contraindication to continuing cyclosporine and supports that the transplanted kidney is functioning well.

D. Blood pressure 180/98 mm Hg: Hypertension is a known side effect of cyclosporine and can become severe. A blood pressure this high, especially when accompanied by headache and blurred vision, suggests possible cyclosporine-induced hypertensive crisis or toxicity, and warrants immediate withholding of the medication and notification of the HCP.

Nursing Test Bank

Quiz #1: RN Exams Pharmacology Exams Quiz #2: RN Exams Medical-Surgical Exams Quiz #3: RN Exams Fundamentals Exams Quiz #4: RN Exams Maternal-Newborn Exams Quiz #5: RN Exams Anatomy and Physiology Exams Quiz #6: RN Exams Obstetrics and Pediatrics Exams Quiz #7: RN Exams Fluid and Electrolytes Exams Quiz #8: RN Exams Community Health Exams Quiz #9: RN Exams Promoting Health across the lifespan Exams Quiz #10: RN Exams Multidimensional care Exams

Get 100+ Naxlex Exit Exams for $79 Try Naxlex NCLEX-RN (14 Day Free-Trial)

Naxlex Comprehensive Predictor Exams

Quiz #1: Naxlex RN Comprehensive online practice 2019 B with NGN Quiz #2: Naxlex RN Comprehensive Predictor 2023 Quiz #3: Naxlex RN Comprehensive Predictor 2023 Exit Exam A Quiz #4: Naxlex HESI Exit LPN Exam Quiz #5: Naxlex PN Comprehensive Predictor PN 2020 Quiz #6: Naxlex VATI PN Comprehensive Predictor 2020 Quiz #8: Naxlex PN Comprehensive Predictor 2023 - Exam 1 Quiz #10: Naxlex HESI PN Exit exam Quiz #11: Naxlex HESI PN EXIT Exam 2

Free Nursing Study Resources

Correct Answer is A

Explanation

A. Hold both medications until contacting the healthcare provider (HCP): A total calcium level of 14 mg/dL is critically high and indicates hypercalcemia. Continuing calcitriol or calcium carbonate could worsen the hypercalcemia, so both medications should be held and the HCP contacted immediately for further orders.

B. Hold the calcitriol, but administer the calcium carbonate as scheduled: Calcium carbonate increases serum calcium levels, and administering it would exacerbate the already dangerously high calcium level. It should not be given until the situation is reassessed.

C. Hold the calcium carbonate, but administer the calcitriol as scheduled: Calcitriol promotes intestinal absorption of calcium, which could further elevate serum calcium levels. Giving calcitriol would be unsafe until the client’s calcium status is re-evaluated.

D. Administer both prescribed medications as scheduled: Administering both medications would significantly increase the risk of severe hypercalcemia complications, such as cardiac arrhythmias or neurologic changes, and must be avoided until new instructions are received.

A. No known allergies B. Used for prophylaxis C. Potassium 4.4 mEq/L (4.4 mmol/L) D. Dosage in safe range E. Peripheral IV (PIV) in large vein F. Blood urea nitrogen 17 mg/dL (6.07 mmol/L)

Correct Answer is ["A","D","E","F"]

Explanation

A. No known allergies: Confirming the client has no allergies to vancomycin or related substances is critical for safe administration. Administering an antibiotic to a client with a known allergy could result in life-threatening anaphylaxis.

B. Used for prophylaxis: Although vancomycin is often used prophylactically before procedures to prevent infection, the indication alone does not ensure that it is safe to administer. Safety focuses more on client-specific factors like allergies and organ function.

C. Potassium 4.4 mEq/L (4.4 mmol/L): This is a normal potassium level and reflects good electrolyte balance but does not directly relate to the safety of administering vancomycin, which is more concerning for kidney function and allergic reactions.

D. Dosage in safe range: Verifying that the vancomycin dose is within the recommended therapeutic range is essential to prevent toxicity, particularly nephrotoxicity and ototoxicity, which are risks with improper dosing.

E. Peripheral IV (PIV) in large vein: Administering vancomycin through a large-bore IV in a large vein reduces the risk of phlebitis and tissue irritation. Proper venous access is an important safety consideration when giving this medication.

F. Blood urea nitrogen 17 mg/dL (6.07 mmol/L): A normal BUN level suggests that renal function is adequate. Since vancomycin is primarily excreted by the kidneys, good renal function supports safe medication clearance and reduces toxicity risk.

View Question and Answer

Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.

Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today

A client who had a kidney transplant last week is receiving cyclosporine. This morning the client reports experiencing a headache and blurred vision. Based on which assessment finding should the nurse withhold the medication until the healthcare provider (HCP) is notified?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Prior to administering oral doses of calcitriol and calcium carbonate to a client with hypoparathyroidism, the nurse notes that the client's total calcium level is 14 mg/dL (3.5 mmol/L). Which action should the nurse implement?Reference Range:Calcium [8.5 to 10.5 mg/dL (2.25 to 2.75 mmol/L]

Correct Answer is A

Explanation

Patient Data Exhibits The nurse is preparing the client's plan of care (POC). Select 4 findings that would indicate to the nurse that the administration of the vancomycin antibiotic would be safe to administer.

Correct Answer is ["A","D","E","F"]

Explanation

When administering zolpidem to an older adult client, which computer documentation indicates that the desired outcome has been achieved?

Patient Data Exhibits Choose the most likely options for the information missing from the statement(s) by selecting from the lists of options provided. The nurse should expect for the insulin lispro to start working at dropdown and to peak at dropdown to dropdown

A client with chronic asthma receives a prescription for montelukast, a leukotriene modifier. Which statement by the client indicates to the nurse that medication teaching was effective?

Patient Data Exhibits Mark whether the assessment finding represents a therapeutic result of the lactulose administered, a nontherapeutic side effect, or an unrelated finding. Each row must have one option selected.

After receiving the third dose of a new oral anticoagulant prescription, an older adult client develops bleeding and tender gums and has many new bruises. Which action(s) should the nurse implement? Select all that apply.

Which client's laboratory value should the nurse review prior to administering the initial dose of a statin medication?

Patient Data Exhibits Choose the most likely options for the information missing from the statement(s) by selecting from the lists of options provided. The nurse should expect for the insulin glargine to start working in dropdown. and to continue working for dropdown.