A client with anemia secondary to chronic kidney disease (CKD) started a prescription for epoetin alfa two months ago. Which client finding best indicates that the medication is effective?
Reference Range
- Hemoglobin (Hgb) [Reference Range: Male: 14 to 18 g/dL (8.7 to 11.2 mmol/L)]
Hemoglobin level increased to 12 g/dL (7.45 mmol/L).
Reports of increased energy levels and decreased fatigue.
Food diary shows increased consumption of iron-rich foods.
Takes concurrent iron therapy without adverse effects.
The Correct Answer is A
A: The primary therapeutic effect of epoetin alfa is to stimulate erythropoiesis, leading to an increase in hemoglobin levels. An increase to 12 g/dL demonstrates that the medication is effectively treating the anemia caused by CKD. Monitoring hemoglobin levels is the most objective and reliable indicator of the medication’s effectiveness.
B: While these subjective improvements can indicate an overall improvement in anemia-related symptoms, they are not the best or most definitive measure of the medication's effectiveness. Objective data, such as hemoglobin levels, provide more concrete evidence.
C: Increased consumption of iron-rich foods is beneficial for clients with anemia, but it is not a direct indicator of the effectiveness of epoetin alfa. Dietary changes can support overall health but do not provide evidence of the medication's impact on hemoglobin levels.
D: Taking concurrent iron therapy is common for clients receiving epoetin alfa, as iron is necessary for the production of red blood cells. However, the absence of adverse effects does not directly indicate the effectiveness of epoetin alfa in increasing hemoglobin levels.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale: Serum ammonia levels are not relevant to the effectiveness of sodium polystyrene sulfonate in treating hyperkalemia.
Choice B rationale: Sodium polystyrene sulfonate is a medication used to treat hyperkalemia (high potassium levels). A serum potassium level of 3.8 mEq/L falls within the normal reference range (3.5 to 5.0 mEq/L), indicating that the medication has been effective in promoting the excretion of potassium and reducing hyperkalemia.
Choice C rationale: Serum glucose levels are not relevant to the effectiveness of sodium polystyrene sulfonate in treating hyperkalemia.
Choice D rationale: Hemoglobin levels are not relevant to the effectiveness of sodium polystyrene sulfonate in treating hyperkalemia.
Correct Answer is ["B","C","D"]
Explanation
Choice A rationale: Quinapril is an ACE inhibitor and, like captopril, is typically given twice daily. It does not have an extended duration of action that would allow for once-daily dosing.
Choice B rationale: Lisinopril is an ACE inhibitor that can be given once per day. It has a long duration of action, which allows for once-daily dosing. This makes it a convenient option for patients who have difficulty remembering to take their medications multiple times a day.
Choice C rationale: Ramipril is another ACE inhibitor that can be given once per day. Like lisinopril, it has an extended duration of action, allowing for once-daily dosing.
Choice D rationale: Trandolapril is an ACE inhibitor that can also be given once per day. It has a prolonged duration of action, which supports once-daily dosing for optimal blood pressure control.
Choice E rationale: Captopril itself is listed in the options, and it is not an ACE inhibitor that can be given only once per day. Captopril has a short duration of action and is usually prescribed for twice-daily dosing.
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