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.

Answer and Explanation

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.

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Correct Answer is D

Explanation

The correct answer is D.

Choice A rationale: While iodine is essential for thyroid hormone synthesis, it is not relevant to the administration of levothyroxine. The client does not need to consume foods high in iodine specifically for taking levothyroxine.

Choice B rationale: While iron supplements can interfere with the absorption of levothyroxine, this statement does not indicate that the client understands when to take levothyroxine correctly.

Choice C rationale: Levothyroxine should be taken in the morning, not at bedtime, to avoid interference with sleep and to optimize absorption.

Choice D rationale: Levothyroxine, a thyroid hormone replacement, should be taken on an empty stomach, preferably in the morning, at least 30 minutes before eating. Taking it on an empty stomach maximizes its absorption and ensures optimal therapeutic effects.

A. Administer both prescribed medications as scheduled. B. Hold both medications until contacting the healthcare provider. C. Hold the calcium carbonate, but administer the calcitriol as scheduled. D. Hold the, calcitriol but administer the calcium carbonate as scheduled.

Correct Answer is B

Explanation

Choice A rationale: This is not appropriate because the client's elevated calcium level requires immediate attention and further assessment by the healthcare provider before administering any medications that may further raise calcium levels.

Choice B rationale: The client's total calcium level is significantly elevated, which may indicate hypercalcemia. Given the reference range for total calcium in adults is 9 to 10.5 mg/dL (2.25 to 2.62 mmol/L), a calcium level of 14 mg/dL (3.5 mmol/L) is abnormally high. Both calcitriol (active form of vitamin D) and calcium carbonate (calcium supplement) can increase calcium levels in the body. Before administering any medication, the nurse should hold both calcitriol and calcium carbonate and notify the healthcare provider of the elevated calcium level. The healthcare provider will determine the appropriate course of action and may adjust the dosage or temporarily discontinue the medications to prevent further complications related to hypercalcemia.

Choice C rationale: Holding calcium carbonate is a step in the right direction, but given the significant elevation of total calcium, it is best to hold both medications and consult the healthcare provider.

Choice D rationale: Holding calcitriol is a step in the right direction, but both medications should be held to prevent exacerbation of hypercalcemia until further instructions are received from the healthcare provider.

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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)]

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client receives a new prescription for levothyroxine. Which statement made by client indicates to the nurse the education was effective?

Correct Answer is D

Explanation

Correct Answer is B

Explanation

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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)]