A client with anemia secondary to chronic kidney disease started a prescription for epoetin alfa two months ago. Which client finding best indicates that the medication is eﬀective?

Reports on increased energy levels and decreased fatigue.

Takes concurrent iron therapy without adverse eﬀects.

The hemoglobin level increased to 12 grams/dL (120mmol/L).

Food diary shows increased consumption of iron rich foods.

Answer and Explanation

The Correct Answer is C

Epoetin alfa is a medication that stimulates the production of red blood cells and is commonly used to treat anemia in patients with chronic kidney disease. Hemoglobin level is the most important parameter to monitor the eﬀectiveness of epoetin alfa therapy. An increase in hemoglobin level indicates an improvement in the patient's anemia and suggests that the medication is eﬀective.

While options a, b, and d are also important considerations in the management of anemia, they do not provide a definitive indication of the eﬀectiveness of epoetin alfa therapy. Reports of increased energy levels and decreased fatigue can be subjective and inﬂuenced by many factors. Taking concurrent iron therapy without adverse eﬀects is important to support the production of red blood cells but does not confirm the eﬀectiveness of epoetin alfa. Increased consumption of iron-rich foods can be helpful in managing anemia, but it does not provide a direct indication of the eﬀectiveness of epoetin alfa therapy.

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Correct Answer is C

Explanation

The correct answer is C. Instruct the client to request assistance when ambulating to the bathroom.

Choice A reason:

Advise the client that the medication should start to work in about 30 minutes.

While it is important to inform the client about the onset of action of the medication, this is not the highest priority. Codeine, an opioid, can cause dizziness and sedation, which increases the risk of falls. Therefore, safety measures take precedence over informing the client about the medication’s onset time.

Choice B reason:

Administer a stool softener/laxative at the same time as the analgesic.

Opioids like codeine can cause constipation, so administering a stool softener or laxative is a good practice. However, this action is not the highest priority when considering the immediate safety of the client. Ensuring the client’s safety from potential falls due to dizziness or sedation is more urgent.

Choice C reason:

Instruct the client to request assistance when ambulating to the bathroom.

This is the correct answer because codeine can cause dizziness, sedation, and orthostatic hypotension, increasing the risk of falls. Ensuring the client requests assistance when moving can prevent potential injuries, making it the highest priority nursing action.

Choice D reason:

Tell the client to notify the nurse if the pain is not relieved.

While it is important for the client to communicate about the effectiveness of pain relief, this is not the highest priority. The immediate concern is the client’s safety due to the sedative effects of codeine. Therefore, preventing falls and injuries takes precedence.

A. Platelets B. Glucose C. Osmolality D. Calcium

Correct Answer is C

Explanation

Diabetes insipidus is a condition in which the kidneys are unable to conserve water, leading to excessive thirst and urination. It is treated with antidiuretic hormone (ADH), which helps the kidneys retain water and reduce urine output. When caring for a client with diabetes insipidus who is receiving ADH intranasally, it is important for the nurse to monitor the client’s serum osmolality.

Osmolality is a measure of the concentration of particles in a solution and can provide information about the client’s hydration status.

Monitoring serum osmolality can help determine if the ADH therapy is eﬀective in managing the client’s diabetes insipidus.

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A client with anemia secondary to chronic kidney disease started a prescription for epoetin alfa two months ago. Which client finding best indicates that the medication is eﬀective?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Which nursing action had the highest priority when administering a dose of codeine with acetaminophen to a client?

Correct Answer is C

Explanation

When caring for a client with diabetes insipidus who is receiving antidiuretic hormone intranasally, which serum lab test is most important for the nurse to monitor?

Correct Answer is C

Explanation

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