A newly admitted client has been prescribed sulfamethoxazole/trimethoprim. The nurse understands that this medication is contraindicated based on which lab result?

Serum fasting glucose 101 mg/dL

platelets 160,000 uL

Serum creatinine 2.5 mg/dL

Hemoglobin 13.6 g/dL

Answer and Explanation

The Correct Answer is C

A.   A serum fasting glucose level of 101 mg/dL indicates a mild elevation but is not significantly high enough to contraindicate the use of TMP-SMX. It does not directly relate to the medication’s safety.
B.   A platelet count of 160,000 µL is within normal limits (normal range is typically 150,000-450,000 µL). This result does not indicate any contraindication for using TMP-SMX.

C.   A serum creatinine level of 2.5 mg/dL indicates impaired kidney function (normal range is typically 0.6-1.2 mg/dL). TMP-SMX can be contraindicated in patients with significant renal impairment due to the potential for drug accumulation and toxicity, particularly affecting renal function.
D.   A hemoglobin level of 13.6 g/dL is within normal limits (normal range is approximately 13.5-17.5 g/dL for males and 12.0-15.5 g/dL for females). This result does not indicate a contraindication for using TMP- SMX.

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Correct Answer is D

Explanation

A. While costovertebral tenderness is significant and indicates kidney involvement, it is a common symptom of acute pyelonephritis and not necessarily a sign of deterioration. Immediate notification may not be warranted unless other concerning symptoms are present.
B. Although back massage may seem comforting, it is not indicated in this scenario. The kidneys are inflamed, and massage could exacerbate pain or discomfort. It does not address the underlying condition or the pain effectively.
C. The prone position is not typically recommended for clients with pyelonephritis. Instead, the client may be more comfortable in a position that does not put pressure on the kidneys, such as sitting up or lying on their back or side. This intervention does not directly address the pain or comfort of the client.
D. Offering an analgesic is the most appropriate action. Pain management is crucial for the comfort of the client, and an analgesic can help alleviate the discomfort associated with costovertebral tenderness. If the physician has prescribed an analgesic, administering it would be in line with promoting comfort and addressing the client’s needs.

A. Ensure adequate fluid intake to prevent kidney damage B. Schedule and keep appointments for annual eye exams C. Podiatry exams are necessary every 3 months D. Excessive exercise increases insulin resistances

Correct Answer is ["B","C"]

Explanation

A. While maintaining adequate hydration is important for overall health and can help the kidneys function properly, this statement alone does not capture the full scope of kidney-related issues associated with diabetes, such as diabetic nephropathy. It’s important to emphasize regular monitoring of kidney function through lab tests (e.g., microalbuminuria) as part of diabetes management.
B. People with diabetes are at increased risk for eye complications such as diabetic retinopathy, cataracts, and glaucoma. Regular eye exams are essential for early detection and management of these conditions, making this information critical for a client with diabetes.
C. Many sources recommend at least annual foot exams, but those with neuropathy or previous foot problems may need more frequent evaluations (every 3 to 6 months). This statement is generally accurate but should be tailored to the individual's risk factors.
D. Regular physical activity is generally recommended for individuals with diabetes as it improves insulin sensitivity, helping to manage blood glucose levels. While extreme exercise without proper management can lead to complications, stating that excessive exercise increases insulin resistance is misleading. The key is to balance exercise with proper nutrition and medication.

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A newly admitted client has been prescribed sulfamethoxazole/trimethoprim. The nurse understands that this medication is contraindicated based on which lab result?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A 72-year-old client is admitted to the medical-surgical unit with a diagnosis of acute pyelonephritis. The client complains of costovertebral tenderness. What it the most appropriate nursing intervention?

Correct Answer is D

Explanation

A nurse is teaching a client with diabetes mellitus about chronic complications associated with the disease. Which information should be included in the teaching?

Correct Answer is ["B","C"]

Explanation

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