A newly admitted client has been prescribed trimethoprim-sulfamethoxazole.
The nurse understands that this medication is contraindicated based on which lab result?
Serum fasting glucose of 101 mg/dL.
Platelets of 160,000 uL.
Hemoglobin of 13.6 g/dL.
Serum creatinine of 2.5 mg/dL.
The Correct Answer is D
Choice A rationale
A serum fasting glucose of 101 mg/dL is slightly above the normal range (70-100 mg/dL), indicating a possible prediabetes condition. However, it is not a contraindication for trimethoprim-sulfamethoxazole.
Choice B rationale
A platelet count of 160,000 uL is within the normal range (150,000-450,000 uL). Therefore, it is not a contraindication for trimethoprim-sulfamethoxazole.
Choice C rationale
A hemoglobin level of 13.6 g/dL is within the normal range for both men (13.5-17.5 g/dL) and women (12.0-15.5 g/dL). Thus, it is not a contraindication for trimethoprim-sulfamethoxazole.
Choice D rationale
A serum creatinine level of 2.5 mg/dL is above the normal range (0.6-1.2 mg/dL for men, 0.5- 1.1 mg/dL for women), indicating impaired kidney function. Trimethoprim-sulfamethoxazole is contraindicated in patients with severe renal insufficiency.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A rationale
Limiting intake to non-caloric containing liquids until the glucose is within normal limits is not the best advice for a patient with Type 1 diabetes reporting a blood glucose level of 210 mg/dL and symptoms of a sore throat, cough, and fever. While it’s important to stay hydrated, especially when sick, it’s also crucial to maintain a balanced diet to provide the body with necessary nutrients for recovery.
Choice B rationale
Decreasing intake of carbohydrates until blood glucose level is less than 100 mg/dL is not recommended. Carbohydrates are a primary source of energy, and reducing their intake could lead to low blood sugar or hypoglycemia, which can be dangerous.
Choice C rationale
Monitoring blood glucose levels every 4 hours and notifying the doctor if it continues to rise is the best advice. When a patient with diabetes is sick, their blood glucose levels can rise due to the stress the body is under. Regular monitoring allows for timely adjustments in insulin dosage and helps prevent diabetic ketoacidosis, a serious complication.
Choice D rationale
Administering only the morning prescribed dose of insulin is not advisable. Insulin requirements can increase when a person with diabetes is sick. Therefore, sticking to the regular insulin regimen without adjustments could lead to high blood sugar or hyperglycemia.
Correct Answer is C
Explanation
Choice A rationale
The client’s fasting blood glucose level, postprandial blood glucose level, and hemoglobin A1c level are all within the target range for good blood glucose control in diabetes. Therefore, the client is not at an increased risk for developing hypoglycemia.
Choice B rationale
Insulin resistance is a characteristic of type 2 diabetes, not type 1 diabetes. The client’s blood glucose levels are well controlled, which suggests that the client’s insulin regimen is effective, not that the client is demonstrating signs of insulin resistance.
Choice C rationale
The client’s fasting blood glucose level, postprandial blood glucose level, and hemoglobin A1c level are all within the target range for good blood glucose control in diabetes. Therefore, the client is demonstrating good control of blood glucose.
Choice D rationale
The client’s fasting blood glucose level, postprandial blood glucose level, and hemoglobin A1c level are all within the target range for good blood glucose control in diabetes. Therefore, the client is not at an increased risk for developing hyperglycemia.
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