A nurse is caring for a client who has chronic hepatitis B infection and is taking lamivudine (Epivir).

The nurse should monitor the client for which of the following adverse effects?

Pancreatitis

Lactic acidosis

Hypothyroidism

Nephrotoxicity

Answer and Explanation

The Correct Answer is B

The correct answer is choice B. Lactic acidosis.

Lamivudine (Epivir) is a nucleoside reverse transcriptase inhibitor (NRTI) used to treat chronic hepatitis B infection and HIV infection.

One of the rare but serious adverse effects of lamivudine is lactic acidosis, which is a condition where the blood becomes too acidic due to the accumulation of lactate. Lactic acidosis can cause symptoms such as nausea, vomiting, abdominal pain, muscle weakness, rapid breathing, and low blood pressure.

Choice A is wrong because pancreatitis is not a common side effect of lamivudine.

Pancreatitis is an inflammation of the pancreas that can cause severe abdominal pain, nausea, vomiting, and fever. Pancreatitis is more likely to occur with other NRTIs such as didanosine (Videx) or stavudine (Zerit).

Choice C is wrong because hypothyroidism is not a common side effect of lamivudine.

Hypothyroidism is a condition where the thyroid gland does not produce enough thyroid hormones, which regulate the metabolism and energy levels of the body.

Hypothyroidism can cause symptoms such as fatigue, weight gain, cold intolerance, dry skin, hair loss, and depression.

Hypothyroidism is more likely to occur with other drugs that interfere with thyroid function such as amiodarone (Cordarone) or lithium

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Correct Answer is A

Explanation

The correct answer is choice A. Administer fresh frozen plasma.This is because fresh frozen plasma contains clotting factors that can help stop the bleeding caused by vitamin K deficiency.Vitamin K is needed for the synthesis of clotting factors in the liver, but newborns have low levels of vitamin K and may develop vitamin K deficiency bleeding (VKDB) if they do not receive prophylaxis at birth.VKDB can manifest as bleeding in various sites, such as the skin, mucous membranes, umbilicus, gastrointestinal tract, or central nervous system.

Choice B is wrong because packed red blood cells do not contain clotting factors and will not correct the underlying deficiency of vitamin K.

Choice C is wrong because intravenous immunoglobulin is used to treat immune-mediated thrombocytopenia, not vitamin K deficiency.

Choice D is wrong because recombinant erythropoietin is used to stimulate red blood cell production in anemia, not to treat bleeding disorders.

Early-onset VKDB occurs within 24 hours of birth and is associated with maternal use of drugs that interfere with vitamin K metabolism, such as anticoagulants, anticonvulsants, or antituberculosis drugs.

These drugs induce the enzymes that break down vitamin K in the fetal liver

A. Factor II B. Factor V C. Factor VIII D. Factor XI

Correct Answer is A

Explanation

The correct answer is choice A.Factor II, also known as prothrombin, is one of the coagulation factors that are activated by vitamin K.Vitamin K is a cofactor for the carboxylation of specific glutamic acid groups in coagulation factors II, VII, IX, and X.

This process is essential for the activation of these factors in the coagulation cascade.

Choice B is wrong because factor V is not a vitamin K-dependent coagulation factor.

Factor V is activated by thrombin and acts as a cofactor for factor Xa in the conversion of prothrombin to thrombin.

Choice C is wrong because factor VIII is not a vitamin K-dependent coagulation factor.

Factor VIII is activated by thrombin and acts as a cofactor for factor IXa in the activation of factor X.

Choice D is wrong because factor XI is not a vitamin K-dependent coagulation factor.

Factor XI is activated by factor XIIa and activates factor IX in the intrinsic pathway of coagulation.

Normal ranges for coagulation factors are:

• Factor II: 70-120% of normal activity

• Factor V: 50-150% of normal activity

• Factor VIII: 50-150% of normal activity

• Factor IX: 50-150% of normal activity

• Factor X: 70-140% of normal activity

• Factor XI: 70-150% of normal activity

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A nurse is caring for a client who has chronic hepatitis B infection and is taking lamivudine (Epivir). The nurse should monitor the client for which of the following adverse effects?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a newborn who has early-onset VKDB due to maternal use of anticoagulants during pregnancy. Which of the following interventions should the nurse anticipate for this newborn?

Correct Answer is A

Explanation

A nurse is reviewing laboratory results for a newborn who received vitamin K injection at birth. Which of the following coagulation factors should be activated by vitamin K?

Correct Answer is A

Explanation

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A nurse is caring for a client who has chronic hepatitis B infection and is taking lamivudine (Epivir). The nurse should monitor the client for which of the following adverse effects?

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A nurse is caring for a client who has chronic hepatitis B infection and is taking lamivudine (Epivir).

The nurse should monitor the client for which of the following adverse effects?