A nurse is caring for a client who has chronic renal disease and is receiving therapy with epoetin alfa. Which of the following laboratory results should the nurse review for an indication of a therapeutic effect of the medication?

The erythrocyte sedimentation rate (ESR)

The hematocrit (Hct)

The leukocyte count

The platelet count

Answer and Explanation

The Correct Answer is B

A.   The erythrocyte sedimentation rate (ESR) is a nonspecific marker of inflammation and is not used to assess the therapeutic effect of epoetin alfa.
B.   The hematocrit (Hct) measures the proportion of red blood cells in the blood. Epoetin alfa stimulates the production of red blood cells, leading to an increase in hematocrit levels, indicating a therapeutic effect of the medication.
C.   The leukocyte count measures the number of white blood cells in the blood and is not relevant for assessing the therapeutic effect of epoetin alfa.
D.   The platelet count measures the number of platelets in the blood and is not relevant for assessing the therapeutic effect of epoetin alfa.

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Correct Answer is ["B","D","E"]

Explanation

A. Bicarbonate excess is not a clinical manifestation but rather the underlying cause of metabolic alkalosis.
B. Metabolic alkalosis can lead to potassium depletion, which may cause muscle weakness.
C. Kussmaul's respirations, characterized by deep and labored breathing, are more commonly associated with metabolic acidosis, not alkalosis, as the body tries to compensate for acidemia by expelling more carbon dioxide through deep breaths.
D. Alkalosis can cause peripheral vasodilation and decreased calcium ionization, leading to circumoral and digital paresthesia.
E. Alkalosis can cause cerebral vasoconstriction and decreased cerebral perfusion, leading to dizziness.

A. Obtain a prescription for insulin for the client. B. Have the client breath into a paper bag. C. Place the client on continuous cardiac monitoring, D. Plan to administer sodium bicarbonate to the client.

Correct Answer is C

Explanation

A. Insulin administration is not indicated for metabolic alkalosis.
B. Breathing into a paper bag is a treatment for respiratory alkalosis, not metabolic alkalosis.
C. Metabolic alkalosis can lead to cardiac dysrhythmias due to electrolyte imbalances, particularly hypokalemia. Continuous cardiac monitoring is essential to promptly identify and manage any dysrhythmias that may occur.
D. Administering sodium bicarbonate would exacerbate metabolic alkalosis and is not indicated.

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A nurse is caring for a client who has chronic renal disease and is receiving therapy with epoetin alfa. Which of the following laboratory results should the nurse review for an indication of a therapeutic effect of the medication?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has metabolic alkalosis. For which of the following clinical manifestations should the nurse monitor? (Select all that apply.)

Correct Answer is ["B","D","E"]

Explanation

A nurse is caring for a client who has metabolic alkalosis. Which of the following actions should the nurse take?

Correct Answer is C

Explanation

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