A nurse is caring for a client who has developed agranulocytosis as a result of taking propylthiouracil to treat hyperthyroidism. The nurse should understand that this client is at increased risk for which of the following conditions?
Infection
Excessive bleeding
Hyperglycemia
Ecchymosis
The Correct Answer is A
Choice A reason: Infection is the correct condition that the client is at increased risk for. Agranulocytosis is a severe decrease in the number of granulocytes, which are a type of white blood cell that fight infection. Propylthiouracil is an antithyroid drug that can cause agranulocytosis as a rare but serious side effect. The client with agranulocytosis is more susceptible to bacterial and fungal infections, and may present with fever, sore throat, mouth ulcers, and skin lesions.
Choice B reason: Excessive bleeding is not the correct condition that the client is at increased risk for. Agranulocytosis does not affect the platelets, which are the blood cells that help with clotting. Propylthiouracil does not cause bleeding disorders, although it may interact with anticoagulants and increase their effect.
Choice C reason: Hyperglycemia is not the correct condition that the client is at increased risk for. Agranulocytosis does not affect the insulin, which is the hormone that regulates blood glucose levels. Propylthiouracil does not cause hyperglycemia, although it may interfere with the metabolism of oral hypoglycemic agents and decrease their effect.
Choice D reason: Ecchymosis is not the correct condition that the client is at increased risk for. Ecchymosis is a bruise caused by bleeding under the skin. Agranulocytosis does not cause ecchymosis, as it does not affect the blood vessels or the platelets. Propylthiouracil does not cause ecchymosis, although it may increase the risk of skin rash and pruritus.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: Taking the medication in the morning is not the correct instruction. Simvastatin is a statin drug that lowers cholesterol levels by inhibiting the enzyme that produces cholesterol in the liver. The liver produces more cholesterol at night, so simvastatin is more effective when taken in the evening or at bedtime.
Choice B reason: Avoiding grapefruit juice is the correct instruction. Grapefruit juice can increase the blood levels of simvastatin and cause serious side effects such as muscle damage, liver damage, and kidney failure. Grapefruit juice inhibits the enzyme that metabolizes simvastatin in the intestine, leading to higher concentrations of the drug in the bloodstream.
Choice C reason: Monitoring for ringing in the ears is not the correct instruction. Ringing in the ears, or tinnitus, is not a common or serious side effect of simvastatin. However, some other medications that lower cholesterol, such as niacin and gemfibrozil, can cause tinnitus. The client should report any unusual or persistent symptoms to the prescriber.
Choice D reason: Expecting brown-colored urine is not the correct instruction. Brown-colored urine, or hematuria, is not a normal or expected side effect of simvastatin. However, it may indicate a serious condition such as rhabdomyolysis, which is a rare but life-threatening complication of statin therapy. Rhabdomyolysis is the breakdown of muscle tissue that releases a protein called myoglobin into the bloodstream. Myoglobin can damage the kidneys and cause brown-colored urine. The client should seek immediate medical attention if they notice any signs of rhabdomyolysis, such as muscle pain, weakness, fever, or dark urine.
Correct Answer is C
Explanation
Choice A reason: Naloxone is not the correct medication. Naloxone is an opioid antagonist that reverses the effects of opioid overdose, such as respiratory depression, sedation, and hypotension. Naloxone has no effect on magnesium sulfate, which is a mineral and electrolyte that is used to prevent seizures in clients with preeclampsia or eclampsia.
Choice B reason: Protamine is not the correct medication. Protamine is a heparin antagonist that reverses the effects of heparin overdose, such as bleeding, bruising, and thrombocytopenia. Protamine has no effect on magnesium sulfate, which is not an anticoagulant.
Choice C reason: Calcium gluconate is the correct medication. Calcium gluconate is a calcium salt that antagonizes the effects of magnesium sulfate overdose, such as hypotension, bradycardia, respiratory depression, and muscle weakness. Calcium gluconate is the antidote for magnesium sulfate toxicity, which can occur when the serum magnesium level is above 7.5 mEq/L. The nurse should monitor the client's vital signs, deep tendon reflexes, and urine output, and report any signs of toxicity to the provider.
Choice D reason: Flumazenil is not the correct medication. Flumazenil is a benzodiazepine antagonist that reverses the effects of benzodiazepine overdose, such as drowsiness, confusion, and coma. Flumazenil has no effect on magnesium sulfate, which is not a sedative.
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