A nurse is caring for a client who is taking azathioprine to treat rheumatoid arthritis. Which of the following laboratory values indicates an adverse effect of this medication?
BUN 15 mg/dL
WBC 3,000/mm
Hct 45%
Platelets 250,000/mm
The Correct Answer is B
Choice A Reason:
BUN 15 mg/dL (blood urea nitrogen) is incorrect. An elevated BUN level can indicate kidney dysfunction or dehydration, but it's not typically associated with azathioprine's adverse effects. Azathioprine is known to affect bone marrow, leading to decreased blood cell counts, rather than directly impacting kidney function.
Choice B Reason:
WBC 3,000/mm³ (low white blood cell count) is correct. Azathioprine is an immunosuppressive medication used to treat various conditions, including rheumatoid arthritis. One of its known adverse effects is bone marrow suppression, which can lead to decreased production of blood cells, including white blood cells (WBCs). A low WBC count (leukopenia) can increase the risk of infections due to compromised immune function, making it an important adverse effect to monitor in individuals taking azathioprine.
Choice C Reason:
Hct 45% (hematocrit) is incorrect. A hematocrit of 45% is within the normal range for both men and women. Azathioprine adverse effects usually manifest as blood cell-related issues (such as leukopenia) rather than directly impacting hematocrit levels.
Choice D Reason:
Platelets 250,000/mm³: Platelets within the range of 150,000 to 400,000/mm³ are considered normal. Azathioprine typically affects white blood cells more prominently than platelet counts.

Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A Reason:
Furosemide is not correct. Furosemide is a diuretic used to treat conditions like heart failure and edema by increasing urine output. It is not a contraindication for sildenafil. However, it's essential to monitor blood pressure when these medications are used together, as both can potentially lower blood pressure.
Choice B Reason:
Albuterol is not correct. Albuterol is a bronchodilator commonly used to treat asthma and other respiratory conditions. It doesn't have direct contraindications with sildenafil for erectile dysfunction. Although both medications can cause some cardiovascular effects, they are not typically considered contraindications for each other.
Choice C Reason:
Indomethacin is not correct. Indomethacin is a nonsteroidal anti-inflammatory drug (NSAID) used to reduce inflammation and pain. While it can have effects on blood pressure and the cardiovascular system, it is not a direct contraindication for sildenafil specifically for erectile dysfunction.
Choice D Reason:
Nitroglycerin is correct. Nitroglycerin is a contraindication for sildenafil. Both medications can cause a significant drop in blood pressure. When taken together, they can potentiate each other's effects, leading to a severe decrease in blood pressure, which can be dangerous and potentially life-threatening. Therefore, individuals using nitroglycerin or any nitrate medications should not take sildenafil or other medications for erectile dysfunction due to the risk of hypotension (dangerously low blood pressure).

Correct Answer is C
Explanation
Choice A Reason:
"Limit your sodium intake." Is incorrect. Sodium restriction might be appropriate for some cardiovascular or renal conditions, but it is not specifically related to theophylline use.
Choice B Reason:
"Restrict milk products." is incorrect. Restricting milk products is not a necessary dietary consideration for theophylline. However, consuming high-fat dairy products may delay the absorption of theophylline, potentially affecting its effectiveness.
Choice C Reason:
"Avoid caffeinated beverages." Is correct. Theophylline is a bronchodilator used to treat respiratory conditions like asthma or chronic obstructive pulmonary disease (COPD). It belongs to the class of methylxanthine medications and acts similarly to caffeine. Consuming additional caffeine through beverages like coffee, tea, or certain sodas can increase the risk of adverse effects associated with theophylline, such as increased heart rate or nervousness. Hence, avoiding caffeinated beverages is advisable to minimize the risk of exacerbating these effects.
Choice D Reason:
"Take the medication with meals." Taking theophylline with or without meals is typically acceptable, but it's essential to maintain consistency in timing and avoid significant changes in dietary habits that might affect its absorption or metabolism.
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