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 B
Explanation
Choice A Reason:
Sodium 141 mEq/L is incorrect. This value is within the normal range (usually around 135-145 mEq/L).
Choice B Reason:
Potassium 2.5 mEq/ is correct. Furosemide, a loop diuretic, can lead to potassium loss through increased urine output. If a client already has a low potassium level (hypokalemia), administering furosemide can further decrease potassium levels, potentially causing or worsening hypokalemia. Hypokalemia can lead to various complications, including cardiac arrhythmias.
Choice C Reason:
WBC count 8,000/mm3 is incorrect. This value falls within the normal range for white blood cell count.
Choice D Reason:
INR 1.0: An INR of 1.0 is within the normal range for a person not on anticoagulation therapy.
Correct Answer is C
Explanation
Choice A Reason:
There's no requirement to lie down for an hour after administering nasal cyanocobalamin.
Choice B Reason:
The duration of treatment might vary depending on the healthcare provider's instructions and the client's response, so stating a specific duration of 6 months may not be accurate.
Choice C Reason:
"Administer the medication into one nostril once per week. “Nasal cyanocobalamin is typically used weekly for the treatment of pernicious anemia. It's administered into one nostril as directed by a healthcare provider. This method allows for the absorption of vitamin B12 through the nasal mucosa.
Choice D Reason:
Using a nasal decongestant before administering the medication is not typically part of the recommended administration protocol for nasal cyanocobalamin.
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