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/mm²
Het 45W
Platelets 250.000/mm²
The Correct Answer is B
A. BUN 15 mg/dL (Blood Urea Nitrogen):
BUN is a measure of kidney function, and an elevated BUN may suggest impaired kidney function. However, it is not a specific marker for azathioprine adverse effects.
B. WBC 3,000/mm² (White Blood Cell count):
This is the correct answer. Azathioprine can suppress bone marrow function, leading to leukopenia (low white blood cell count). A WBC count of 3,000/mm² indicates a lower-than-normal white blood cell count, which can increase the risk of infection.
C. Hct 45% (Hematocrit):
Hematocrit measures the percentage of red blood cells in the blood. While it can be affected by various factors, it is not a specific marker for azathioprine adverse effects.
D. Platelets 250,000/mm²:
Platelets are involved in blood clotting, and a platelet count of 250,000/mm² is within the normal range. Azathioprine is not typically associated with adverse effects on platelet counts.
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Related Questions
Correct Answer is B
Explanation
A. Glasgow Coma Scale rating of 15: A Glasgow Coma Scale (GCS) rating of 15 is a positive sign indicating that the client is fully conscious and oriented. It is not an adverse effect of mannitol.
B. Crackles on auscultation: Crackles, also known as rales, can indicate fluid overload or pulmonary edema, which can be an adverse effect of mannitol. Mannitol can cause shifts of fluid, including into the lungs, leading to pulmonary edema.
C. Increase in urinary output: Mannitol is an osmotic diuretic, and an increase in urinary output is an expected and therapeutic effect of the medication. It is not considered an adverse effect.
D. Intracranial pressure reading of 12 mmHg: A decrease in intracranial pressure is a therapeutic effect of mannitol, and a reading of 12 mmHg is generally within a normal range. It is not considered an adverse effect.
Correct Answer is D
Explanation
A. Insulin glargine:
Insulin glargine is a long-acting insulin used to control blood sugar levels in people with diabetes. However, it is typically not the first-line choice for a client with a new diagnosis of metabolic syndrome and an HbA1c of 6.
B. Regular insulin:
Regular insulin is a short-acting insulin used to control blood sugar levels, but it is not typically the first choice for initial management of metabolic syndrome. It may be considered in certain situations, but other options are often explored first.
C. Exenatide:
Exenatide is a medication that belongs to the class of incretin mimetics and is used to improve blood sugar control. However, it may not be the first choice for initial treatment.
D. Metformin:
This is the correct answer. Metformin is a first-line medication for the treatment of type 2 diabetes and is commonly used to manage metabolic syndrome. It helps improve insulin sensitivity and reduce glucose production by the liver.
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