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

Answer and Explanation

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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Correct Answer is ["A","C"]

Explanation

A. Absence of deep-tendon reflexes:
Absence of deep-tendon reflexes is a sign of magnesium toxicity. Magnesium sulfate, when infused in high doses, can lead to neuromuscular blockade and affect reflexes. Discontinuing the infusion and administering calcium gluconate can counteract the effects of magnesium.

B. Urine output 80 mL in 4 hours:
Urine output is not a direct indicator of magnesium toxicity. Monitoring urine output is important for assessing renal function, but it is not a specific sign of magnesium toxicity.

C. Decreased level of consciousness:
Decreased level of consciousness is another sign of magnesium toxicity. Central nervous system depression is a potential adverse effect of elevated magnesium levels. Administering calcium gluconate can help antagonize the effects of magnesium.

D. Report of chills:
Chills are not typically associated with magnesium toxicity. This symptom may indicate other issues, such as infection or discomfort.
E. Systolic blood pressure 130 mm/Hg:
Systolic blood pressure within a normal range is not a sign of magnesium toxicity. Blood pressure changes are not typically the primary indicators of magnesium toxicity.

A. Urine specific gravity 1.020 B. BUN 28 mg/dl C. Serum hematocrit 55% D. Serum osmolarity 310 mOsm

Correct Answer is D

Explanation

A. Urine specific gravity 1.020: While this value indicates concentrated urine and can be useful in assessing dehydration, it doesn’t specifically confirm effective treatment. High urine specific gravity suggests dehydration because the kidneys are conserving water, but it doesn’t directly confirm the effectiveness of treatment.
B. BUN 28 mg/dl (Blood Urea Nitrogen): Elevated BUN levels can be seen in dehydration, but it's not a direct marker of effective treatment. It indicates dehydration due to increased urea concentration in the blood but doesn’t confirm if the treatment has been effective or not.
C. Serum hematocrit 55%: In dehydration, the blood becomes more concentrated due to water loss, causing an increase in hematocrit levels. However, while this value might indicate dehydration initially, it may not specifically confirm the effectiveness of treatment once initiated.
D. Serum osmolarity 310 mOsm: Serum osmolarity measures the concentration of particles in the blood. In dehydration, the blood becomes more concentrated, leading to increased serum osmolarity. When treatment is effective, rehydration occurs, diluting the blood and bringing serum osmolarity back toward normal levels. Therefore, a decrease in serum osmolarity towards the normal range (280-300 mOsm) would indicate effective treatment of dehydration

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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?

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Naxlex Comprehensive Predictor Exams

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Explanation

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