A nurse is collecting data from a client who has gout and is taking allopurinol. Which of the following adverse effects should the nurse identify as the priority to report to the provider?

Rash

Diarrhea

Nausea

Metallic taste in mouth

Answer and Explanation

The Correct Answer is A

A. Rash. A rash while taking allopurinol can indicate a serious hypersensitivity reaction, including Stevens-Johnson syndrome (SJS) or toxic epidermal necrolysis (TEN). These life-threatening conditions involve widespread skin blistering, mucosal involvement, and systemic symptoms. Immediate discontinuation of allopurinol and medical intervention are required to prevent severe complications.

B. Diarrhea. Mild gastrointestinal disturbances, including diarrhea, are common with allopurinol use. While bothersome, diarrhea is not life-threatening and can often be managed by adjusting the dose or taking the medication with food. It does not require immediate discontinuation unless severe or persistent.

C. Nausea. Nausea is a common, mild side effect of allopurinol that usually resolves with time or by taking the medication after meals. It is not an emergency and does not require urgent intervention unless accompanied by other concerning symptoms such as vomiting or severe abdominal pain.

D. Metallic taste in mouth. A metallic taste can occur with allopurinol use but is not harmful. It is a minor side effect that does not indicate toxicity or severe adverse reactions. Clients can be reassured that this effect is temporary and not a reason to stop the medication.

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Correct Answer is A

Explanation

A. Hemoglobin levels. Epoetin alfa stimulates erythropoiesis (red blood cell production) in clients with chronic renal failure, where natural erythropoietin production is impaired. The therapeutic effect of epoetin alfa is measured by monitoring hemoglobin (Hgb) levels to ensure adequate response without exceeding safe limits. Target Hgb levels should not exceed 11 g/dL, as higher levels increase the risk of thromboembolic events and hypertension.

B. Iron levels. While iron is necessary for red blood cell production, epoetin alfa does not directly affect iron levels. However, iron supplementation may be required if iron deficiency is present, as inadequate iron stores can limit the effectiveness of epoetin alfa therapy.

C. Platelet count. Epoetin alfa primarily affects red blood cell production and has no direct effect on platelet levels. Although polycythemia (excess red blood cells) can increase the risk of clot formation, platelet count is not the primary indicator of epoetin alfa’s therapeutic effects.

D. White blood cell count. Epoetin alfa does not impact white blood cell (WBC) production. Leukocyte production is regulated by different growth factors, and WBC monitoring is more relevant for conditions such as infections, chemotherapy-induced neutropenia, or bone marrow disorders.

A. Increased Hct B. Decreased WBC count C. Decreased heart rate D. Increased blood pressure

Correct Answer is C

Explanation

A. Increased Hct. Propylthiouracil (PTU) is an antithyroid medication that reduces excessive thyroid hormone production in Graves' disease. It does not directly affect hematocrit (Hct) levels. While anemia can occur in some clients with untreated hyperthyroidism, PTU itself is not expected to raise Hct.

B. Decreased WBC count. A serious adverse effect of PTU is agranulocytosis, which results in a dangerously low white blood cell (WBC) count, increasing the risk of infection. However, this is a potential complication rather than an expected therapeutic outcome. Clients on PTU require regular monitoring of WBC levels to detect early signs of agranulocytosis.

C. Decreased heart rate. Graves’ disease causes hyperthyroidism, which increases metabolism and leads to symptoms such as tachycardia. PTU works by inhibiting thyroid hormone synthesis, leading to a gradual reduction in heart rate as thyroid function normalizes. This is a desired outcome of treatment, helping to reduce cardiovascular strain associated with hyperthyroidism.

D. Increased blood pressure. Hyperthyroidism can cause elevated blood pressure due to increased cardiac output. As PTU lowers thyroid hormone levels, blood pressure is expected to decrease or stabilize rather than increase. An increase in blood pressure would be unexpected and may indicate another underlying issue requiring evaluation.

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A nurse is collecting data from a client who has gout and is taking allopurinol. Which of the following adverse effects should the nurse identify as the priority to report to the provider?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has chronic renal failure and is receiving epoetin alfa. To check for therapeutic effects, the nurse should monitor which of the following client laboratory tests?

Correct Answer is A

Explanation

A nurse is caring for a client who has Graves' disease and is to start therapy with propylthiouracil. The nurse should expect which of the following outcomes?

Correct Answer is C

Explanation

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