A nurse is reviewing the BUN result of a client who is taking cyclosporine following a kidney transplant. Which of the following laboratory studies should the nurse recognize as another renal function study that should be monitored?

Bilirubin

Alkaline phosphatase

Amylase

Creatinine

Answer and Explanation

The Correct Answer is D

Choice A reason: Bilirubin assesses liver function, not kidneys. Cyclosporine’s nephrotoxicity affects glomerular filtration, not heme metabolism. Monitoring bilirubin is irrelevant for renal function in transplant clients, as it reflects hepatic or hemolytic processes, not kidney health or drug toxicity.
Choice B reason: Alkaline phosphatase evaluates liver or bone health, not kidneys. Cyclosporine may cause hepatotoxicity, but renal monitoring is critical due to its nephrotoxic potential. Alkaline phosphatase does not reflect glomerular or tubular function, making it unsuitable for assessing renal impact.
Choice C reason: Amylase measures pancreatic function, not kidneys. Cyclosporine’s nephrotoxicity affects renal filtration, not pancreatic enzymes. Monitoring amylase is irrelevant for kidney transplant clients, as it does not indicate renal impairment or cyclosporine’s toxic effects on kidney function.
Choice D reason: Creatinine is a key renal function marker, reflecting glomerular filtration rate. Cyclosporine’s nephrotoxicity elevates creatinine, indicating kidney damage. Monitoring it with BUN ensures early detection of renal impairment, guiding dose adjustments to prevent further injury in transplant clients.

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Correct Answer is A

Explanation

Choice A reason: Smoked salmon is high in tyramine, which phenelzine, an MAOI, prevents from being metabolized. This risks hypertensive crisis due to norepinephrine release, potentially causing stroke or cardiovascular complications. Avoiding tyramine-rich foods is critical for safety in clients on MAOI therapy.
Choice B reason: Cottage cheese is low in tyramine, safe for phenelzine users. Unlike aged cheeses, fresh dairy poses minimal risk of hypertensive crisis, as it lacks significant tyramine content. MAOIs require avoiding high-tyramine foods, making cottage cheese an acceptable dietary choice for these clients.
Choice C reason: Grapefruit affects CYP450 enzymes, interacting with some drugs, but is not contraindicated with phenelzine. It lacks significant tyramine, so it does not trigger hypertensive crises. Avoidance is unnecessary, as it does not impact MAOI metabolism or related cardiovascular risks.
Choice D reason: Fresh apples are low in tyramine and safe for phenelzine users. MAOIs require avoiding tyramine-rich foods like aged meats, but fresh fruits do not cause hypertensive crises, as they lack amino acids interacting with MAOI metabolism, making them safe for consumption.

A. The client exhibits increased energy and motivation. B. The client experiences self-doubt when making decisions. C. The client reports sleeping 12 hours per day. D. The client isolates themselves from social interactions.

Correct Answer is A

Explanation

Choice A reason: Increased energy and motivation signal improvement in major depressive disorder, countering fatigue and anhedonia. Serotonin and norepinephrine rebalance, often from treatment, restores drive and engagement, reflecting neurochemical stabilization in the brain’s limbic system, critical for mood regulation and recovery.
Choice B reason: Self-doubt in decision-making reflects persistent depressive symptoms, like low self-esteem and cognitive impairment. Negative thought patterns, driven by altered prefrontal cortex activity, indicate ongoing depression, not improvement, requiring adjusted interventions to address these neurocognitive deficits in major depressive disorder.
Choice C reason: Sleeping 12 hours daily indicates hypersomnia, a depressive symptom, suggesting no improvement. Disrupted circadian rhythms and serotonin dysregulation cause excessive sleep, contrasting with recovery signs like normalized sleep patterns. This reflects persistent neurochemical imbalances hindering mood stabilization in depression.
Choice D reason: Social isolation is a core depressive symptom, driven by anhedonia and low mood, indicating no improvement. Withdrawal reflects ongoing dopamine and serotonin imbalances, preventing social engagement. Recovery involves increased interaction, making isolation a sign of persistent major depressive disorder.

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A nurse is reviewing the BUN result of a client who is taking cyclosporine following a kidney transplant. Which of the following laboratory studies should the nurse recognize as another renal function study that should be monitored?

Nursing Test Bank

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