A nurse is reviewing the laboratory results of a client who is taking amitriptyline. Which of the following laboratory values should to the provider?
Potassium 4.2 mEq/L
Total bilirubin 1.5 mg/dL
WBC count 5.000/mm²
Hct 44
The Correct Answer is B
A. Potassium 4.2 mEq/L: While potassium levels should be monitored during amitriptyline therapy, the value of 4.2 mEq/L is within the normal range. There is no immediate concern based on this potassium level.
B. Total bilirubin 1.5 mg/dL
Amitriptyline, a tricyclic antidepressant, can sometimes cause hepatotoxicity, which may manifest as elevated liver enzymes or bilirubin levels. Therefore, any abnormality in liver function tests, such as total bilirubin, should be reported to the provider for further evaluation and management.
C. WBC count 5,000/mm³: The white blood cell count is not a commonly monitored parameter for amitriptyline, and the value of 5,000/mm³ is within the normal range. There is no immediate concern based on this WBC count.
D. Hct 44: The hematocrit (Hct) level is related to the percentage of red blood cells in the blood. A value of 44% falls within the normal range for hematocrit. There’s no immediate concern related to amitriptyline use based on this result either.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Visual disturbances:
Visual disturbances, such as blurred or yellow-tinted vision, are common signs of digoxin toxicity. Clients should report any changes in vision promptly.
B. Potassium 4.4 mEq/L:
While electrolyte imbalances, particularly low potassium levels, can increase the risk of digoxin toxicity, a potassium level of 4.4 mEq/L is within the normal range and, by itself, does not indicate digoxin toxicity.
C. Insomnia:
Insomnia is not a typical sign of digoxin toxicity. Symptoms of toxicity are more likely to involve the gastrointestinal and visual systems.
D. Sudden weight gain:
Sudden weight gain can be a symptom of heart failure exacerbation but is not a direct indication of digoxin toxicity. Other signs, such as visual disturbances, are more specific to digoxin toxicity.
Correct Answer is B
Explanation
A. Simvastatin 40 mg PO at bedtime: This prescription is clear and specifies the medication (Simvastatin), the dose (40 mg), route (PO – oral), and timing (at bedtime). There is no need for clarification.
B. Morphine 4 mg IV every 4 hr PRN for pain: The need for clarification arises here because "PRN" (pro re nata) means "as needed," and prescribing an IV medication on an as-needed basis might need further clarification regarding the specific indications and circumstances for administering the medication.
C. Levothyroxine 100 mcg PO every morning: This prescription is clear and specifies the medication (Levothyroxine), the dose (100 mcg), route (PO – oral), and timing (every morning). There is no need for clarification.
D. Acetaminophen 500 mg every 4 hr PRN for fever: Similar to option B, there might be a need for clarification regarding the specific indications and circumstances for administering acetaminophen on an as-needed basis. However, in many cases, PRN for fever is reasonable, so it may not be as critical as in the case of an IV pain medication.
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