A nurse is reviewing the laboratory results of a client who is taking amitriptyline. Which of the following laboratory values should the nurse report to the provider?

WBC count 5,000/mm.

Total bilirubin 1.5 mg/dL.

Hct 44%.

Potassium 5.2 mEq/L.

Answer and Explanation

The Correct Answer is D

A WBC count of 5,000/mm3 is low and could indicate leukopenia, a possible side effect of amitriptyline. Leukopenia increases the risk of infection and should be reported to the provider.

Choice B is wrong because a total bilirubin of 1.5 mg/dL is within the normal range of 0.3 to 1.9 mg/dL.

Choice C is wrong because a Hct of 44% is within the normal range of 37% to 48% for women and 45% to 52% for men.

Choice D is wrong because a potassium level of 4.2 mEq/L is within the normal range of 3.5 to 5.0 mEq/L.

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Correct Answer is C

Explanation

The correct answer is choice C. Keep the tablets at room temperature in their original glass bottle. Rationales: Choice A rationale: Taking one tablet each morning 30 minutes prior to eating is incorrect. Sublingual nitroglycerin is used to relieve acute angina attacks and is taken as needed rather than on a fixed schedule. Choice B rationale: Discarding any tablets not used every 6 months is incorrect. Sublingual nitroglycerin tablets should be replaced every 6 months to ensure potency, but this is not the main teaching point for safe storage. Choice C rationale: Keeping the tablets at room temperature in their original glass bottle is correct. Nitroglycerin tablets are sensitive to light and moisture, and the original glass bottle protects them from these elements, ensuring their effectiveness. Choice D rationale: Placing the tablet between the cheek and gum to dissolve is incorrect. Sublingual nitroglycerin tablets should be placed under the tongue where they dissolve and are absorbed quickly into the bloodstream for rapid relief of angina symptoms

A. The client had chemotherapy 12 hr before the medication was administered. B. The medication vial sat at room temperature for 2 hr before it was administered. C. The client’s absolute neutrophil count was 2,500/mm3 before the medication was administered. D. The nurse flushed the client’s IV line with dextrose 5% in water before and after the medication was administered.

Correct Answer is D

Explanation

The correct answer is d

Choice A reason:

Administering filgrastim 12 hours after chemotherapy does not typically require an incident report. Filgrastim is often given at least 24 hours after chemotherapy to avoid the risk of increasing the toxicity of the chemotherapy agents. While the timing is closer than recommended, it does not necessarily constitute an error unless specific instructions for the timing were provided by the prescribing physician.

Choice B reason:

The medication vial sitting at room temperature for 2 hours before administration does not require an incident report. Filgrastim can be left out at room temperature for up to 24 hours before use. This is within the safe handling guidelines for the medication.

Choice C reason:

An absolute neutrophil count (ANC) of 2,500/mm³ is within the normal range, which is typically 1,500-8,000/mm³. Filgrastim is used to increase neutrophil counts in patients with low ANC due to chemotherapy. Since the ANC was not low before administration, this would not necessitate an incident report, although it may prompt a review of the necessity of the medication.

Choice D reason:

Flushing the client's IV line with dextrose 5% in water before and after the medication was administered is not the standard procedure and could potentially lead to medication errors or adverse effects. Filgrastim should be diluted in glucose 5% in water for intravenous infusion, but not used to flush the line. This deviation from the standard protocol is what necessitates an incident report.

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A nurse is reviewing the laboratory results of a client who is taking amitriptyline. Which of the following laboratory values should the nurse report to the provider?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is teaching a client who has angina about a new prescription for sublingual nitroglycerin tablets. Which of the following instructions should the nurse include in the teaching?

Correct Answer is C

Explanation

A nurse recently administered filgrastim intravenously to a client who has cancer and is receiving cytotoxic chemotherapy. For which of the following data, discovered after the medication was administered, should the nurse file an incident report?

Correct Answer is D

Explanation

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