An older female client comes to the clinic for a regular check-up. The client tells the nurse that she has increased her daily doses of acetaminophen for the past month to control joint pain. Based on this patient's comment, which previous laboratory results should the nurse compare with today's laboratory report?
Determine if there is a decrease in serum potassium due to renal compromise
Expect to find an increase in today's activated partial thromboplastin time (APTT) as compared to last quarter's due to bleeding.
Look at last quarter's hemoglobin and hematocrit, expecting an increase today due to dehydration.
Look for an increase in today's lactic dehydrogenase (LDH) compared to the previous one to assess for possible liver damage.
The Correct Answer is D
A. Determine if there is a decrease in serum potassium due to renal compromise: Acetaminophen is not commonly associated with significant renal impairment or changes in serum potassium levels, making this a less relevant consideration.
B. Expect to find an increase in today's activated partial thromboplastin time (APTT) as compared to last quarter's due to bleeding: Acetaminophen does not significantly affect APTT or bleeding risk, so changes in APTT would not be expected due to acetaminophen use.
C. Look at last quarter's hemoglobin and hematocrit, expecting an increase today due to dehydration: Acetaminophen is not known to cause changes in hemoglobin and hematocrit levels or dehydration-related increases in these values.
D. Look for an increase in today's lactic dehydrogenase (LDH) compared to the previous one to assess for possible liver damage: Acetaminophen overdose or chronic high use can lead to liver damage, which would be indicated by elevated LDH levels. Monitoring LDH is appropriate to assess for potential liver damage related to acetaminophen use.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. Administer both prescribed medications as scheduled: Given that the client's total calcium level is already elevated (14 mg/dL), administering additional calcium carbonate could exacerbate hypercalcemia. Calcitriol, a form of vitamin D, can also increase calcium levels, so administering it without addressing the high calcium level could worsen the condition.
B. Hold the calcium carbonate, but administer the calcitriol as scheduled: This option is not appropriate because calcitriol can further increase calcium levels, potentially worsening hypercalcemia. Both medications should be reviewed, and their administration should be adjusted according to the client's current calcium status.
C. Hold the calcitriol, but administer the calcium carbonate as scheduled: Holding calcitriol alone would not address the potential for further increasing calcium levels. Calcium carbonate should also be withheld since the client is already hypercalcemic.
D. Hold both medications until contacting the healthcare provider: This is the most appropriate action. The client's elevated calcium level indicates hypercalcemia, which requires careful management. The healthcare provider should be contacted to assess the situation and determine the appropriate course of action to avoid worsening hypercalcemia.
Correct Answer is D
Explanation
A. Low-density lipoprotein (LDL): Atorvastatin's primary effect is to decrease LDL cholesterol levels. A decrease in LDL levels would indicate the medication is working as intended, not an increase.
B. Prothrombin time (PT): PT is a measure of blood clotting, which is not directly affected by atorvastatin. This value is more relevant for monitoring anticoagulant therapy.
C. Creatine phosphokinase (CK): CK levels can be used to monitor for muscle damage or side effects related to statin use. An increase in CK levels would suggest muscle damage, not the effectiveness of the statin.
D. High-density lipoprotein (HDL): Atorvastatin is a statin medication used to lower cholesterol levels, particularly low-density lipoprotein (LDL) cholesterol, which is a key target in reducing the risk of coronary artery disease (CAD). While the primary goal of atorvastatin is to lower LDL cholesterol, an increase in HDL cholesterol (often termed "good" cholesterol) is also desirable as it can help reduce the risk of CAD. Therefore, an increase in HDL is a positive indicator that the medication is having a beneficial effect.
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