a client who received a kidney transplant is taking azathioprine imuran and the nurse provides instructions about the medication which statement by th

HESI RN

Pharmacology HESI

1. A client who received a kidney transplant is taking azathioprine (Imuran), and the nurse provides instructions about the medication. Which statement by the client indicates a need for further instructions?

A. I need to watch for signs of infection.
B. I need to discontinue the medication after 14 days of use.
C. I can take the medication with meals to minimize nausea.
D. I need to call the health care provider (HCP) if more than one dose is missed.

Correct answer: B

Rationale: Azathioprine is an immunosuppressant taken for life. Discontinuing the medication after 14 days is incorrect.

2. A client who is receiving digoxin (Lanoxin) daily has a serum potassium level of 3.0 mEq/L and is complaining of anorexia. A healthcare provider prescribes a digoxin level to rule out digoxin toxicity. A nurse checks the results, knowing that which of the following is the therapeutic serum level (range) for digoxin?

A. 3 to 5 ng/mL
B. 0.5 to 2 ng/mL
C. 1.2 to 2.8 ng/mL
D. 3.5 to 5.5 ng/mL

Correct answer: B

Rationale: The therapeutic serum level for digoxin ranges from 0.5 to 2 ng/mL. This range is considered optimal for therapeutic effects while minimizing the risk of toxicity. Levels above 2 ng/mL may lead to digoxin toxicity, which can manifest as anorexia among other symptoms. Therefore, the nurse should be vigilant in monitoring the digoxin levels to ensure the client's safety and therapeutic effectiveness of the medication.

3. A client with Crohn's disease is scheduled to receive an infusion of infliximab (Remicade). The nurse assisting in caring for the client should take which action to monitor the effectiveness of treatment?

A. Monitoring the leukocyte count for 2 days after the infusion
B. Checking the frequency and consistency of bowel movements
C. Checking serum liver enzyme levels before and after the infusion
D. Carrying out a Hematest on gastric fluids after the infusion is completed

Correct answer: B

Rationale: To monitor the effectiveness of infliximab (Remicade) treatment in a client with Crohn's disease, the nurse should observe the frequency and consistency of bowel movements. Infliximab is an immunomodulator that works to reduce inflammation in the colon, leading to improvements in bowel symptoms such as frequency and consistency. Monitoring these bowel patterns can provide valuable insight into the response to the medication and the overall management of Crohn's disease. Checking the leukocyte count (Choice A) is not specific to monitoring the effectiveness of infliximab for Crohn's disease. Checking serum liver enzyme levels (Choice C) may be important for liver function but does not directly monitor the effectiveness of infliximab. Carrying out a Hematest on gastric fluids (Choice D) is not relevant to monitoring the effectiveness of infliximab in Crohn's disease.

4. A client with hypertension is prescribed clonidine (Catapres) transdermal patch. Which statement by the client indicates an understanding of the medication?

A. I should change the patch daily.
B. I should remove the old patch before applying a new one.
C. I should avoid alcohol consumption while using this patch.
D. I should apply the patch to different sites each time.

Correct answer: B

Rationale: The correct answer is B. The client should remove the old clonidine (Catapres) patch before applying a new one to prevent overdose. The patch is typically changed every 7 days. Avoiding alcohol consumption is important as it can potentiate the sedative effects of clonidine. It is recommended to rotate application sites to prevent skin irritation and ensure optimal drug absorption.

5. When is the best time for a client to take a daily dose of prednisone?

A. At noon
B. At bedtime
C. Early morning
D. Anytime, at the same time each day

Correct answer: C

Rationale: The correct time for a client to take a daily dose of prednisone is early morning. Corticosteroids like prednisone should be taken in the morning to mimic the body's natural hormone release pattern. This timing helps reduce the risk of disrupting the body's internal clock and minimizes the potential for insomnia or other sleep disturbances.