A nurse is caring for a client who has chronic renal disease and is receiving therapy with epoetin alfa.
Which of the following laboratory results should the nurse review for an indication of a therapeutic effect of the medication?
The hematocrit (Hct).
The erythrocyte sedimentation rate (ESR).
The platelet count.
The leukocyte count.
The Correct Answer is A
Choice A rationale
The hematocrit (Hct). This statement is correct. Epoetin alfa is used to treat anemia by stimulating the production of red blood cells. An increase in hematocrit levels indicates a therapeutic effect of the medication, as it reflects an increase in the proportion of red blood cells in the blood.
Choice B rationale
The erythrocyte sedimentation rate (ESR). This statement is incorrect. The ESR is a non- specific marker of inflammation and is not used to monitor the therapeutic effect of epoetin alfa. It does not provide information about red blood cell production or anemia.
Choice C rationale
The platelet count. This statement is incorrect. The platelet count measures the number of platelets in the blood, which are involved in clotting. It is not affected by epoetin alfa therapy and does not indicate the therapeutic effect of the medication.
Choice D rationale
The leukocyte count. This statement is incorrect. The leukocyte count measures the number of white blood cells in the blood, which are involved in the immune response. It is not affected by epoetin alfa therapy and does not indicate the therapeutic effect of the medication.
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Correct Answer is D
Explanation
Choice A rationale
A room that is within view of the nurses’ station is not suitable for a client with active tuberculosis. This placement does not provide the necessary isolation to prevent the spread of the infection to other patients and staff. Tuberculosis is an airborne disease, and the client needs to be in a room that minimizes the risk of airborne transmission.
Choice B rationale
A room with another nonsurgical client is also inappropriate for a client with active tuberculosis. Placing the client with another patient increases the risk of transmission of the infection. Tuberculosis requires strict airborne precautions, and the client should be in a private room with appropriate ventilation.
Choice C rationale
A room in the ICU is not necessary unless the client requires intensive care for other reasons. The primary concern for a client with active tuberculosis is to prevent the spread of the infection, which can be effectively managed in a regular medical-surgical unit with proper isolation measures.
Choice D rationale
A room with air exhaust directly to the outdoor environment is the correct choice. This type of room, often referred to as a negative pressure room, ensures that air from the room does not flow to other parts of the facility, thereby preventing the spread of infectious airborne particles. This setup is essential for managing clients with active tuberculosis.
Correct Answer is D
Explanation
Choice A rationale
The SA node sending an electrical signal greater than 100/min describes sinus tachycardia, not atrial fibrillation. In atrial fibrillation, the issue is not with the SA node but with the atria’s chaotic electrical activity.
Choice B rationale
An early electrical signal occurring before the expected SA node signal describes a premature atrial contraction (PAC), not atrial fibrillation. PACs are isolated events, whereas atrial fibrillation involves sustained irregular electrical activity.
Choice C rationale
Slow electrical transmission through the AV node describes a heart block, not atrial fibrillation. In atrial fibrillation, the problem is with the atria’s rapid and irregular electrical signals, not the AV node’s conduction speed.
Choice D rationale
Atrial fibrillation is characterized by rapid, chaotic, and irregular electrical signals in the atria. This leads to an irregular and often rapid heart rate, causing symptoms like dizziness and palpitations. .