A nurse is reviewing the laboratory findings for a female client who is taking zidovudine to treat HIV. Which of the following should the nurse identify as an adverse finding associated with this medication?
Neutrophil count 650/mm³ (2,500 to 8,000/mm³).
Platelets 450,000/mm³ (150,000 to 400,000/mm³).
Hgb 17 g/dL (12 to 16 g/dL).
Creatinine 1.5 mg/dL (0.5 to 1 mg/dL).
The Correct Answer is A
Choice A rationale
A neutrophil count of 650/mm³ is significantly lower than the normal range (2,500 to 8,000/mm³) and indicates neutropenia, which is a known adverse effect of zidovudine. Neutropenia increases the risk of infections and requires close monitoring and potential dose adjustment or discontinuation of the medication.
Choice B rationale
A platelet count of 450,000/mm³ is slightly above the normal range (150,000 to 400,000/mm³) but is not typically associated with zidovudine toxicity. Zidovudine is more commonly associated with bone marrow suppression leading to anemia and neutropenia rather than thrombocytosis.
Choice C rationale
An Hgb level of 17 g/dL is above the normal range for females (12 to 16 g/dL) but is not a common adverse effect of zidovudine. Zidovudine is more likely to cause anemia, leading to lower hemoglobin levels rather than elevated levels.
Choice D rationale
A creatinine level of 1.5 mg/dL is within the upper limit of the normal range (0.5 to 1 mg/dL) and is not a typical adverse effect of zidovudine. Zidovudine primarily affects the bone marrow and does not have a significant impact on renal function.
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Correct Answer is D
Explanation
Choice A rationale
Sitagliptin is a DPP-4 inhibitor used to manage blood sugar levels in type 2 diabetes but does not specifically slow the progression of nephropathy.
Choice B rationale
Glipizide is a sulfonylurea that helps control blood sugar levels but does not have a direct effect on slowing nephropathy progression.
Choice C rationale
Metoprolol is a beta-blocker used to manage hypertension but does not specifically target nephropathy progression.
Choice D rationale
Losartan is an angiotensin II receptor blocker (ARB) that helps manage hypertension and has been shown to slow the progression of nephropathy in patients with type 2 diabetes.
Correct Answer is ["C","E"]
Explanation
Choice A rationale
Glucose levels are not typically monitored for patients receiving gentamicin.
Choice B rationale
Prothrombin time is not typically monitored for patients receiving gentamicin.
Choice C rationale
Serum creatinine should be monitored because gentamicin can cause nephrotoxicity, and elevated serum creatinine levels can indicate kidney damage.
Choice D rationale
Cardiac enzymes are not typically monitored for patients receiving gentamicin.
Choice E rationale
WBC count should be monitored because gentamicin can cause leukopenia or other changes in white blood cell counts.