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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?

A.

Neutrophil count 650/mm³ (2,500 to 8,000/mm³).

B.

Platelets 450,000/mm³ (150,000 to 400,000/mm³).

C.

Hgb 17 g/dL (12 to 16 g/dL).

D.

Creatinine 1.5 mg/dL (0.5 to 1 mg/dL).

Answer and Explanation

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

Immediate-release exenatide pens should be discarded 30 days after the first use, not two months. This ensures the medication remains effective and free from contamination.

Choice B rationale

Exenatide is administered subcutaneously, not intramuscularly. The preferred injection sites are the abdomen, thigh, or upper arm.

Choice C rationale

Open exenatide pens should be stored at room temperature, but this is not the most critical aspect of patient education. Proper storage ensures the medication’s stability and effectiveness.

Choice D rationale

Immediate-release exenatide should be taken one hour before morning and evening meals to optimize its glucose-lowering effects by enhancing insulin secretion in response to meals.

Correct Answer is A

Explanation

Choice A rationale

Elevated alanine aminotransferase (ALT) is an adverse effect of simvastatin therapy. Statins, including simvastatin, can cause liver damage, which is indicated by elevated liver enzymes such as ALT2.

Choice B rationale

Elevated troponin T is not typically associated with simvastatin therapy. Troponin T is a marker for cardiac muscle damage, not a common adverse effect of statins.

Choice C rationale

Elevated WBC count is not a known adverse effect of simvastatin therapy. An elevated WBC count usually indicates an infection or inflammation.

Choice D rationale

Elevated thyroid-stimulating hormone (TSH) is not associated with simvastatin therapy. TSH levels are related to thyroid function, not the effects of statins.

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