Page 1919 - Saunders Comprehensive Review For NCLEX-RN

Content Area: Pharmacology: Renal and Urinary Medications: Urinary tract
antiseptics
Health Problem: Adult Health: Renal and Urinary: Inflammation/Infections
Priority Concepts: Elimination; Safety
Reference: Lewis et al. (2017), p. 1036.

674. Answer: 1

Rationale: Epoetin alfa is synthetic erythropoietin, which the kidneys produce to
stimulate red blood cell production in the bone marrow. It is used to treat anemia
associated with chronic kidney disease. The normal hematocrit level is 42% to 52%
(0.42 to 0.52) for males and 37% to 47% (0.37 to 0.47) for females. Therapeutic effect is
seen when the hematocrit reaches between 30% and 33% (0.30 and 0.33). The normal
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3
platelet count is 150,000 to 400,000 mm (150 to 400 × 10 /L). The normal blood urea
nitrogen level is 10 to 20 mg/dL (3.6 to 7.1 mmol/L). The normal white blood cell
3
9
count is 5000 to 10,000 mm (5 to 10 × 10 /L). Platelet production, white blood cell
production, and blood urea nitrogen do not respond to erythropoietin.
Test-Taking Strategy: Focus on the subject, a therapeutic effect. Relate the name
of the medication, epoetin alfa, to the potential action or effect of erythropoietin. The
only laboratory test that would reflect the effect of this medication is a hematocrit of
33% (0.33), found in the correct option.
Level of Cognitive Ability: Evaluating
Client Needs: Physiological Integrity
Integrated Process: Nursing Process—Evaluation
Content Area: Pharmacology: Hematological Medications: Hematopoietic agents
Health Problem: Adult Health: Renal and Urinary: Chronic kidney disease
Priority Concepts: Clinical Judgment; Evidence
Reference: Skidmore-Roth (2017), p. 441.

675. Answer: 1

Rationale: Ciprofloxacin is prescribed for treatment of mild, moderate, severe,
and complicated infections of the urinary tract, lower respiratory tract, and skin and
skin structure. A single dose is administered slowly over 60 minutes to minimize
discomfort and vein irritation. Ciprofloxacin is not light-sensitive, may be infused
through a peripheral IV access, and is not given by IV push method.
Test-Taking Strategy: Focus on the subject, the appropriate way to administer an
IV medication ciprofloxacin. Recall that this medication has adverse effects, so IV
push would not be the recommended method of administration. Eliminate option 3
because of the closed-ended word, “only.” Next, it is necessary that the presence of
light does not affect the integrity of this medication.
Level of Cognitive Ability: Applying
Client Needs: Physiological Integrity
Integrated Process: Nursing Process—Implementation
Content Area: Pharmacology: Renal and Urinary Medications: Urinary tract
antiseptics
Health Problem: Adult Health: Renal and Urinary: Inflammation/Infections

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