Before initiating a client with tuberculosis on anti-tuberculosis therapy with isoniazid (INH), a nurse ensures that which of the following baseline studies has been completed?

Correct Answer: C

Rationale: In the context of initiating a client with tuberculosis on isoniazid therapy, ensuring baseline liver enzyme levels have been completed is crucial. Isoniazid is known to cause hepatotoxicity, making monitoring liver function essential to detect early signs of liver damage. Elevated liver enzymes can indicate drug-induced liver injury, prompting timely intervention to prevent severe complications. Electrolyte levels (Option A) are not directly impacted by isoniazid therapy and do not require baseline monitoring for this specific medication. Coagulation times (Option B) and serum creatinine levels (Option D) are also unaffected by isoniazid and not necessary as baseline studies before starting treatment. Educationally, understanding the importance of baseline liver enzyme monitoring before initiating specific medications is vital for nursing practice. It emphasizes the need for individualized patient care, tailored monitoring strategies, and proactive identification of potential adverse drug reactions to ensure patient safety and treatment efficacy.

Correct Answer: C

Rationale: The correct answer is C. Hydrochlorothiazide is a thiazide diuretic, which can lead to hypokalemia, hyperglycemia, hypercalcemia, hyperlipidemia, and hyperuricemia. It is a sulfa-based medication, so individuals with a sulfa allergy are at risk for an allergic reaction when taking hydrochlorothiazide.

Correct Answer: B

Rationale: Nalidixic acid can intensify the effects of oral anticoagulants by displacing these agents from binding sites on plasma proteins. When an oral anticoagulant, like warfarin sodium (Coumadin), is combined with nalidixic acid, a decrease in the anticoagulant dosage may be necessary to avoid excessive anticoagulation and potential bleeding risks.

Correct Answer: B

Rationale: Bethanechol chloride (Urecholine) should not be administered to clients with urinary strictures as it can contract the bladder and increase pressure within the urinary tract. In individuals with urinary strictures, this elevated pressure may lead to bladder rupture. Therefore, caution is advised when considering the use of Bethanechol chloride in clients with urinary strictures to prevent potential complications.

Correct Answer: A

Rationale: Bethanechol chloride (Urecholine) stimulates muscarinic receptors, which can lead to bradycardia as an adverse effect. Monitoring for bradycardia is crucial when administering this medication. Constipation, hypertension, and dry mouth are not typically associated with the effects of bethanechol chloride.