Mr. Ramos consulted at the health center for follow up after one month of Isoniazid and Rifampicin. Which diagnostic test will have an abnormal result if the client is taking these medications?

Correct Answer: C

Rationale: The client is taking Isoniazid and Rifampicin, which are two common first-line medications prescribed for the treatment of tuberculosis. Both of these drugs can potentially cause liver toxicity as a side effect. Therefore, the diagnostic test that is most likely to have an abnormal result if the client is taking these medications is the liver function tests. These tests include parameters such as alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), and bilirubin levels, which can indicate liver damage or dysfunction. Monitoring liver function is essential during treatment with these medications to detect any hepatic adverse effects early and make appropriate management decisions.

Correct Answer: B

Rationale: Carbamazepine is a known enzyme inducer, and it can increase the metabolism of other drugs, such as phenytoin (Dilantin). This can lead to lower levels of phenytoin in the blood and potentially reduce its effectiveness. Therefore, patients taking carbamazepine should be monitored for elevated levels of phenytoin to ensure optimal seizure control. Diplopia (double vision), leukocytosis, and adult respiratory distress syndrome are not typically associated with carbamazepine use.

Correct Answer: D

Rationale: During the first 24 hours after a client is diagnosed with Addisonian crisis, it is crucial for the nurse to frequently assess the client's vital signs. Addisonian crisis is a life-threatening condition resulting from acute adrenal insufficiency. Monitoring vital signs such as blood pressure, heart rate, respiratory rate, and temperature can provide valuable information about the client's condition and response to treatment. Changes in vital signs may indicate worsening or improvement in the client's health status, helping the nurse to make timely interventions and adjustments in the client's care plan. Regular assessment of vital signs is essential in managing the client's stability and preventing complications during this critical period.

Correct Answer: C

Rationale: The signs and symptoms of headache, sweating, tremor, pallor, and nervousness described in the client suggest hypoglycemia, which is caused by low blood sugar levels. Insulin is a medication used to lower blood sugar levels in individuals with diabetes. In this case, the client has taken a combination of regular insulin and NPH insulin before breakfast, which could have led to a rapid drop in blood sugar levels by the afternoon causing the symptoms described. It is important to treat hypoglycemia promptly by giving the client a fast-acting carbohydrate source, such as glucose tablets or juice, to raise their blood sugar back to a safe level.

Correct Answer: A

Rationale: The most important instruction to include in the client's teaching plan would be to maintain a moderate exercise routine (Option A). Regular physical activity is important for overall health, including helping to maintain bone health and strength. This is particularly crucial for individuals with hyperparathyroidism who are declining surgery and opting for hormone replacement therapy, as exercise can help to support bone density and reduce the risk of fractures. However, it is essential to emphasize that the exercise should be moderate and appropriate for the individual's current fitness level, as excessive exercise can have negative effects on bone health in this population.