A client with anemia secondary to chronic kidney disease (CKD) started a prescription for epoetin alfa two months ago. Which client finding best indicates that the medication is effective?Reference Range:• Hemoglobin (Hgb): 14 to 18 g/dL (8.7 to 11.2 mmol/L)

Choice A Reason:Reports of increased energy levels and decreased fatigue are subjective indicators of improvement in anemia symptoms. While these reports are important and suggest that the client is feeling better, they do not provide objective evidence of the effectiveness of epoetin alfa. Hemoglobin levels are a more precise measure of the medication’s impact on anemia.Choice B Reason:A food diary showing increased consumption of iron-rich foods indicates that the client is making dietary changes to support their anemia treatment. However, this does not directly measure the effectiveness of epoetin alfa. The medication’s primary goal is to stimulate red blood cell production, which is best assessed through hemoglobin levels.Choice C Reason:An increase in hemoglobin level to 12 g/dL (7.45 mmol/L) is an objective indicator that epoetin alfa is effective. Hemoglobin levels are a direct measure of the red blood cell count and oxygen-carrying capacity of the blood. An increase in hemoglobin levels indicates that the medication is successfully treating the anemia associated with CKD.Choice D Reason:Taking concurrent iron therapy without adverse effects is important for overall treatment adherence and minimizing side effects. However, it does not directly indicate the effectiveness of epoetin alfa. The primary measure of effectiveness is the improvement in hemoglobin levels.