A client has been prescribed metoclopramide. Which of the following should the nurse include in client education regarding this medication?
- A. Notify your provider if you experience restlessness or spasms of the face or neck
- B. This medication can cause insomnia
- C. Decrease your fluid intake while taking this medication
- D. This medication can cause urinary frequency
Correct Answer: A
Rationale: The correct answer is A: 'Notify your provider if you experience restlessness or spasms of the face or neck.' Metoclopramide can lead to extrapyramidal symptoms such as restlessness or facial spasms, which are serious and require immediate medical attention. Choices B, C, and D are incorrect. Insomnia is not a common side effect of metoclopramide. Increasing fluid intake is usually recommended to prevent dehydration caused by potential side effects like diarrhea. Urinary frequency is not a typical side effect associated with metoclopramide.
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A client has been prescribed lisinopril. Which of the following medication interactions should the nurse instruct this client about?
- A. Potassium supplements
- B. Ciprofloxacin
- C. Escitalopram
- D. Magnesium supplements
Correct Answer: A
Rationale: The correct answer is A: Potassium supplements. Clients taking lisinopril should avoid potassium supplements and potassium-sparing diuretics due to the risk of hyperkalemia. This interaction can lead to dangerously high levels of potassium in the blood, which can be harmful. Choice B, Ciprofloxacin, is not typically associated with a significant interaction with lisinopril. Choice C, Escitalopram, is an antidepressant and does not have a known significant interaction with lisinopril regarding potassium levels. Choice D, Magnesium supplements, are generally safe to take with lisinopril and do not pose a significant risk of hyperkalemia.
A nurse is caring for a client receiving IV vancomycin. The nurse notes flushing of the client's neck and chest. Which of the following actions should the nurse take?
- A. Stop the infusion
- B. Document the findings as a harmless reaction
- C. Slow the infusion rate
- D. Administer diphenhydramine
Correct Answer: C
Rationale: The correct action for the nurse to take when a client receiving IV vancomycin shows flushing of the neck and chest is to slow the infusion rate. Flushing is a common sign of Red Man Syndrome, which is associated with rapid infusions of vancomycin. Slowing down the infusion rate can help prevent further flushing and the development of Red Man Syndrome. Stopping the infusion (Choice A) may be too drastic if the symptoms are mild and can be managed by slowing the rate. Documenting the findings as a harmless reaction (Choice B) is incorrect because flushing should be addressed promptly to prevent complications. Administering diphenhydramine (Choice D) is not the initial or best intervention for flushing associated with vancomycin; slowing the infusion rate is the priority.
A client is prescribed spironolactone. Which of the following findings would indicate an adverse effect of this medication?
- A. Hyperkalemia
- B. Hypokalemia
- C. Hyponatremia
- D. Hypernatremia
Correct Answer: A
Rationale: Hyperkalemia is the correct answer as it is an adverse effect associated with spironolactone, a potassium-sparing diuretic. Spironolactone works by blocking the aldosterone receptor in the distal convoluted tubule, leading to decreased potassium excretion and potential hyperkalemia. Hypokalemia (choice B) and hyponatremia (choice C) are not typically associated with spironolactone use. Hypernatremia (choice D) is also an unlikely finding with spironolactone.
A nurse is preparing to administer furosemide to a client. Which of the following findings indicates the client may be at risk for an adverse effect of the medication?
- A. Hypertension
- B. Hypokalemia
- C. Increased urine output
- D. Hyperglycemia
Correct Answer: B
Rationale: The correct answer is B: Hypokalemia. Furosemide is a loop diuretic that can cause potassium depletion, leading to hypokalemia, which is a common adverse effect. Hypokalemia can result in serious complications like cardiac arrhythmias. Choices A, C, and D are not directly associated with the adverse effects of furosemide. Hypertension is a condition that furosemide is often used to treat, increased urine output is an expected effect of furosemide, and hyperglycemia is not a typical adverse effect of this medication.
A nurse is preparing to administer potassium chloride IV to a client. Which of the following actions should the nurse take to prevent complications?
- A. Administer the medication by IV bolus over 2 minutes
- B. Infuse the medication slowly using an IV pump
- C. Add the medication to an IV solution of D5W
- D. Dilute the medication in 5 mL of sterile water
Correct Answer: B
Rationale: The correct action to prevent complications when administering potassium chloride IV is to infuse the medication slowly using an IV pump. Rapid administration of potassium chloride can lead to complications such as hyperkalemia and cardiac arrest. Options A, C, and D are incorrect as they do not promote the safe administration of potassium chloride. Administering the medication by IV bolus over 2 minutes is too rapid and can cause adverse effects. Adding the medication to an IV solution of D5W or diluting it in sterile water may not control the rate of administration, increasing the risk of complications.