Nokea
A client is admitted to the hospital with findings of liver failure with ascites. The health care provider orders spironolactone (Aldactone). What is the pharmacological effect of this medication?
- A. Promotes sodium and chloride excretion
- B. Increases aldosterone levels
- C. Depletes potassium reserves
- D. Combines safely with antihypertensives
Correct Answer: A
Rationale: Spironolactone promotes sodium and chloride excretion while sparing potassium and decreasing aldosterone levels. It has no effect on ammonia levels.
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A newborn has hyperbilirubinemia and is undergoing phototherapy with a fiberoptic blanket. Which safety measure is most important during this process?
- A. Regulate the neonate's temperature using a radiant heater
- B. Withhold feedings while under the phototherapy
- C. Provide water feedings at least every 2 hours
- D. Protect the eyes of neonate from the phototherapy lights
Correct Answer: C
Rationale: Provide water feedings at least every 2 hours. Protecting the eyes of the neonates is very important to prevent damage when under the ultraviolet lights, but since the blanket is used, extra protection of the eyes is unnecessary. It is recommended that the neonate remain under the lights for extended periods. The neonate's skin is exposed to the light and the temperature is monitored, but a heater may not be necessary. There is no reason to withhold feedings. Frequent water or feedings are given to help with the excretion of the bilirubin in the stool.
The nurse is caring for a client with a history of heart failure who is receiving torsemide (Demadex) 20 mg PO daily. Which of the following laboratory results should the nurse report immediately?
- A. Potassium 3.0 mEq/L
- B. Sodium 140 mEq/L
- C. Creatinine 1.2 mg/dL
- D. Glucose 100 mg/dL
Correct Answer: A
Rationale: Hypokalemia (3.0 mEq/L) is a serious torsemide side effect, risking arrhythmias in heart failure. Options B, C, and D are normal.
The nurse is caring for a client who has psoriasis. Which observation by the nurse is most consistent with the diagnosis?
- A. The client has thick, yellow toenails.
- B. The client has open, weeping lesions.
- C. The skin lesions are multicolored.
- D. The pain follows a nerve root.
Correct Answer: B
Rationale: Psoriasis typically presents with dry, scaly plaques that may crack and weep, consistent with open lesions. Yellow nails, multicolored lesions, or nerve pain are unrelated.
The nurse is assigned to care for a client who had a myocardial infarction (MI) 2 days ago. The client has many questions about this condition. What area is a priority for the nurse to discuss at this time?
- A. Daily needs and concerns
- B. The overview cardiac rehabilitation
- C. Medication and diet guideline
- D. Activity and rest guidelines
Correct Answer: A
Rationale: At 2 days post-MI, the client's education should be focused on the immediate needs and concerns for the day.
A client receiving HTZ (hydrochlorothiazide) is instructed to increase her dietary intake of potassium. The best snack for the client requiring increased potassium is:
- A. A pear
- B. An apple
- C. An orange
- D. A banana
Correct Answer: D
Rationale: Hydrochlorothiazide is a diuretic that can cause potassium loss. Bananas are high in potassium, making them the best choice. Pears , apples , and oranges have less potassium.