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A client is taking phenytoin (Dilantin) for seizure control, and a sample for a serum drug level is drawn. Which of the following indicates a therapeutic serum drug range?
- A. 5 to 10 mcg/mL
- B. 10 to 20 mcg/mL
- C. 20 to 30 mcg/mL
- D. 30 to 40 mcg/mL
Correct Answer: B
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
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A client with a history of chronic heart failure is prescribed spironolactone (Aldactone). Which of the following statements indicates that the client understands the medication teaching?
- A. I will avoid potassium-rich foods.
- B. I will not use a salt substitute.
- C. I will monitor my weight daily.
- D. I will increase my fluid intake as prescribed.
Correct Answer: A
Rationale: The correct statement is 'I will avoid potassium-rich foods.' Spironolactone (Aldactone) is a potassium-sparing diuretic, which can lead to hyperkalemia if potassium intake is not regulated. Therefore, avoiding potassium-rich foods is crucial to prevent this complication. Using a salt substitute can also increase potassium levels. Monitoring weight daily is essential in heart failure management, but it is not specific to spironolactone. Increasing fluid intake as prescribed is generally recommended for heart failure management but is not directly related to spironolactone use.
Prednisone is prescribed for a client with diabetes mellitus who is taking Humulin neutral protamine Hagedorn (NPH) insulin daily. Which of the following prescription changes does the nurse anticipate during therapy with prednisone?
- A. An additional dose of prednisone daily
- B. A decreased amount of daily Humulin NPH insulin
- C. An increased amount of daily Humulin NPH insulin
- D. The addition of an oral hypoglycemic medication daily
Correct Answer: C
Rationale: When prednisone is prescribed for a client with diabetes mellitus who is taking Humulin NPH insulin daily, the nurse should anticipate an increased amount of daily Humulin NPH insulin. Prednisone, a glucocorticoid, can elevate blood glucose levels, requiring an increase in insulin dosage to maintain optimal blood sugar control.
The client has begun medication therapy with pancrelipase (Pancrease MT). The nurse evaluates that the medication is having the optimal intended benefit if which effect is observed?
- A. Weight loss
- B. Relief of heartburn
- C. Reduction of steatorrhea
- D. Absence of abdominal pain
Correct Answer: C
Rationale: Pancrelipase (Pancrease MT) is a pancreatic enzyme replacement therapy used to aid digestion in clients with pancreatic insufficiency. One of the key goals of pancrelipase therapy is to reduce the amount of undigested fat in the stool, known as steatorrhea. Therefore, the nurse should evaluate the effectiveness of pancrelipase by looking for a reduction in steatorrhea, indicating improved digestion and absorption of fats.
Before administering furosemide (Lasix) to a client with heart failure, what is the most important laboratory test result for the nurse to check?
- A. Potassium level
- B. Creatinine level
- C. Cholesterol level
- D. Blood urea nitrogen
Correct Answer: A
Rationale: The correct answer is to check the potassium level before administering furosemide (Lasix) to a client with heart failure. Furosemide is a loop diuretic that can cause hypokalemia, so it is crucial to assess the potassium level to prevent complications like cardiac arrhythmias associated with low potassium levels.
A healthcare professional prepares to reinforce instructions to a client who is taking allopurinol (Zyloprim). The healthcare professional plans to include which of the following in the instructions?
- A. Instruct the client to drink 3000 mL of fluid per day.
- B. Instruct the client to take the medication with food.
- C. Inform the client that the effect of the medication will occur immediately.
- D. Instruct the client that, if swelling of the lips occurs, this is a normal expected response.
Correct Answer: A
Rationale: Allopurinol is an antigout medication that works by reducing the production of uric acid in the body. To prevent kidney stones and promote the excretion of uric acid, increased fluid intake is essential. Instructing the client to drink 3000 mL of fluid per day helps to reduce the risk of kidney stones and assists in the elimination of uric acid, thereby enhancing the effectiveness of allopurinol therapy.