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A home health nurse is visiting a client who is receiving diuretic therapy for congestive heart failure. Which medication places the client at risk for the development of hypokalemia?
- A. Aldactone (spironolactone)
- B. Demadex (torsemide)
- C. Dyrenium (triamterene)
- D. Midamor (amiloride hydrochloride)
Correct Answer: B
Rationale: Demadex, a loop diuretic, causes potassium loss, increasing the risk of hypokalemia, unlike potassium-sparing diuretics like Aldactone.
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A schizophrenic client has been taking haloperidol (Haldol) for 20 months and has developed moderate extrapyramidal symptoms (EPS). The nurse anticipates the physician will likely prescribe what medication for EPS?
- A. flumazenil (Anexate)
- B. donepezil (Aricept)
- C. naloxone (Narcan)
- D. benztropine (Cogentin)
Correct Answer: D
Rationale: Benztropine, an anticholinergic, treats EPS (e.g., dystonia, parkinsonism) caused by antipsychotics like haloperidol.
An elderly preoperative client seems very anxious but denies concerns when the nurse asks; however, the client's son confides that the client is very superstitious and believes it is bad luck that he is in room 113. Which of the following actions is the best response?
- A. Reassure the client that the room number will not affect his surgery outcome.
- B. Contact the admissions department and request that the client be reassigned to a different room.
- C. Ask the physician for medication to relax the client.
- D. Ask the son to stay with the client to reassure him.
Correct Answer: B
Rationale: Reassigning the client to a different room (B) addresses the client's anxiety by respecting his superstitious beliefs, promoting comfort. Reassurance (A), medication (C), or family presence (D) may not fully alleviate the specific concern.
The nurse is preparing a client with type 2 diabetes for a CT with contrast to evaluate diverticulitis with a possible mass. Which of the following medications on the client's medication list would be of concern to the nurse?
- A. fish oil
- B. warfarin (Coumadin)
- C. fluoxetine (Prozac)
- D. metformin (Glucophage)
Correct Answer: D
Rationale: Metformin should be held before and after contrast CT due to the risk of lactic acidosis if renal function is impaired by contrast dye.
The charge nurse on a surgical unit incorporates an authoritative style of leadership. Which characteristics describe this style of leadership? Select all that apply.
- A. involves little planning
- B. motivates staff by coercion
- C. motivates staff by supporting their achievements
- D. involves communication flow down the chain of command
- E. includes group members in the decision-making process
Correct Answer: B, D
Rationale: Authoritative leadership involves top-down communication and can use coercion to motivate, focusing on control rather than collaboration or support.
In planning care for the patient with ulcerative colitis, the nurse identifies which nursing diagnosis as a priority?
- A. Anxiety
- B. Impaired skin integrity
- C. Fluid volume deficit
- D. Nutrition altered, less than body requirements
Correct Answer: C
Rationale: Fluid volume deficit is a priority in ulcerative colitis due to frequent diarrhea, which can lead to dehydration.