Nokea
A nurse caring for a client with diabetes controlled with metformin recently began taking a drug for edema. The nurse notices that the client's blood glucose levels are increasing. Which of the following diuretics are likely to cause hyperglycemia? Select all that apply.
- A. Hydrochlorothiazide
- B. Furosemide
- C. Chlorthalidone
- D. Acetazolamide
- E. Metolazone
Correct Answer: A,C,E
Rationale: Thiazide diuretics, like hydrochlorothiazide, chlorthalidone, and metolazone, can result in hyperglycemia in clients receiving antidiabetic drugs, like metformin.
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A nurse is caring for a client with increased intracranial pressure caused by cerebral edema. The physician has prescribed mannitol. After administering the drug, the nurse should do which of the following?
- A. Monitor blood pressure every 4 hours
- B. Check response of pupils to light
- C. Monitor client for joint pain
- D. Monitor serum uric acid concentrations
Correct Answer: B
Rationale: When caring for a client who has been given mannitol for intracranial pressure, the nurse should perform neurologic assessments such as response of the pupils to light, level of consciousness, or response to a painful stimulus.
A nurse may notice a decrease in diuretic effect when furosemide (Lasix) is given with which of the following drugs? Select all that apply.
- A. Phenytoin
- B. Naproxen
- C. Digoxin
- D. Lithium
- E. Ibuprofen
Correct Answer: A,B,E
Rationale: A nurse may notice a decrease in diuretic effect when furosemide (Lasix) is given with hydantoins (phenytoin) and NSAIDs (naproxen and ibuprofen).
A client is prescribed metolazone. As part of the client's teaching plan, the nurse instructs the client to increase his consumption of potassium-rich foods. The nurse determines that the teaching was successful when the client identifies which of the following as a good choice? Select all that apply.
- A. Bananas
- B. Shrimp
- C. Asparagus
- D. Salmon
- E. Peanuts
Correct Answer: A,C,D,E
Rationale: The top 10 foods with the highest amount of potassium per serving include white beans, dark leafy greens, baked potatoes with skin on, dried apricots, acorn squash, plain low-fat yogurt, salmon, avocado, mushrooms, and bananas.
A nurse is administering acetazolamide to a client. The nurse understands that this drug leads to excretion of which of the following? Select all that apply.
- A. Sodium
- B. Magnesium
- C. Potassium
- D. Bicarbonate
- E. Chloride
Correct Answer: A,C,D
Rationale: Carbonic anhydrase inhibitors, like acetazolamide, result in the excretion of sodium, potassium, bicarbonate, and water.
A nurse is reviewing the medical record of several clients who are prescribed amiloride. The nurse would identify a client with which condition as being at highest risk for developing hyperkalemia? Select all that apply.
- A. Diabetes
- B. Hypertension
- C. Renal disease
- D. Epilepsy
- E. Asthma
Correct Answer: A,C
Rationale: Hyperkalemia is most likely to occur in clients with an inadequate fluid intake and urine output, those with diabetes or renal disease, the elderly, and those who are severely ill.