Nokea
A nurse is caring for a client who has prescriptions for spironolactone and lisinopril. The nurse should monitor for which of the following adverse effects?
- A. Hyperkalemia
- B. Hypoglycemia
- C. Hypokalemia
- D. Hyperglycemia
Correct Answer: A
Rationale: The correct answer is A: Hyperkalemia. Spironolactone is a potassium-sparing diuretic, which can lead to elevated potassium levels (hyperkalemia). Lisinopril is an ACE inhibitor that may also contribute to increased potassium levels. Monitoring for hyperkalemia is essential due to the risk of serious cardiac arrhythmias. Hypoglycemia (choice B) and hyperglycemia (choice D) are not typically associated with these medications. Hypokalemia (choice C) is the opposite of what is expected with spironolactone.
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A nurse is preparing to administer medications to a client. Which of the following client identifiers should the nurse use to verify that the correct client is receiving the medication? (Select all that apply.)
- A. Date of birth
- B. Facility identification number
- C. Name
- D. Physical location
- E. Room number
Correct Answer: A, B, C
Rationale: The correct identifiers for verifying the client are date of birth, facility identification number, and name. Date of birth ensures the client's age and helps avoid mix-ups with clients of the same name. Facility identification number uniquely identifies the client within the facility. Name is crucial for confirming the client's identity verbally. Physical location and room number are not reliable identifiers as clients may move within the facility. Overall, using a combination of unique identifiers helps prevent medication errors and ensures the correct client receives the right medication.
A nurse is reinforcing discharge teaching with a client who has a new diagnosis of type 2 diabetes mellitus and a prescription for exenatide. Which of the following instructions should the nurse include in the teaching?
- A. Contact the provider if you experience unexplained muscle pain.
- B. Inject the medication into the subcutaneous tissue of your abdomen.
- C. Take the medication at bedtime.
- D. Discard excess medication after 60 days.
Correct Answer: B
Rationale: The correct answer is B: Inject the medication into the subcutaneous tissue of your abdomen. Exenatide is a medication used to treat type 2 diabetes and is administered by subcutaneous injection. Injecting it into the abdomen allows for better absorption. It is important for the nurse to instruct the client on the correct administration technique to ensure the medication is effective.
Incorrect choices:
A: Contact the provider if you experience unexplained muscle pain - Although monitoring for side effects is important, muscle pain is not a common side effect of exenatide.
C: Take the medication at bedtime - Exenatide is typically taken before meals, not at bedtime.
D: Discard excess medication after 60 days - Exenatide must be refrigerated and has a shorter shelf life once opened, typically 30 days, not 60.
A nurse is preparing to administer medication to a client who has a new prescription. Which of the following actions should the nurse take first?
- A. Identify the client using two means of identification.
- B. Document the time of the medication administration.
- C. Validate the prescription with the available medication.
- D. Calculate the correct amount of the medication.
Correct Answer: A
Rationale: The correct answer is A. Identifying the client using two means of identification is the first step to ensure the right patient receives the right medication. This process involves checking the client's name, date of birth, and/or unique identifier against the prescription and their identification band. Documenting the time of administration (B) is important but should come after verifying the patient's identity. Validating the prescription (C) and calculating the correct amount (D) are essential steps but should follow patient identification to prevent errors.
A nurse is talking with a client who takes NSAIDs routinely to treat osteoarthritis and has a new prescription for misoprostol. The client asks the nurse why he needs the second medication. Which of the following is an appropriate response?
- A. Misoprostol will help prevent stomach ulcers, which can develop from taking NSAIDs for a long time.
- B. Misoprostol helps protect you against the effects long-term NSAID use can have on your kidney function.
- C. Misoprostol will boost the effectiveness of the NSAIDs, so you can get the same pain relief with lower dosages.
- D. Misoprostol is a very effective antacid that will help reduce the stomach irritation you can get from NSAIDs.
Correct Answer: A
Rationale: The correct answer is A because misoprostol is often prescribed along with NSAIDs to help prevent stomach ulcers that can develop from long-term NSAID use. NSAIDs can irritate the stomach lining and increase the risk of ulcers. Misoprostol works by reducing the production of stomach acid and protecting the stomach lining. Choices B, C, and D are incorrect because misoprostol is specifically used to protect the stomach from NSAID-related ulcers, not to protect kidney function, boost NSAID effectiveness, or act as an antacid.
A nurse in a provider's office is reviewing the laboratory findings of client who has been taking gemfibrozil for 3 months. Which of the following findings should the nurse expect?
- A. Increased serum creatinine
- B. Reduced serum calcium
- C. Increased Hgb
- D. Reduced triglycerides
Correct Answer: D
Rationale: The correct answer is D: Reduced triglycerides. Gemfibrozil is a lipid-lowering medication that works by decreasing triglyceride levels. The nurse should expect a reduction in triglycerides as a therapeutic effect of the medication. Option A (Increased serum creatinine) is incorrect as gemfibrozil typically does not affect creatinine levels. Option B (Reduced serum calcium) is incorrect as gemfibrozil does not impact calcium levels. Option C (Increased Hgb) is incorrect as gemfibrozil does not directly affect hemoglobin levels. Therefore, the nurse should anticipate a decrease in triglyceride levels as the expected finding in a client taking gemfibrozil.