A nurse is monitoring a client who is receiving spironolactone. Which of the following findings should the nurse report to the provider?
- A. Serum Sodium 144 mEq/L
- B. Urine output 120 mL in 4 hr
- C. Serum Potassium 5.2 mEq/L
- D. Blood Pressure 140/90 mm Hg
Correct Answer: C
Rationale: Hyperkalemia (5.2 mEq/L, C) is a serious side effect of spironolactone, a potassium-sparing diuretic.
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The term 'chemical antagonism' means that:
- A. two drugs combine with one another to form an inactive compound
- B. two drugs combine with one another to form a more active compound
- C. two drugs combine with one another to form a more water soluble compound
- D. two drugs combine with one another to form a more fat soluble compound
Correct Answer: A
Rationale: Chemical antagonism involves a direct chemical interaction rendering the drug inactive, e.g., chelation.
Which action will the nurse take if a dosage is unclear on a health care provider's order?
- A. Ask the patient what dosage was given in the past.
- B. Ask another physician to determine the correct dosage.
- C. Tell the patient that the medication will not be given.
- D. Contact the health care provider to verify the correct dosage.
Correct Answer: D
Rationale: Any questionable orders should be verified by the health care provider who wrote the orders. The patient is not a reliable source of verification. The physician who wrote the order should verify it. It would be a medication error to withhold the dose instead of verifying it.
The anthelminthic whose dose is 400 gms stat for most worm infestation:
- A. Piperazine
- B. Mebendazole
- C. Albendazole
- D. Levamisole
Correct Answer: C
Rationale: Albendazole is commonly prescribed as a single 400 mg dose (stat) for most intestinal worm infestations, such as ascariasis and hookworm, due to its broad-spectrum efficacy.
A patient arrives at the health care clinic and informs the nurse that he has consumed several aspirin tablets for a severe headache over the past 24 hours. The nurse would be alert for which of the following as a harmful effect?
- A. Gastrointestinal bleeding
- B. Breathing difficulties
- C. Visual disturbances
- D. Loss of balance
Correct Answer: A
Rationale: Aspirin is potentially harmful and can cause gastrointestinal bleeding and salicylism. Breathing difficulties, visual disturbances, and loss of balance could be due to an illness or the effects of some other drug.
Combined alpha-beta antagonists are used to reduce the progression of heart failure because they:
- A. Vasodilate the peripheral vasculature
- B. Decrease cardiac output
- C. Increase renal vascular resistance
- D. Reduce atherosclerosis secondary to elevated serum lipoproteins
Correct Answer: A
Rationale: Alpha-beta blockers (e.g., carvedilol) vasodilate, reducing afterload in heart failure.