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A patient with heart failure develops hyperaldosteronism and is prescribed spironolactone. What instructions should the nurse include in the patient’s care plan?
- A. Substitute salt with a salt substitute.
- B. Protect your skin before going outside.
- C. Limit intake of high-potassium foods.
- D. Monitor skin for excessive bruising.
Correct Answer: C
Rationale: This question is identical to Question 7. Spironolactone increases potassium retention, so limiting high-potassium foods (C) prevents hyperkalemia. Salt substitutes (A) contain potassium. Sun protection (B) and bruising (D) are unrelated. Note: Duplicate question; consider removing.
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The nurse administers naloxone to a patient with opioid-induced respiratory depression. An hour later, the nurse finds the patient has a respiratory rate of 4 breaths/minute, oxygen saturation of 75%, and is unresponsive. What action should the nurse take?
- A. Administer a second dose of naloxone.
- B. Prepare to assist with chest tube insertion.
- C. Determine Glasgow Coma Scale score.
- D. Initiate cardiopulmonary resuscitation (CPR).
Correct Answer: D
Rationale: Severe respiratory depression (4 breaths/min), hypoxia (75% SpO₂), and unresponsiveness require immediate CPR (D) to restore circulation/oxygenation. A second naloxone dose (A) may be needed but is secondary. Chest tubes (B) are irrelevant. Glasgow scoring (C) delays critical intervention.
The nurse initiates an infusion of piperacillin-tazobactam for a client with a urinary tract infection. Five minutes into the infusion, the client reports not feeling well. Which client manifestation should the nurse identify as a reason to stop the infusion?
- A. Hypertension.
- B. Scratchy throat.
- C. Bradycardia.
- D. Pupillary constriction.
Correct Answer: B
Rationale: A scratchy throat (B) may indicate an allergic reaction, potentially anaphylaxis, requiring immediate cessation of the piperacillin-tazobactam infusion and assessment. Hypertension (A), bradycardia (C), and pupillary constriction (D) are not typical signs of an allergic response to this antibiotic.
An adult patient at an outpatient clinic has been prescribed the antibiotic tetracycline HCl. What instructions should the nurse include in the patient’s teaching plan?
- A. Consume with milk or antacids to prevent gastrointestinal irritation.
- B. Protect your skin from sunlight while on this medication.
- C. Enhance gastrointestinal absorption by taking with orange juice.
- D. Return to the clinic weekly for serum drug level checks.
Correct Answer: B
Rationale: This question is identical to Question 9. Tetracycline increases photosensitivity, requiring sun protection (B). Milk/antacids (A) and orange juice (C) impair absorption. Weekly drug checks (D) are unnecessary. Note: Duplicate question; consider removing.
A client with chemotherapy-induced nausea receives a prescription for metoclopramide. Which adverse effect is most important for the nurse to report?
- A. Diarrhea.
- B. Unusual irritability.
- C. Nausea.
- D. Involuntary movements.
Correct Answer: D
Rationale: Involuntary movements (D), such as tardive dyskinesia, are a serious, potentially irreversible side effect of metoclopramide, requiring immediate reporting. Diarrhea (A) and irritability (B) are less severe. Nausea (C) is the treated condition, not an adverse effect.
When administering medications to a group of patients, which patient should the nurse closely monitor for the development of acute kidney injury (AKI)?
- A. Patient on Vancomycin.
- B. Patient on Sucralfate.
- C. Patient on Lorazepam.
- D. Patient on Digoxin.
Correct Answer: A
Rationale: Vancomycin (A) is nephrotoxic and requires monitoring for AKI, especially with high doses or prolonged use. Sucralfate (B) protects the stomach, not kidneys. Lorazepam (C) and digoxin (D) have minimal renal toxicity risks.