Nokea
The nurse is caring for a patient who is taking spironolactone. Which of the following parameters should the nurse monitor?
- A. Decreased urinary output
- B. Evidence of fluid overload
- C. Increased serum sodium levels
- D. Elevated serum potassium levels
Correct Answer: D
Rationale: Spironolactone is a diuretic and it blocks aldosterone. Recalling that aldosterone increases the excretion of potassium, a medication that blocks aldosterone will tend to cause hyperkalemia. Aldosterone also promotes the reabsorption of sodium and water in the renal tubules, so spironolactone will tend to cause increased urine output, a decreased or normal serum sodium level, and signs of dehydration.
You may also like to solve these questions
Which of the following information about a patient who is scheduled for an oral glucose tolerance test should be reported to the health care provider before starting the test?
- A. Occasional orthostatic dizziness
- B. A 5 kg weight gain in the last month
- C. Intake of 1 L of water an hour previously
- D. Oral corticosteroid use for rheumatoid arthritis
Correct Answer: D
Rationale: Corticosteroids can affect blood glucose results. The other information will be provided to the provider but will not affect the test results.
The nurse is caring for a patient who was admitted with tetany. Which of the following laboratory values should the nurse monitor?
- A. Total protein
- B. Blood glucose
- C. Ionized calcium
- D. Serum phosphate
Correct Answer: C
Rationale: Tetany is associated with hypocalcemia. The other values would not be useful for this patient in relation to tetany.
The nurse is teaching a patient how to prepare for an oral glucose tolerance test (OGTT). Which of the following patient response indicates that the teaching has been effective?
- A. Fast 12 hours before the procedure
- B. Clear fluid diet 12 hours prior to the test
- C. Drink only full fluids 6 hours before the test
- D. No fluid or food restrictions prior to the test
Correct Answer: A
Rationale: Fasting for 12 hours before the procedure demonstrates that teaching has been effective. The patient is to be NPO 12 hours prior to the test. A clear fluid diet 12 hours pretest is not indicated. A full fluid diet 6 hours pretest is not indicated.
A patient has a total serum calcium level of 3.3 mmol/L. Which of the following laboratory results should the nurse assess next?
- A. Calcitonin
- B. Catecholamine
- C. Thyroid hormone
- D. Parathyroid hormone
Correct Answer: D
Rationale: Parathyroid hormone is the major controller for blood calcium levels. Although calcitonin secretion is a counter-mechanism to parathyroid hormone, it does not play a major role in calcium balance. Catecholamine and thyroid hormone levels do not affect serum calcium level.
The nurse is caring for a patient who has clinical manifestations of hypothyroidism. Which of the following laboratory tests is most accurate to evaluate thyroid function?
- A. Thyroxine (T4) level
- B. Triiodothyronine (T3) level
- C. Thyroid-stimulating hormone (TSH) level
- D. Thyrotropin-releasing hormone (TRH) level
Correct Answer: C
Rationale: The most sensitive and accurate laboratory test is measurement of TSH; thus it is often recommended as a first diagnostic test for evaluation of thyroid function. A low TSH level indicates that the patient's hypothyroidism is caused by decreased anterior pituitary secretion of TSH. Low T4 and T3 levels are not diagnostic of the primary cause of the hypothyroidism. TRH levels indicate the function of the hypothalamus.