a nurse is teaching a client who has a new prescription for spironolactone which of the following instructions should the nurse include
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ATI LPN

LPN Pharmacology Practice Questions

1. When teaching a client with a new prescription for spironolactone, which instruction should the nurse include?

Correct answer: D

Rationale: The correct answer is to instruct the client to monitor for signs of hyperkalemia when taking spironolactone since it is a potassium-sparing diuretic. Hyperkalemia is a potential adverse effect due to the medication's mechanism of action. Advising the client to increase potassium-rich foods (Choice A) would be incorrect as it can further elevate potassium levels, which could lead to hyperkalemia. Avoiding grapefruit juice (Choice B) is not directly related to spironolactone use. Though taking the medication with food (Choice C) can help reduce gastrointestinal upset, it is not the most critical instruction when initiating spironolactone therapy.

2. A client with chronic heart failure has been prescribed furosemide (Lasix). Which instruction should the nurse reinforce to the client regarding this medication?

Correct answer: C

Rationale: The correct instruction for the nurse to reinforce to the client regarding furosemide (Lasix) is to report any muscle cramps or weakness to the healthcare provider. Muscle cramps or weakness may indicate hypokalemia, a potential side effect of furosemide. Monitoring and reporting these symptoms promptly can help in preventing complications related to electrolyte imbalances. Choice A is incorrect because furosemide should be taken on an empty stomach. Choice B is not directly related to furosemide use; in fact, foods high in potassium may be beneficial for clients taking furosemide to prevent hypokalemia. Choice D is a common expected side effect of furosemide due to its diuretic action but is not as crucial to report as potential signs of electrolyte imbalances.

3. A nurse is assessing a client who has been taking phenytoin for epilepsy. Which of the following findings should the nurse report to the provider?

Correct answer: B

Rationale: The correct answer is B: Gingival hyperplasia. Phenytoin is known to cause gingival hyperplasia, an overgrowth of gum tissue, which can lead to oral health issues and requires dental care. Choices A, C, and D are not directly associated with phenytoin use. Weight loss, increased thirst, and frequent urination are not typically reported findings related to phenytoin and should not be prioritized over gingival hyperplasia when assessing a client taking this medication.

4. A client with a history of heart failure is admitted with a diagnosis of pulmonary edema. Which intervention should the LPN/LVN expect to assist with first?

Correct answer: B

Rationale: In a client with pulmonary edema, placing them in a high Fowler's position is the priority intervention. This position helps to improve ventilation and oxygenation by decreasing venous return, reducing the workload on the heart, and facilitating fluid redistribution from the lungs. It is crucial to optimize respiratory function and oxygenation before considering other interventions like administering medications, preparing for intubation, or inserting a urinary catheter. Administering a diuretic, preparing for intubation, or inserting a urinary catheter may be necessary but should follow the priority of improving oxygenation through positioning.

5. A client in the emergency department is bleeding profusely from a gunshot wound to the abdomen. In what position should the nurse immediately place the client to promote maintenance of the client's blood pressure above a systolic pressure of 90 mm Hg?

Correct answer: C

Rationale: In a client with profuse bleeding from a gunshot wound to the abdomen, maintaining the client in a supine position is essential to manage blood pressure. This position helps in reducing diaphragmatic pressure and allows for proper visualization of the wound, aiding in prompt assessment and intervention to control the bleeding and stabilize the client's condition. Placing the client in a 45-degree Trendelenburg position (Choice A) could worsen the bleeding by increasing intrathoracic pressure and venous return, potentially leading to further hemorrhage. Turning the client prone (Choice B) may not be feasible in this situation and can delay essential interventions. Placing the client on the right side (Choice D) does not address the immediate need to manage the bleeding and stabilize the client's condition.

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