A nurse is assisting with a presentation about caring for clients who are receiving diuretic therapy. The nurse should explain that which of the following medications can put clients at risk for hyperkalemia?

Mannitol

Spironolactone

Hydrochlorothiazide

Furosemide

Answer and Explanation

The Correct Answer is B

A) Mannitol:
Mannitol is an osmotic diuretic that works by increasing the osmotic pressure in the glomerular filtrate, leading to increased urine output. It is not associated with causing hyperkalemia.

B) Spironolactone:
This is the correct choice. Spironolactone is a potassium-sparing diuretic that can put clients at risk for hyperkalemia. It works by blocking the action of aldosterone in the distal tubules of the kidneys, leading to decreased sodium reabsorption and increased potassium retention.

C) Hydrochlorothiazide:
Hydrochlorothiazide is a thiazide diuretic that promotes the excretion of sodium and water and can lead to potassium depletion (hypokalemia) rather than hyperkalemia.

D) Furosemide:
Furosemide is a loop diuretic that inhibits sodium and chloride reabsorption in the ascending loop of Henle. It can lead to potassium depletion (hypokalemia) rather than hyperkalemia.

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Correct Answer is A

Explanation

A) Atropine:
Atropine is a medication used to increase heart rate. It acts by blocking the parasympathetic nervous system, leading to increased heart rate. It is commonly used to treat bradycardia, which is characterized by a heart rate less than 60 beats per minute. In this scenario, with the client's apical heart rate at 49/min, indicating bradycardia, the nurse should prepare to administer atropine to increase the heart rate.

B) Verapamil:
Verapamil is a calcium channel blocker that can decrease heart rate. It is used to treat various cardiac conditions, but it is not appropriate for a client with bradycardia, as it would further lower the heart rate.

C) Digoxin:
Digoxin is a medication used to treat heart failure and certain arrhythmias, but it does not directly increase heart rate. In fact, it can exacerbate bradycardia in some cases.

D) Carvedilol:
Carvedilol is a beta-blocker that can decrease heart rate. It is used to treat hypertension, heart failure, and other cardiovascular conditions, but it is not appropriate for a client with bradycardia, as it would further lower the heart rate.

A. "I’ll breathe deeply and cough every 4 hours." B. "I’ll splint my incision with a pillow to cough." C. " I’ll start to use the incentive spirometer when I can get out of bed." D. " I’ll lie flat in bed to cough and deep breath."

Correct Answer is B

Explanation

(A) "I’ll breathe deeply and cough every 4 hours."
Deep breathing and coughing exercises should be done more frequently, typically every 1-2 hours while awake, to help prevent respiratory complications such as atelectasis and pneumonia.

(B) "I’ll splint my incision with a pillow to cough."
This statement indicates an understanding of the instructions. Splinting the incision with a pillow helps support the surgical site, reduces pain, and makes coughing more effective and less uncomfortable. This technique is important for clients to use to help clear secretions from the lungs postoperatively.

(C) "I’ll start to use the incentive spirometer when I can get out of bed."
The use of an incentive spirometer should begin as soon as possible, usually while the client is still in bed, to encourage deep breathing and prevent postoperative respiratory complications. It should not be delayed until the client can get out of bed.

(D) "I’ll lie flat in bed to cough and deep breathe."
Lying flat is not the optimal position for deep breathing and coughing exercises, as it can make it more difficult to fully expand the lungs. The client should be positioned with the head of the bed elevated or sitting up to facilitate better lung expansion and more effective coughing.

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A nurse is assisting with a presentation about caring for clients who are receiving diuretic therapy. The nurse should explain that which of the following medications can put clients at risk for hyperkalemia?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has a prescription for diltiazem. The nurse measures the client's vital signs and notes that the client's apical heart rate is 49/min. The nurse should prepare to administer which of the following medications?

Correct Answer is A

Explanation

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Correct Answer is B

Explanation

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