A nurse is caring for a client who has cirrhosis of the liver and is receiving spironolactone. Which of the following findings indicates that the client responding to the treatment?

Decreased jaundice

Decreased ascites

Increased energy

Increased appetite

Answer and Explanation

The Correct Answer is B

A. Decreased jaundice: While spironolactone may indirectly improve liver function in clients with cirrhosis, its primary mechanism of action is to reduce fluid retention by inhibiting aldosterone, thereby decreasing sodium and water retention. Improvement in jaundice may occur over time as liver function improves, but it is not a direct indicator of spironolactone's effectiveness.

B. Decreased ascites: Spironolactone is commonly used to treat ascites, a common complication of cirrhosis resulting from fluid accumulation in the abdomen due to portal hypertension and hypoalbuminemia. The reduction of ascites indicates that spironolactone is effectively reducing fluid retention, a key therapeutic goal in clients with cirrhosis.

C. Increased energy: While improving fluid balance may indirectly contribute to increased energy levels by reducing the symptoms of fluid overload, increased energy is not a direct effect of spironolactone therapy. Other factors, such as improved liver function or nutritional status, may contribute to increased energy levels.

D. Increased appetite: Spironolactone is not typically associated with increasing appetite. While improving fluid balance may indirectly impact appetite by reducing symptoms of fluid overload such as abdominal distension or discomfort, increased appetite is not a primary therapeutic effect of spironolactone.

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Correct Answer is D

Explanation

A) Urinary output of 20 mL within 1 hr:
While low urinary output is a concern and could indicate issues such as dehydration or renal impairment, it is not the most immediate threat to the client's life when compared to respiratory depression.

B) Blood pressure 90/60 mm Hg:
A blood pressure of 90/60 mm Hg is hypotensive and should be monitored, but it is not as immediately life-threatening as respiratory depression in the context of morphine administration.

C) Vomiting 30 mL of fluid:
Vomiting is a common side effect of morphine but does not present as immediate a danger as respiratory depression. It can be managed with antiemetics and supportive care.

D) Respirations deep at a rate of 10/min:
Correct. Respiratory depression is a serious and potentially life-threatening side effect of morphine. A respiratory rate of 10 breaths per minute, even if the respirations are deep, indicates that the client's breathing is significantly slower than normal. This requires immediate attention because if untreated, it can lead to hypoxia, respiratory arrest, and death. The nurse should prioritize assessing and addressing this finding, potentially by reducing the morphine dose or administering naloxone if necessary.

A. Reason B. Route C. Dose D. Frequency

Correct Answer is A

Explanation

Answer: A. Reason

A. Reason
The prescription does not specify the reason for administering ondansetron, which is important for ensuring appropriate use. Clarifying the reason helps ensure the medication is used for the intended indication, such as nausea and vomiting due to chemotherapy, surgery, or other causes.

B. Route
The route is correctly specified as "by mouth," which is appropriate for ondansetron. There’s no need for clarification on this part.

C. Dose
The dose of 8 mg is a standard dose for ondansetron and does not require clarification.

D. Frequency
The frequency of "every 12 hr PRN" is clear, indicating that the medication can be taken every 12 hours as needed. This part does not need clarification.

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A nurse is caring for a client who has cirrhosis of the liver and is receiving spironolactone. Which of the following findings indicates that the client responding to the treatment?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is assessing an adult client who is receiving morphine via continuous IV infusion. The nurse should identify that which of the following is the priority finding?

Correct Answer is D

Explanation

A nurse is preparing to transcribe a prescription for a client that reads "ondansetron 8 mg by mouth every 12 hr PRN." Which of the following parts of the prescription should the nurse clarify with the provider?

Correct Answer is A

Explanation

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