A nurse is providing teaching to a client who has a history of diabetes mellitus and a new prescription for hydrochlorothiazide to treat uncontrolled hypertension. Which of the following information should the nurse include in the teaching?
"Blood glucose monitoring is likely to be inaccurate while taking hydrochlorothiazide
"You might need to decrease your insulin dosage while taking hydrochlorothiazide."
Hydrochlorothiazide therapy can elevate blood glucose levels in clients who have diabetes
Reducing sodium in your die whim taking your control your blood glucose."
The Correct Answer is C
The nurse should include in the teaching that hydrochlorothiazide therapy can elevate blood glucose levels in clients who have diabetes. Hydrochlorothiazide is a diuretic commonly used to treat hypertension (high blood pressure). While it is effective in reducing blood pressure, it can sometimes cause adverse effects on blood glucose levels, particularly in individuals with diabetes mellitus.
Hydrochlorothiazide can cause an increase in blood glucose levels by reducing insulin sensitivity, leading to potential hyperglycemia (high blood sugar) in some individuals. Clients with diabetes should closely monitor their blood glucose levels while taking hydrochlorothiazide and inform their healthcare provider if they notice significant changes.
Let's go through the other options:
A. "Blood glucose monitoring is likely to be inaccurate while taking hydrochlorothiazide": This statement is not accurate. Hydrochlorothiazide does not directly affect the accuracy of blood glucose monitoring. However, it is essential for clients with diabetes to be aware of the potential impact of hydrochlorothiazide on their blood glucose levels.
B. "You might need to decrease your insulin dosage while taking hydrochlorothiazide": Hydrochlorothiazide can potentially elevate blood glucose levels, which may require adjustments in diabetes management, including insulin dosage. However, it is not accurate to state that all clients will need to decrease their insulin dosage while taking hydrochlorothiazide. Each client's response to the medication may vary, and adjustments to diabetes medications should be made under the guidance of their healthcare provider based on individual blood glucose monitoring.
D. "Reducing sodium in your diet can help control your blood glucose while taking hydrochlorothiazide": While reducing sodium in the diet is generally a beneficial recommendation for individuals with hypertension, it is not directly related to controlling blood glucose levels in clients with diabetes. The primary focus for individuals with diabetes taking hydrochlorothiazide should be on monitoring blood glucose levels and working with their healthcare provider to manage any changes related to the medication.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Neonatal abstinence syndrome (NAS) is a group of withdrawal symptoms that occur in newborns who were exposed to drugs, including heroin, in utero. Hyporeflexia, which refers to reduced or diminished reflexes, is one of the key findings in neonates experiencing NAS.
During pregnancy, when the mother uses opioids like heroin, the baby becomes dependent on the drug. After birth, when the drug is no longer available, the baby experiences withdrawal symptoms as the body adjusts to the absence of the drug. Hyporeflexia is a common manifestation of NAS and is observed due to the central nervous system's response to the withdrawal.
Let's go through the other options:
B. Frequent yawning: While yawning can be seen in neonates with NAS, it is not as specific to the condition as hyporeflexia. Yawning can occur for various reasons and may not always be indicative of NAS.
C. Respiratory depression: Respiratory depression can be a severe complication of opioid exposure in utero and can result in life-threatening situations for the neonate. However, it is not specific to NAS. Respiratory depression is more closely associated with opioid overdose in the newborn, which can be a separate concern from NAS.
D. Constipation: Constipation is a possible symptom in neonates experiencing NAS, but it is not as specific as hyporeflexia. Constipation can occur due to various factors and is not unique to NAS.

Correct Answer is B
Explanation
A. History of asthma:Verapamil is a calcium channel blocker and does not affect the airways or cause bronchospasm, unlike beta-blockers, which can exacerbate asthma.
B. History of heart failure:Verapamil has negative inotropic effects, meaning it decreases the strength of heart contractions. This can exacerbate heart failure, particularly in clients with reduced ejection fraction (systolic heart failure). It is generally contraindicated in clients with severe heart failure as it can worsen symptoms.
C. Systolic BP 110 mm Hg:While verapamil can cause a drop in blood pressure due to its vasodilatory effects, a systolic blood pressure of 110 mm Hg is not an absolute contraindication.
D. A blood creatinine level of 1.0 mg/dL is within the normal range (approximately 0.6–1.2 mg/dL for adults). Verapamil is not contraindicated in clients with normal renal function.
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