A nurse is reviewing a patient’s medications before administration. Which drug-to-drug interactions will most concern the nurse in a patient with a history of heart failure and a potassium level of 5.5 mEq/L?

Metoprolol [Lopressor] and furosemide [Lasix]

Furosemide [Lasix] and enalapril [Vasotec]

Captopril [Capoten] and spironolactone [Aldactone]

Amlodipine [Norvasc] and propranolol [Inderal]

Answer and Explanation

The Correct Answer is C

Choice A reason: Metoprolol (beta-blocker) and furosemide (loop diuretic) are commonly used in heart failure. Furosemide may lower potassium, counteracting hyperkalemia (5.5 mEq/L), and metoprolol doesn’t significantly affect potassium. This combination poses less risk for hyperkalemia exacerbation, making it less concerning than potassium-sparing combinations.

Choice B reason: Furosemide promotes potassium excretion, potentially reducing hyperkalemia (5.5 mEq/L), while enalapril (ACE inhibitor) may increase potassium. However, furosemide’s effect often offsets enalapril’s, making this combination less likely to worsen hyperkalemia significantly compared to two potassium-sparing drugs, so this choice is less critical.

Choice C reason: Captopril (ACE inhibitor) and spironolactone (potassium-sparing diuretic) both increase potassium levels by reducing aldosterone activity, exacerbating hyperkalemia (5.5 mEq/L). In heart failure, this combination risks severe hyperkalemia, causing arrhythmias, making it the most concerning interaction requiring close monitoring or adjustment.

Choice D reason: Amlodipine (calcium channel blocker) and propranolol (beta-blocker) primarily affect blood pressure and heart rate, not potassium levels. Their interaction may cause bradycardia or hypotension but doesn’t worsen hyperkalemia (5.5 mEq/L), making this combination less concerning for the patient’s current electrolyte status.

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Free Nursing Study Resources

Correct Answer is ["A","C","D"]

Explanation

Choice A reason: Benzonatate suppresses cough by anesthetizing stretch receptors in the respiratory tract, reducing the cough reflex. It acts locally on nerve endings in the lungs and pleura, effectively decreasing cough frequency without systemic opioid effects, making it an appropriate choice for cough suppression.

Choice B reason: Guaifenesin is an expectorant, promoting mucus clearance by thinning secretions, not suppressing the cough reflex. It facilitates productive coughing rather than inhibiting it, making it ineffective for cough suppression and an incorrect choice for this indication in managing cough symptoms.

Choice C reason: Dextromethorphan suppresses cough by acting on the medulla’s cough center, reducing the urge to cough. As a non-opioid antitussive, it effectively controls non-productive cough without significant respiratory depression, making it a suitable and correct choice for cough suppression in various conditions.

Choice D reason: Codeine, an opioid, suppresses cough by acting on the central nervous system’s cough center, reducing reflex activity. It’s effective for non-productive cough but carries risks of sedation and dependency, making it a correct but cautiously used choice for cough suppression.

A. Respiratory alkalosis B. Respiratory acidosis C. Metabolic alkalosis D. Metabolic acidosis

Correct Answer is D

Explanation

Choice A reason: Respiratory alkalosis involves low PaCO2 (<35 mm Hg) due to hyperventilation, raising pH. Here, pH is 7.31 (acidic), PaCO2 is 41 mm Hg (normal), and HCO3- is 20 mEq/L (low), indicating a metabolic cause, not respiratory, making this choice incorrect.

Choice B reason: Respiratory acidosis requires elevated PaCO2 (>45 mm Hg), lowering pH. With PaCO2 at 41 mm Hg (normal) and low HCO3- (20 mEq/L), the acidosis stems from reduced bicarbonate, not CO2 retention, ruling out respiratory acidosis and making this choice incorrect.

Choice C reason: Metabolic alkalosis involves high HCO3- (>26 mEq/L) and elevated pH. Here, pH is 7.31 (acidic) and HCO3- is 20 mEq/L (low), indicating acidosis, not alkalosis. The low bicarbonate points to a metabolic cause, making this choice incorrect for the ABG values.

Choice D reason: pH 7.31 (acidic), PaCO2 41 mm Hg (normal), and HCO3- 20 mEq/L (low) indicate metabolic acidosis, likely from conditions like diabetic ketoacidosis or lactic acidosis. No respiratory compensation (normal PaCO2) confirms uncompensated metabolic acidosis, making this the correct choice for the imbalance.

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A nurse is reviewing a patient’s medications before administration. Which drug-to-drug interactions will most concern the nurse in a patient with a history of heart failure and a potassium level of 5.5 mEq/L?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Which medication is indicated for suppression of cough? (Select all that apply)

Correct Answer is ["A","C","D"]

Explanation

Name the imbalance using the following Arterial Blood Gas (ABG) values: pH 7.31, PaCO2 41, HCO3- 20

Correct Answer is D

Explanation

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