A patient with a history of heart failure is prescribed furosemide (Lasix). Several days after the aggressive diuretic therapy started, the patient began to exhibit confusion, tremors, muscle cramps, and nausea.
What does the nurse suspect?

Hypokalemia.

Renal failure.

Hyperkalemia.

Heart failure.

Answer and Explanation

The Correct Answer is A

Hypokalemia is a condition of low potassium levels in the blood, which can be caused by diuretics such as furosemide (Lasix) that increase the excretion of potassium in the urine. Potassium is an important electrolyte that helps regulate the function of nerves and muscles, including the heart. Low potassium levels can cause symptoms such as confusion, tremors, muscle cramps, and nausea, which are consistent with the patient’s presentation.

Choice B, renal failure, is wrong because furosemide is used to treat fluid retention and edema caused by kidney disease, not to cause it. Renal failure would also cause symptoms such as decreased urine output, swelling, fatigue, and shortness of breath, which are not mentioned in the question.

Choice C, hyperkalemia, is wrong because hyperkalemia is a condition of high potassium levels in the blood, which can be caused by kidney disease or certain medications that decrease the excretion of potassium in the urine. Hyperkalemia can cause symptoms such as weakness, irregular heartbeat, paralysis, and chest pain, which are different from the patient’s symptoms.

Choice D, heart failure, is wrong because furosemide is also used to treat fluid retention and edema caused by heart failure, not to cause it. Heart failure would also cause symptoms such as shortness of breath, coughing, fatigue, and rapid weight gain, which are not mentioned in the question.

Normal ranges for potassium levels in the blood are 3.5 to 5.0 milliequivalents per liter (mEq/L) for adults and 3.4 to 4.7 mEq/L for children.

A level below 3.5 mEq/L is considered hypokalemic and a level above 5.0 mEq/L is considered hyperkalemic.

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Correct Answer is B

Explanation

Nitroglycerin transdermal patches are used to prevent episodes of angina (chest pain) in people who have coronary artery disease (narrowing of the blood vessels that supply blood to the heart).Nitroglycerin is a vasodilator that works by relaxing the blood vessels so that the heart does not need to work as hard and therefore does not need as much oxygen.However, if nitroglycerin is used continuously, the body may develop tolerance to its effects, meaning that it will not work as well to prevent angina attacks.Therefore, it is important to remove the patch at bedtime and apply a new one in the morning, leaving a 10-12 hour nitrate-free interval.This way, the body can restore its sensitivity to nitroglycerin and avoid angina episodes during the day.

Choice A is wrong because allergic response is not a common reason to remove the patch at night.Although some people may experience skin irritation or rash from the patch, this is usually mild and does not require discontinuation of the medication.If the skin reaction is severe or bothersome, the patch can be applied to a different area of the skin or switched to another form of nitroglycerin.

Choice C is wrong because overdose is unlikely to occur from using the patch as prescribed.Nitroglycerin patches come in doses ranging from 0.1 milligrams per hour to 0.8 mg/hr, and should be placed on clean, dry, and hairless skin for 12-14 hours and removed for 10-12 hours.If a patch loosens or falls off, it should be replaced with a fresh one.Overdose symptoms may include severe headache, dizziness, blurred vision, nausea, vomiting, sweating, chest pain, fast or irregular heartbeat, difficulty breathing, fainting, or seizures.If these occur, the patch should be removed immediately and medical attention should be sought.

Choice D is wrong because management of BPH (benign prostatic hyperplasia) is not related to nitroglycerin use.

BPH is a condition

A. Calcium channel blockers:. B. Beta Blocker:. C. Platelet inhibitors:. D. Angiotensin receptor blocker (ARBS):. E. ACE inhibitor:.

Correct Answer is D

Explanation

Angiotensin receptor blockers (ARBs) are a class of drugs that block the action of angiotensin II, a hormone that causes blood vessels to constrict and raise blood pressure. Examples of ARBs include losartan, valsartan, candesartan, and irbesartan.ARBs are used to treat hypertension, heart failure, and chronic kidney disease.

Choice A is wrong because calcium channel blockers (CCBs) are a class of drugs that prevent calcium from entering the cells of the heart and blood vessels, causing them to relax and lower blood pressure.

Examples of CCBs include amlodipine, diltiazem, verapamil, and nifedipine.CCBs are used to treat hypertension, angina, and arrhythmias.

Choice B is wrong because beta blockers are a class of drugs that reduce the heart rate and force of contraction, lowering the cardiac output and blood pressure.

Examples of beta blockers include atenolol, metoprolol, propranolol, and bisoprolol.Beta blockers are used to treat hypertension, angina, heart failure, and arrhythmias.

Choice C is wrong because platelet inhibitors are a class of drugs that prevent platelets from clumping together and forming blood clots.

Examples of platelet inhibitors include aspirin, clopidogrel, ticagrelor, and prasugrel.Platelet inhibitors are used to prevent or treat cardiovascular events such as heart attack or stroke.

Choice E is wrong because ACE inhibitors are a class of drugs that inhibit the enzyme that converts angiotensin I to angiotensin II, reducing the production of this vasoconstrictor hormone.

Examples of ACE inhibitors include lisinopril, enalapril, ramipril, and captopril.ACE inhibitors are used to treat hypertension, heart failure, and chronic kidney disease.

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A patient with a history of heart failure is prescribed furosemide (Lasix). Several days after the aggressive diuretic therapy started, the patient began to exhibit confusion, tremors, muscle cramps, and nausea. What does the nurse suspect?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Why is a patient who is using a transdermal nitroglycerin patch instructed to remove the patch at bedtime and apply a new one in the morning?

Correct Answer is B

Explanation

Match the following drug classification with the appropriate drug,

Correct Answer is D

Explanation

Which of the following Alpha adrenergic class has a vasodilating effect and can be used for the management of hypertension?

A nurse understands that a common reason why a patient is prescribed a combination of diuretics is because?

Which of the following anti-hypertensive medication belongs to the ACE Inhibitors?

A patient with peripheral vascular disease has been on pentoxifylline (Trental) for 2 weeks. Which statements by the patient indicate no need for further patient teaching about the disease? Select all that apply.

To prevent urinary tract infection, the nurse must teach the patient the following. Select all that apply.

Why is a patient who is using a transdermal nitroglycerin patch instructed to remove the patch at bedtime and apply a new one in the morning?

Which laboratory test measures the effectiveness of warfarin?

The nurse is preparing a patient’s daily dose of digoxin (Lanoxin), an inotropic drug. The adult patient has an apical pulse of 48/min. What should the nurse do next?

A patient with a history of heart failure is prescribed furosemide (Lasix). Several days after the aggressive diuretic therapy started, the patient began to exhibit confusion, tremors, muscle cramps, and nausea.
What does the nurse suspect?