A patient with chronic congestive heart failure has repeated hospitalizations despite ongoing treatment with hydrochlorothiazide (HydroDIURIL) and digoxin. The prescriber has ordered spironolactone (Aldactone) to be added to this patient’s drug regimen, and the nurse provides education about this medication. Which statement by the patient indicates understanding of the teaching?
“I should use salt substitutes to prevent toxic side effects.”
“I need to stop taking potassium supplements.”
“I should watch closely for overhydration.”
“I can expect improvement within a few hours after taking this drug.”
The Correct Answer is B
Choice A reason: Salt substitutes contain potassium, which risks hyperkalemia with spironolactone, a potassium-sparing diuretic. This is dangerous, so it’s incorrect for understanding.
Choice B reason: Spironolactone spares potassium, so stopping supplements prevents hyperkalemia, a serious risk. This shows correct understanding, making it the correct choice.
Choice C reason: Spironolactone reduces fluid, not causes overhydration. Monitoring for dehydration is more relevant, so this is incorrect for the medication’s effects.
Choice D reason: Spironolactone’s effects take days to weeks, not hours. Immediate improvement is unrealistic, so this is incorrect for proper patient understanding.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: To calculate volume, divide the ordered dose (40 mg) by the concentration (20 mg/mL): 40 ÷ 20 = 2 mL. Choice A (5 mL) delivers 100 mg (5 × 20), far exceeding the ordered dose, risking fluid and electrolyte imbalances, making it incorrect for safe administration.
Choice B reason: The correct volume is 40 mg ÷ 20 mg/mL = 2 mL. Choice B (6 mL) delivers 120 mg (6 × 20), significantly overdosing Lasix, which could cause severe dehydration, hypokalemia, or hypotension. This excessive dose is unsafe and incorrect for the prescribed administration.
Choice C reason: Calculating 40 mg ÷ 20 mg/mL yields 2 mL. Choice C (4 mL) delivers 80 mg (4 × 20), doubling the ordered dose. This could lead to excessive diuresis, electrolyte disturbances, or hypotension, making it an incorrect and potentially harmful choice for administration.
Choice D reason: Dividing the ordered dose (40 mg) by the concentration (20 mg/mL) gives 40 ÷ 20 = 2 mL. This volume accurately delivers the prescribed 40 mg of Lasix, ensuring effective diuresis for conditions like edema or heart failure while minimizing risks, making it the correct choice.
Correct Answer is D
Explanation
Choice A reason: Insulin glargine is a long-acting insulin given once daily, not twice daily. Morning and 4:00 PM dosing is typical for intermediate-acting insulins, so this incorrect for glargine’s schedule.
Choice B reason: Rapid-acting insulins are given before meals, not glargine, which provides basal coverage. Glargine is dosed once daily, so this is incorrect.
Choice C reason: Post-meal or after meals and bedtime dosing does not suit glargine’s 24-hour action. It’s given once daily, typically at bedtime, so this is incorrect for the administration timing.
Choice D reason: Insulin glargine is administered once daily, often at bedtime, to provide steady basal insulin coverage for 24 hours. This aligns with its pharmacokinetics, making it the correct choice.
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