A patient with heart failure develops hyperaldosteronism and is prescribed spironolactone.

What instructions should the nurse include in the patient’s care plan?

Substitute salt with a salt substitute.

Protect your skin before going outside.

Limit intake of high-potassium foods.

Monitor skin for excessive bruising.

Answer and Explanation

The Correct Answer is C

Choice A rationale

While salt substitutes can be a good option for some patients with heart failure, they are often high in potassium. Because spironolactone is a potassium-sparing diuretic, using a salt substitute could lead to dangerously high levels of potassium.

Choice B rationale

Protecting your skin before going outside is generally good advice, but it’s not specifically related to the use of spironolactone.

Choice C rationale

Spironolactone is a potassium-sparing diuretic, which means it can cause the body to retain potassium. Therefore, patients taking spironolactone should limit their intake of high- potassium foods to prevent hyperkalemia.

Choice D rationale

While it’s always important to monitor for side effects when taking a new medication, excessive bruising is not a common side effect of spironolactone.

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Correct Answer is A

Explanation

Choice A rationale

Ipratropium is a bronchodilator used to prevent bronchospasm in people with chronic obstructive pulmonary disease (COPD)3. The inhaler needs to be primed before use to ensure the right amount of medicine is delivered. However, priming the inhaler with 7 pumps is not recommended. Therefore, if the client primes the inhaler with 7 pumps, it indicates that additional teaching is needed.

Choice B rationale

Storing the medication at room temperature is the correct way to store ipratropium. Therefore, this action does not indicate that additional teaching is needed.

Choice C rationale

Rinsing the mouth after each use of the inhaler is a recommended practice. This helps to prevent dry mouth and throat irritation caused by the medication. Therefore, this action does not indicate that additional teaching is needed.

Choice D rationale

Attaching a spacer device to the inhaler can help improve the delivery of the medication. Therefore, this action does not indicate that additional teaching is needed.

A. Eliminate spinach and other green vegetables from the diet. B. Avoid the use of nonsteroidal anti-inflammatory drugs (NSAIDs). C. Continue to obtain scheduled laboratory bleeding tests. D. Keep an antidote available in case of hemorrhage.

Correct Answer is B

Explanation

Choice A rationale

Eliminating spinach and other green vegetables from the diet is not necessary for a client taking dabigatran. Unlike warfarin, another anticoagulant that interacts with vitamin K found

in green leafy vegetables, dabigatran does not have this interaction. Therefore, clients taking dabigatran do not need to modify their intake of green vegetables.

Choice B rationale

The nurse should instruct the client to avoid the use of nonsteroidal anti-inflammatory drugs (NSAIDs) while taking dabigatran. NSAIDs can increase the risk of bleeding, which is already elevated in clients taking anticoagulants like dabigatran.

Choice C rationale

Continuing to obtain scheduled laboratory bleeding tests is not necessary for a client taking dabigatran. Unlike some other anticoagulants, dabigatran does not require regular blood tests to monitor its effectiveness or adjust its dosage.

Choice D rationale

Keeping an antidote available in case of hemorrhage is not typically part of the teaching plan for a client taking dabigatran. While an antidote for dabigatran does exist, it is usually administered in a hospital setting in the event of life-threatening bleeding or emergency surgery.

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A patient with heart failure develops hyperaldosteronism and is prescribed spironolactone.What instructions should the nurse include in the patient’s care plan?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client with a history of chronic obstructive pulmonary disease (COPD) has been prescribed a new ipratropium inhaler.Which action indicates to the nurse that additional teaching is needed?

Correct Answer is A

Explanation

A client with atrial fibrillation has been prescribed dabigatran.What instruction should the nurse include in this client’s teaching plan?

Correct Answer is B

Explanation

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A patient with heart failure develops hyperaldosteronism and is prescribed spironolactone.

What instructions should the nurse include in the patient’s care plan?