Select whether the following drugs carry a risk of causing hyperkalemia or hypokalemia:

Losartan

Furosemide

Spironolactone

Lisinopril

Digoxin

Answer and Explanation

The Correct Answer is {"A":{"answers":"A"},"B":{"answers":"B"},"C":{"answers":"A"},"D":{"answers":"A"},"E":{"answers":"B"}}

Losartan: As an angiotensin II receptor blocker (ARB), losartan reduces aldosterone secretion, leading to decreased potassium excretion and potential hyperkalemia, especially in patients with renal impairment or those on potassium supplements.

Furosemide: This loop diuretic promotes the excretion of sodium and potassium in the urine, commonly resulting in hypokalemia. Patients on furosemide often require potassium monitoring or supplementation.
Spironolactone: A potassium-sparing diuretic and aldosterone antagonist, spironolactone reduces potassium excretion in the distal nephron. This can lead to hyperkalemia, particularly when used with other potassium-elevating drugs.
Lisinopril: An ACE inhibitor that blocks the conversion of angiotensin I to II, reducing aldosterone levels and thereby decreasing potassium excretion. This places patients at risk for hyperkalemia.
Digoxin: This cardiac glycoside may cause hypokalemia indirectly by increasing sensitivity to potassium shifts. Additionally, low potassium levels enhance digoxin toxicity, so maintaining normal potassium is critical during therapy.

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Correct Answer is C

Explanation

A. "I should maintain a consistent sodium intake in my diet.": Sodium levels directly affect lithium levels in the body. Fluctuations in sodium intake can lead to lithium toxicity or subtherapeutic effects. A consistent sodium intake helps maintain stable lithium blood levels.
B. "I should have regular blood tests to monitor my lithium levels.": Lithium has a narrow therapeutic range and can become toxic if levels rise too high. Regular monitoring is essential to ensure safe and effective treatment, especially during dose adjustments or illness.
C. "It's important to restrict my fluid intake while taking this medication.": This statement is incorrect and indicates a need for further teaching. Fluid restriction can lead to dehydration, increasing lithium reabsorption in the kidneys and raising the risk of toxicity. Clients should maintain adequate hydration, especially during hot weather or illness.
D. "I need to report any signs of nausea, vomiting, or diarrhea to my doctor.": These are early signs of lithium toxicity. Prompt reporting is crucial so that lithium levels can be checked and treatment adjusted to prevent progression to severe toxicity.

A. They inhibit the metabolism of alcohol in the liver B. They block the reuptake of dopamine in the central nervous system C. They have no potential for abuse or dependence D. They enhance the effects of GABA in the central nervous system

Correct Answer is D

Explanation

A. They inhibit the metabolism of alcohol in the liver: Benzodiazepines do not affect alcohol metabolism. Enzymes like alcohol dehydrogenase and aldehyde dehydrogenase are responsible for metabolizing alcohol, and benzodiazepines have no role in this process.
B. They block the reuptake of dopamine in the central nervous system: This mechanism is more characteristic of stimulant drugs like cocaine or certain antidepressants. Benzodiazepines act primarily on GABAergic pathways and do not target dopamine reuptake.
C. They have no potential for abuse or dependence: Benzodiazepines carry a well-documented risk of dependence and abuse, especially with long-term use or in individuals with a history of substance use disorders. Their use in alcohol withdrawal is carefully managed due to this risk.
D. They enhance the effects of GABA in the central nervous system: Benzodiazepines potentiate GABA, the brain’s primary inhibitory neurotransmitter, which helps to stabilize the CNS, reduce seizures, and manage agitation during alcohol withdrawal. This GABAergic action compensates for the decreased inhibitory tone seen in alcohol-dependent individuals during withdrawal.

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Select whether the following drugs carry a risk of causing hyperkalemia or hypokalemia:

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is providing discharge instructions to a client who has been prescribed Lithium for bipolar disorder. Which of the following statements by the client indicates a need for further teaching?

Correct Answer is C

Explanation

Correct Answer is D

Explanation

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