Which symptom reported by a client alerts the practical nurse (PN) to withhold a scheduled dose of hydrochlorothiazide and notify the healthcare provider?

Palpitations

Nervousness

Nausea

Anorexia

Answer and Explanation

The Correct Answer is A

Choice A reason: Palpitations may indicate electrolyte imbalances, like hypokalemia, a serious side effect of hydrochlorothiazide, a thiazide diuretic. It increases potassium excretion, disrupting cardiac electrical activity, potentially causing arrhythmias. Withholding the dose and notifying the provider is critical to prevent life-threatening cardiac complications, requiring urgent electrolyte assessment.

Choice B reason: Nervousness is a vague symptom not typically linked to hydrochlorothiazide’s side effects. It may reflect anxiety or other unrelated issues, not necessitating immediate drug cessation. Electrolyte imbalances or hypotension are more concerning, making this choice less urgent for withholding the medication.

Choice C reason: Nausea is a common, non-specific side effect of many medications, including hydrochlorothiazide, but is not severe enough to warrant withholding the dose. It may resolve or be managed symptomatically. More critical side effects, like electrolyte imbalances, take precedence, making this choice incorrect.

Choice D reason: Anorexia is not a primary concern with hydrochlorothiazide. While it may occur with diuretic-induced dehydration, it is less urgent than cardiac symptoms like palpitations. This symptom does not directly indicate a life-threatening side effect, so withholding the drug is not immediately necessary.

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Correct Answer is A

Explanation

Choice A reason: Antilipidemic medications, like statins, lower serum cholesterol by inhibiting HMG-CoA reductase, reducing low-density lipoprotein (LDL) production. Monitoring cholesterol levels, particularly LDL, directly assesses the drug’s effectiveness in reducing cardiovascular risk, as elevated cholesterol is the primary target of therapy.

Choice B reason: Hemoglobin A1C reflects blood glucose control, relevant for diabetes management, not lipid-lowering therapy. Antilipidemics target cholesterol, not glucose metabolism. This value is unrelated to the drug’s mechanism, making it irrelevant for assessing antilipidemic efficacy.

Choice C reason: INR monitors anticoagulation, relevant for drugs like warfarin, not antilipidemics. Cholesterol-lowering drugs do not affect clotting pathways. Monitoring INR is unnecessary, as it does not reflect the therapeutic goal of reducing lipid levels, making this choice incorrect.

Choice D reason: Platelet count assesses bleeding risk or bone marrow function, not lipid levels. Antilipidemics do not significantly affect platelets. Monitoring cholesterol is the direct measure of efficacy, as platelets are unrelated to the drug’s cholesterol-lowering mechanism, making this choice irrelevant.

A. Observe for healing of ulcers B. Measure pain and sensation C. Palpate temperature of skin D. Check the amount of swelling

Correct Answer is B

Explanation

Choice A reason: Observing ulcer healing is important in diabetic neuropathy but not a direct measure of pregabalin’s effectiveness. Pregabalin reduces neuropathic pain, not primarily promoting tissue repair. Ulcer healing depends on glycemic control and wound care, making this choice secondary.

Choice B reason: Measuring pain and sensation assesses pregabalin’s effectiveness, as it modulates calcium channels in neurons, reducing neuropathic pain and abnormal sensations in diabetic neuropathy. Decreased pain or paresthesia in the feet indicates therapeutic success, making this the most relevant assessment for the drug’s action.

Choice C reason: Palpating skin temperature evaluates circulation or infection, not pregabalin’s effect. While neuropathy may affect perfusion, pregabalin targets pain signaling, not temperature regulation. This assessment is unrelated to the drug’s primary role in pain management, making it irrelevant.

Choice D reason: Checking swelling monitors edema, which may occur in diabetes but is not pregabalin’s target. The drug reduces neuropathic pain, not fluid accumulation. Swelling assessment is secondary to pain and sensation, which directly reflect the medication’s efficacy in neuropathy management.

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Which symptom reported by a client alerts the practical nurse (PN) to withhold a scheduled dose of hydrochlorothiazide and notify the healthcare provider?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Which laboratory value should the practical nurse (PN) monitor to determine if an antilipidemic medication is having the desired effect for the client?

Correct Answer is A

Explanation

A client with diabetic peripheral neuropathy receives a new prescription for pregabalin. To assess the effectiveness of the medication, which action should the practical nurse (PN) include when assessing the client’s feet?

Correct Answer is B

Explanation

A client receives a prescription for intravenous (IV) famotidine. Which finding indicates to the practical nurse (PN) the medication is effective?

The practical nurse (PN) is checking the insulin dose drawn up by another PN and notes that the amount of insulin is 2 units more than the amount indicated for the glucose level written on the client’s medication record. Which action should the PN take?

A client is receiving tetracycline for chlamydia urethritis. The practical nurse (PN) should reinforce which instruction?

The charge nurse asks the practical nurse (PN) to administer diphenhydramine 25 mg IM to a client prior to infusing a blood transfusion. Which explanation should the PN offer the client about the purpose of this drug?

Which client information should the practical nurse (PN) obtain prior to preparing a dose of the influenza vaccine?

Which of the following is a characteristic of a chemical reaction?

The practical nurse (PN) is obtaining information from a female client who is starting a new prescription for conjugated estrogens 0.625 mg PO daily. Prior to the client taking the first dose of the medication, which information should the PN obtain?

A client with terminal cancer reports increasing pain that occurs 1 to 2 hours before the next scheduled dose of a prescribed opioid analgesic. Which action should the practical nurse (PN) implement?