A nurse is caring for a client who is to receive potassium replacement. The provider’s prescription reads, “Potassium chloride 30 mEq in 0.9% sodium chloride 100 mL IV over 30 min.” For which of the following reasons should the nurse clarify this prescription with the provider?

The potassium infusion rate is too rapid.

Another formulation of potassium should be given IV.

Potassium chloride should be diluted in dextrose 5% in water.

The client should be treated by giving potassium by IV bolus.

Answer and Explanation

The Correct Answer is A

According to various guidelines12345, the recommended rate of intravenous potassium replacement is 10-20 mEq/h with continuous ECG monitoring. The maximum rate is 40 mEq/h in emergency situations. The prescription given by the provider exceeds this limit and could cause cardiac arrhythmias or hyperkalemia.

Choice B is wrong because potassium chloride is a common and appropriate formulation of potassium for intravenous administration.

Choice C is wrong because potassium chloride should not be diluted in dextrose 5% in water, as this could cause hyperglycemia or osmotic diuresis.

Choice D is wrong because potassium should never be given by IV bolus, as this could cause cardiac arrest or tissue necrosis.

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Correct Answer is D

Explanation

Pioglitazone is a medication that belongs to a class of drugs called thiazolidinediones, which are used to treat type 2 diabetes by improving insulin sensitivity. One of the common side effects of pioglitazone is edema, which is swelling caused by excess fluid in the body tissues. This can lead to fluid retention and weight gain and may worsen heart failure in some patients.

Choice A is wrong because tinnitus, which is ringing or buzzing in the ears, is not a known side effect of pioglitazone.

Choice B is wrong because insomnia, which is difficulty falling or staying asleep, is not a known side effect of pioglitazone.

Choice C is wrong because orthostatic hypotension, which is a drop in blood pressure when standing up from a sitting or lying position, is not a known side effect of pioglitazone.

In fact, pioglitazone may cause low blood sugar (hypoglycemia) when used with other diabetes medications, which can cause symptoms such as dizziness, sweating, and confusion.

A. BUN 15 mg/dL. B. The client reports difficulty hearing. C. Potassium 3.8 mEq/L. D. The client reports dizziness upon standing.

Correct Answer is B

Explanation

Furosemide is a diuretic that is used to treat heart failure by reducing fluid retention and lowering blood pressure. It can cause some side effects, such as increased urination, thirst, dry mouth, headache, dizziness, nausea, and electrolyte imbalance.

Choice A is wrong because BUN (blood urea nitrogen) is a measure of kidney function and a normal range is 7 to 20 mg/dL.

A BUN of 15 mg/dL is not a cause for concern and does not indicate any adverse effect of furosemide.

Choice C is wrong because potassium is an electrolyte that is important for nerve and muscle function and a normal range is 3.5 to 5.0 mEq/L.

Potassium of 3.8 mEq/L is within the normal range and does not indicate any adverse effect of furosemide. However, furosemide can cause low potassium levels (hypokalemia) in some cases, so the nurse should monitor the client’s potassium levels regularly and advise the client to eat foods rich in potassium, such as bananas, oranges, and potatoes.

Choice D is wrong because dizziness upon standing is a common side effect of furosemide and does not require immediate notification of the provider. However, the nurse should instruct the client to rise slowly from a sitting or lying position to prevent falls and to drink enough fluids to prevent dehydration.

Choice B is correct because difficulty hearing or hearing loss is a rare but serious side effect of furosemide that may indicate ototoxicity (damage to the inner ear). This can be irreversible if not treated promptly and may affect the client’s quality of life and safety. The nurse should notify the provider immediately if the client reports difficulty hearing or any other signs of ototoxicity, such as ringing in the ears (tinnitus) or vertigo (a sensation of spinning). The provider may need to adjust the dose of furosemide or switch to another diuretic that is less ototoxic.

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A nurse is caring for a client who is to receive potassium replacement. The provider’s prescription reads, “Potassium chloride 30 mEq in 0.9% sodium chloride 100 mL IV over 30 min.” For which of the following reasons should the nurse clarify this prescription with the provider?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has diabetes mellitus and is taking pioglitazone. The nurse should plan to monitor the client for which of the following adverse effects?

Correct Answer is D

Explanation

A nurse is caring for a client who has heart failure. The nurse administered furosemide 60 mg IV bolus 30 min earlier. For which of the following findings should the nurse notify the provider?

Correct Answer is B

Explanation

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A nurse is caring for a client who is to receive potassium replacement. The provider’s prescription reads, “Potassium chloride 30 mEq in 0.9% sodium chloride 100 mL IV over 30 min.” For which of the following reasons should the nurse clarify this prescription with the provider?

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