A nurse is providing instruction to a new nurse about caring for clients who are receiving diuretic therapy to treat heart failure. The nurse should explain that which of the following medications puts clients at risk for both hyperkalemia and hyponatremia?
Hydrochlorothiazide
Spironolactone
Furosemide
Metolazone
The Correct Answer is B
A) Hydrochlorothiazide: Hydrochlorothiazide is a thiazide diuretic that promotes sodium and water excretion, leading to decreased blood volume and decreased potassium excretion. While it can cause hypokalemia due to increased potassium excretion, it does not typically lead to hyperkalemia.
B) Spironolactone: Spironolactone is a potassium-sparing diuretic that inhibits aldosterone, leading to decreased sodium reabsorption and increased potassium retention. This mechanism of action can predispose clients to hyperkalemia due to potassium retention. Additionally, spironolactone can cause hyponatremia by promoting the excretion of sodium and water. Therefore, clients receiving spironolactone are at risk for both hyperkalemia and hyponatremia.
C) Furosemide: Furosemide is a loop diuretic that inhibits sodium and chloride reabsorption in the loop of Henle, promoting sodium, chloride, potassium, and water excretion. While it can cause hypokalemia due to increased potassium excretion, it does not typically lead to hyperkalemia.
D) Metolazone: Metolazone is a thiazide-like diuretic that acts similarly to hydrochlorothiazide by promoting sodium and water excretion. Like hydrochlorothiazide, it can cause hypokalemia due to increased potassium excretion but does not typically lead to hyperkalemia.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","C","E"]
Explanation
A. A client who has stage IV breast cancer and is expected to live 3 months:
This client is eligible for hospice care because they have a terminal illness (stage IV breast cancer) with a prognosis of less than six months to live if the disease follows its typical course. Hospice care focuses on comfort and quality of life in the final months of life.
B. A client who has a diagnosis of COPD and requires supplemental oxygen:
This client is not automatically eligible for hospice care based solely on a COPD diagnosis and the need for supplemental oxygen. Eligibility for hospice would require a prognosis of six months or less to live if the disease follows its usual course. More specific criteria, such as frequent hospitalizations or a significant decline in functional status, would need to be met.
C. A client who has end-stage kidney disease and has stopped dialysis:
This client is eligible for hospice care because stopping dialysis typically indicates that the client has a limited life expectancy, usually measured in weeks to months. Hospice care can help manage symptoms and provide support for end-of-life care.
D. A client who has type 1 diabetes mellitus and is on an insulin pump:
This client is not eligible for hospice care based solely on the presence of type 1 diabetes mellitus and the use of an insulin pump. Hospice care eligibility is generally for clients with a terminal diagnosis and a life expectancy of six months or less if the disease follows its usual course.
E. A client who has terminal lung cancer and has discontinued all treatment:
This client is eligible for hospice care because they have a terminal illness (lung cancer) and have chosen to discontinue curative treatment. Hospice care focuses on palliative treatment to improve the quality of life and manage symptoms during the end-of-life stage.
Correct Answer is B
Explanation
A. Placing the soiled linen on the floor before bagging it is unsanitary and violates infection control principles. It increases the risk of spreading pathogens to other surfaces, potentially contaminating the environment.
B. Placing clean linen that touched the floor in the soiled linen bag prevents cross-contamination and maintains cleanliness. It adheres to infection control standards by ensuring that only soiled items are disposed of appropriately.
C. Holding the soiled linen against her body while carrying it to the linen bag risks transferring pathogens to the caregiver's clothing and skin, compromising personal hygiene and promoting contamination.
D. Shaking the soiled linen to remove any toilet paper remnants is ineffective and hazardous. It disperses potentially infectious particles, increasing the risk of contamination and compromising infection control efforts.
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