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

Answer and Explanation

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.

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Correct Answer is C

Explanation

A) Halitosis: Halitosis refers to bad breath, which may or may not be related to bruxism. While teeth grinding can contribute to dental issues that may lead to halitosis, it is not the primary disorder associated with teeth grinding.
B) Sordes: Sordes refers to the accumulation of foul-smelling crusts or deposits around the teeth and gums, typically seen in individuals with poor oral hygiene or compromised oral health. It is not directly related to teeth grinding.
C) Bruxism: Bruxism refers to the habit of grinding or clenching the teeth, especially during sleep. It can lead to dental problems, jaw pain, headaches, and other issues related to the temporomandibular joint (TMJ). Referring the client to a dentist for evaluation and management of bruxism is appropriate to address the underlying dental concerns associated with teeth grinding.
D) Xerostomia: Xerostomia, also known as dry mouth, is a condition characterized by reduced saliva production. While xerostomia may exacerbate dental problems and contribute to oral discomfort, it is not specifically associated with teeth grinding.

A. Metabolic acidosis B. Metabolic alkalosis C. Respiratory alkalosis D. Respiratory acidosis

Correct Answer is D

Explanation

Respiratory acidosis occurs when there is inadequate removal of carbon dioxide (CO2) by the lungs, leading to an accumulation of CO2 and a decrease in pH.

Analysis:

pH 7.22: Indicates acidemia (pH below 7.35), suggesting acidosis.

PaCO2 68 mm Hg: Elevated PaCO2 indicates hypoventilation, which is characteristic of respiratory acidosis.

Base excess -2: Base excess is within normal limits and does not contribute significantly to the acid-base imbalance in this scenario.

PaO2 78 mm Hg: PaO2 is slightly low but not significantly contributing to the acid-base imbalance.

Saturation 80%: Oxygen saturation is low, indicating hypoxemia, which is commonly associated with respiratory acidosis due to hypoventilation.

Bicarbonate 26 mEq/L: Bicarbonate is within normal limits, suggesting compensation for the respiratory acidosis, which is a chronic condition.

Overall, the ABG values indicate respiratory acidosis due to inadequate ventilation, leading to CO2 retention and subsequent acidemia.

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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?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client tells the nurse that he suspects that he grinds his teeth at night. The nurse should explain that the client should see a dentist for this problem, which she should document as which of the following disorders?

Correct Answer is C

Explanation

A client is admitted to the emergency room with a respiratory rate of 7/min. Arterial blood gases (ABG) reveal the following values. Which of the following is an appropriate analysis of the ABGs? PH 7.22 PaCO2 68 mm Hg Base excess -2 PaO2 78 mm Hg Saturation 80% Bicarbonate 26 mEq/L

Correct Answer is D

Explanation

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