A nurse is reviewing data for a client who receives clonidine daily.
Which of the following findings indicates the nurse should withhold the next dose?
Urine output 600 mL in 8 hr.
Blood pressure 88/50 mm Hg.
Heart rate 110/min.
Blood glucose 70 mg/dL.
The Correct Answer is B
Choice A rationale:
A urine output of 600 mL in 8 hours is within the normal range. The average urine output for adults is about 1 to 2 liters per day.
Choice B rationale:
Clonidine is an antihypertensive medication. If the client’s blood pressure is already low (88/50 mm Hg), administering clonidine could further lower the blood pressure and cause hypotension.
Choice C rationale:
A heart rate of 110/min is slightly high, but it’s not a direct indication to withhold clonidine. Clonidine can actually help lower an elevated heart rate by reducing the levels of certain chemicals in your blood.
Choice D rationale:
A blood glucose level of 70 mg/dL is at the lower end of the normal range (70-100 mg/dL) However, clonidine does not directly affect blood glucose levels, so this would not be a reason to withhold the medication.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale:
Docusate sodium is a stool softener and does not have a direct effect on blood pressure. It is generally safe for individuals with hypertension.
Choice B rationale:
Pseudoephedrine is a decongestant that can raise blood pressure or interfere with the effectiveness of some prescribed blood pressure medications. Therefore, it is contraindicated for clients with hypertension.
Choice C rationale:
Omeprazole is a proton pump inhibitor used to decrease stomach acid. It does not have a significant impact on blood pressure and is generally safe for individuals with hypertension.
Choice D rationale:
Guaifenesin is an expectorant used to thin mucus in the air passages. It does not have a significant impact on blood pressure and is generally safe for individuals with hypertension.
Correct Answer is B
Explanation
Choice A rationale:
Hypernatremia (high sodium levels) is not a common side effect of spironolactone. Spironolactone is a potassium-sparing diuretic and does not typically affect sodium levels.
Choice B rationale:
Hyperkalemia (high potassium levels) is a potential adverse effect of spironolactone. As a potassium-sparing diuretic, spironolactone can cause an increase in serum potassium levels.
Choice C rationale:
Hypophosphatemia (low phosphate levels) is not typically associated with spironolactone use.
Choice D rationale:
Hypocalcemia (low calcium levels) is also not a common side effect of spironolactone.
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