A nurse is teaching a client who has a new prescription for hydrochlorothiazide for management of hypertension. Which of the following instructions should the nurse include?

Reduce intake of potassium-rich foods.

Avoid grapefruit juice.

Take this medication before bedtime.

Monitor for leg cramps.

Answer and Explanation

The Correct Answer is D

Choice A reason: Reducing intake of potassium-rich foods is not necessary for clients taking hydrochlorothiazide, as this medication can cause hypokalemia (low potassium levels) due to increased potassium excretion in the urine. Clients may need to increase their intake of potassium-rich foods or take potassium supplements to prevent hypokalemia.

Choice B reason: Avoiding grapefruit juice is not necessary for clients taking hydrochlorothiazide, as this medication does not interact with grapefruit juice. Grapefruit juice can affect the metabolism of some other medications, such as statins, calcium channel blockers, and cyclosporine, by inhibiting the enzyme CYP3A4 in the liver.

Choice C reason: Taking this medication before bedtime is not advisable for clients taking hydrochlorothiazide, as this medication can cause increased urination and nocturia (nighttime urination). Clients should take this medication in the morning or at least 6 hours before bedtime to avoid disrupting their sleep.

Choice D reason: Monitoring for leg cramps is an important instruction for clients taking hydrochlorothiazide, as this medication can cause muscle cramps due to electrolyte imbalances, such as hypokalemia, hyponatremia (low sodium levels), or hypomagnesemia (low magnesium levels). Clients should report any signs of muscle cramps, weakness, or fatigue to their provider.

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Correct Answer is C

Explanation

Choice A reason: Atropine is not the correct answer, as it is an anticholinergic medication that is used to treat bradycardia, not warfarin overdose. Atropine has no effect on the INR or the coagulation cascade.

Choice B reason: Epinephrine is not the correct answer, as it is a catecholamine medication that is used to treat anaphylaxis, cardiac arrest, or severe hypotension, not warfarin overdose. Epinephrine has no effect on the INR or the coagulation cascade.

Choice C reason: Vitamin K is the correct answer, as it is the antidote for warfarin overdose. Vitamin K is a fat-soluble vitamin that is essential for the synthesis of clotting factors II, VII, IX, and X. Vitamin K can reverse the effects of warfarin and lower the INR to a therapeutic range.

Choice D reason: Protamine is not the correct answer, as it is the antidote for heparin overdose, not warfarin overdose. Protamine is a protein that binds to and neutralizes heparin, but has no effect on warfarin or the INR.

A. Migraines B. Glaucoma C. Asthma D. Depression

Correct Answer is C

Explanation

Choice A reason: Migraines are not a contraindication for propranolol. In fact, propranolol is used as a prophylactic treatment for migraines, as it reduces the frequency and severity of migraine attacks.

Choice B reason: Glaucoma is not a contraindication for propranolol. Propranolol does not affect the intraocular pressure or the drainage of aqueous humor in the eye.

Choice C reason: Asthma is a contraindication for propranolol. Propranolol is a nonselective beta-blocker, which means it blocks both beta-1 and beta-2 receptors in the body. Beta-2 receptors are found in the bronchial smooth muscle, and when they are blocked, they cause bronchoconstriction and increased airway resistance. This can worsen the symptoms of asthma and cause a life-threatening asthma attack.

Choice D reason: Depression is not a contraindication for propranolol. Propranolol does not cause depression, although it may cause some side effects such as fatigue, insomnia, and sexual dysfunction. However, these side effects are usually mild and reversible.

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A nurse is teaching a client who has a new prescription for hydrochlorothiazide for management of hypertension. Which of the following instructions should the nurse include?

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Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who is on warfarin therapy for atrial fibrillation. The client's INR is 5.2. Which of the following medications should the nurse prepare to administer?

Correct Answer is C

Explanation

A nurse is caring for a client who has hypertension and asks the nurse about a prescription for propranolol. The nurse should inform the client that this medication is contraindicated in clients who have a history of which of the following conditions?

Correct Answer is C

Explanation

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