A nurse is teaching a hypertensive client who is taking hydrochlorothiazide. What client statement indicates understanding about hydrochlorothiazide?

"I will not take this medicine when my blood pressure is okay"

"I will check blood pressure in both arms and legs before taking the drug."

"I will decrease potassium foods such as bananas in my diet."

"I will take this medication in the morning since I will be urinating more."

Answer and Explanation

The Correct Answer is D

Hydrochlorothiazide is a diuretic medication commonly prescribed for hypertension. It works by increasing urine output, which helps to reduce ﬂuid volume and lower blood pressure. Taking the medication in the morning is beneﬁcial because the increased urine production during the day can help prevent nighttime disruptions due to frequent urination.

Let's go through the other statements and explain why they are not accurate:

"I will not take this medicine when my blood pressure is okay":

This statement indicates a misunderstanding about the purpose of hydrochlorothiazide. It is important to take prescribed medications consistently, even when blood pressure readings are within the normal range, as they are intended to help maintain blood pressure control.

"I will check blood pressure in both arms and legs before taking the drug":

Checking blood pressure in both arms and legs is not directly related to hydrochlorothiazide use. Blood pressure should be monitored regularly, but it is not necessary to perform these measurements speciﬁcally before taking the medication.

"I will decrease potassium foods such as bananas in my diet":

Hydrochlorothiazide can cause potassium loss as a side effect. However, reducing potassium-rich foods without healthcare provider guidance may not be appropriate. It is important for the client to discuss dietary adjustments and potassium supplementation with their healthcare provider if needed.

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Correct Answer is ["D","E"]

Explanation

The traces that should require immediate follow-up by the nurse are:

● Pacer spikes occur directly before the T waves.

Pacer spikes occurring on the T waves indicate an issue with the pacemaker's timing or sensing. This could lead to inappropriate pacing or pacing during the refractory period, which can be detrimental to the client's heart function.

● The heart rate is outside of programmed parameters.

If the heart rate is outside of the programmed parameters set for the client's pacemaker, it may indicate a malfunction or failure of the device or a change in the client's cardiac status. It is important for the nurse to assess the client's condition and notify the healthcare provider for further evaluation and intervention.

Let's review the other options and explain why they do not require immediate follow-up:

Pacer spikes are adequate in number: This indicates that the pacemaker is delivering the appropriate number of electrical impulses as programmed. As long as the other parameters are normal, this finding does not require immediate follow-up.

Pacer spikes occur directly before the P waves: This is the desired and expected pattern for a pacemaker in normal sinus rhythm. It indicates proper timing and coordination between the pacemaker and the client's intrinsic electrical activity.

Pacer spikes occur directly before the QRS waves: This is also the desired and expected pattern for a pacemaker in clients with ventricular pacing. It indicates proper timing and coordination between the pacemaker and the client's intrinsic electrical activity.

The heart rate is within programmed parameters: If the heart rate falls within the programmed parameters set for the client's pacemaker, it indicates that the device is functioning appropriately in maintaining the desired heart rate.

A. "Increased LDL and decreased HDL increase my risk of coronary artery disease." B. "Increased LDL has the potential to decrease my risk of heart disease." C. "The decreased HDL level will increase the amount of cholesterol moved away from the artery walls." D. "The increased LDL will decrease the amount of cholesterol deposited on the artery walls."

Correct Answer is A

Explanation

Elevated levels of LDL (low-density lipoprotein) cholesterol are associated with an increased risk of coronary artery disease (CAD). LDL cholesterol is often referred to as "bad" cholesterol because it can contribute to the formation of plaque in the arteries, leading to narrowing and blockage of the arteries supplying the heart. This increases the risk of developing CAD and related complications such as heart attack and stroke.

On the other hand, HDL (high-density lipoprotein) cholesterol is often referred to as "good" cholesterol. HDL cholesterol helps remove excess cholesterol from the bloodstream and transport it back to the liver for processing and excretion. Higher levels of HDL cholesterol are associated with a decreased risk of CAD because it helps to prevent the accumulation of cholesterol on artery walls.

Therefore, understanding that increased LDL and decreased HDL levels increase the risk of coronary artery disease demonstrates a good understanding of the significance of cholesterol levels and their impact on cardiovascular health.

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A nurse is teaching a hypertensive client who is taking hydrochlorothiazide. What client statement indicates understanding about hydrochlorothiazide?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is caring for a client with a pacemaker/ICD on a continuous cardiac monitor. Which trace should require immediate follow up by the nurse? Select all that apply

Correct Answer is ["D","E"]

Explanation

The nurse is conducting client teaching about cholesterol levels. When discussing the client's elevated LDL and lowered HDL levels, the client shows an understanding of the significance of these levels by making what statement?

Correct Answer is A

Explanation

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Which information is most important for the nurse to include when teaching a client newly diagnosed with hypertension?

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