A patient taking spironolactone has a follow-up appointment. Which of the following laboratory values would be most important to monitor?

Serum calcium levels

White blood cell count

Thyroid hormone levels

Serum potassium levels

Answer and Explanation

The Correct Answer is D

Rationale:

A. Spironolactone is a potassium-sparing diuretic and does not typically affect calcium levels. Monitoring calcium is not a priority unless the client has another condition affecting calcium metabolism.

B. Spironolactone does not directly affect WBC counts. Monitoring WBCs is unrelated to this medication unless the client is taking additional drugs that impact bone marrow or immune function.

C. Spironolactone does not influence thyroid function, so assessing TSH or thyroid hormone levels is not necessary for routine follow-up.

D. Spironolactone is a potassium-sparing diuretic, which can increase serum potassium, potentially leading to hyperkalemia, a life-threatening condition. Monitoring potassium levels is essential to ensure safe use, particularly in clients with kidney impairment or those taking other potassium-increasing medications.

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

Explanation

Rationale:
A. A thready, weak pulse is typically associated with fluid volume deficit, not excess. Clients with FVE often have bounding pulses due to increased intravascular volume.

B. Dizziness is more commonly a sign of hypovolemia or hypotension, rather than fluid overload.

C. Edema occurs when excess fluid accumulates in the interstitial spaces, commonly in the lower extremities in clients with heart failure, making it a classic manifestation of FVE.

D. FVE usually causes distended (full) neck veins due to increased central venous pressure. Flat neck veins are associated with hypovolemia.

E. Rapid or unexplained weight gain in a client with HF is an early sign of fluid retention and is commonly used to monitor FVE.

A. The client who is out of work and has been experiencing increased stress. B. The client who is recovering from a recent illness that caused vomiting and diarrhea. C. The client whose mother and uncle were diagnosed with this same condition D. The client who had a myocardial infarction and required stent placement.

Correct Answer is D

Explanation

Rationale:

A. While stress can contribute to arrhythmias, it is not the highest risk factor for atrial flutter. Stress alone is less likely to trigger atrial flutter without underlying cardiac disease.

B. The client who is recovering from a recent illness that caused vomiting and diarrhea – Electrolyte imbalances from vomiting and diarrhea can predispose to arrhythmias, but the risk is temporary and generally lower compared with structural heart disease.

C. The client whose mother and uncle were diagnosed with this same condition – A family history increases susceptibility, but genetic predisposition alone is not the highest risk factor for atrial flutter.

D. Structural heart disease, such as ischemic heart disease following a myocardial infarction (MI), is a major risk factor for developing atrial flutter because damaged atrial tissue can create abnormal electrical pathways that facilitate reentry circuits, leading to flutter.

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A patient taking spironolactone has a follow-up appointment. Which of the following laboratory values would be most important to monitor?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has fluid volume excess (FVE) due to heart failure (HF). Which of the following manifestations should the nurse associate with FVE? (Select all that apply.)

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

Explanation

A nurse is teaching a group of clients about risk factors for developing atrial flutter. Which of the following clients should the nurse understand is at highest risk for developing atrial flutter?

Correct Answer is D

Explanation

Which of the following is a common symptom of chronic aortic regurgitation?

A nurse is assessing a client who has bradycardia. Which of the following findings should the nurse expect?

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A nurse is interpreting the ECG strip of a client who has bradycardia. Which of the following cardiac components should the nurse identify as the role of the P wave?

A home health nurse is making a home visit to a client who takes a daily diuretic for heart failure. Which of the following manifestations should the nurse identify as indicating the client is hypokalemic?

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