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
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Rationale:
A. Crackles are more commonly associated with left-sided heart failure, due to pulmonary congestion from fluid backing up into the lungs.
B. While a murmur can be present in some cardiac conditions, it is not a hallmark finding specific to right-sided heart failure.
C. Chest pain may occur with ischemic heart disease or myocardial infarction but is not a classic symptom of right-sided heart failure.
D. Right-sided heart failure leads to systemic venous congestion, causing fluid accumulation in dependent areas such as the legs, ankles, and feet, which is a hallmark sign of right-sided heart failure.
Correct Answer is C
Explanation
Rationale:
A. While defibrillation may be necessary, it should not be the first action. Immediate assessment determines whether the client is pulseless or unstable, which guides the appropriate intervention.
B. Delaying assessment to contact the provider could waste critical time, especially in life-threatening arrhythmias like VT. Nurses must act immediately according to the patient’s condition and protocols.
C. The first action in any suspected life-threatening arrhythmia is to assess the patient’s ABCs. This assessment determines hemodynamic stability and guides whether to perform CPR, defibrillation, or prepare for cardioversion, prioritizing patient safety.
D. Antiarrhythmic drugs may be indicated after assessment and determination of stability, but they are not the initial intervention. Immediate evaluation of ABCs is required to prevent deterioration.
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