Which of the following would alert the nurse that a client with diabetes insipidus may be getting too much desmopressin?

Choice A reason: This statement is false. The nurse should not hold glipizide, as it is an oral antidiabetic drug that lowers blood glucose by stimulating the release of insulin from the pancreas. The client has a normal blood glucose level, which can be maintained by taking the glipizide as ordered. The nurse should also encourage the client to follow a balanced diet and exercise regimen.

Choice B reason: This statement is true. The nurse should check the apical heart rate prior to captopril, as it is an angiotensin-converting enzyme (ACE) inhibitor that lowers blood pressure and prevents kidney damage. However, it can also cause bradycardia, which is a slow heart rate. The nurse should hold the captopril and notify the prescriber if the heart rate is below 60 beats per minute.

Choice C reason: This statement is false. The nurse should not give atenolol as ordered, as it is a beta-blocker that lowers blood pressure and heart rate. It can also prevent angina and reduce the risk of heart attack. The client has a slightly elevated blood pressure and a normal heart rate, which can be expected after surgery. The nurse should monitor the client's vital signs and adjust the dose accordingly.

Choice D reason: This statement is false. The nurse should not call the prescriber and ask to change atorvastatin to gemfibrozil, as they are both lipid-lowering drugs that reduce cholesterol and triglycerides. However, they have different mechanisms of action and side effects. Atorvastatin is a statin that inhibits the enzyme that produces cholesterol in the liver. Gemfibrozil is a fibrate that activates the enzyme that breaks down triglycerides in the blood. The nurse should administer the atorvastatin as ordered and monitor the client's liver function and lipid profile.

Choice A reason: This statement is true. The nurse's best response is to explain that generic medications can have different inactive ingredients, such as fillers, binders, or colors, which may affect how the drug is absorbed, distributed, metabolized, or excreted in the body. This can result in variations in the drug levels and effects in some people. Levothyroxine is a synthetic thyroid hormone that requires precise dosing and monitoring to achieve therapeutic levels and avoid adverse effects. Therefore, the prescriber may prefer the client to take the brand name Synthroid, which has a consistent formulation and quality.

Choice B reason: This statement is false. The nurse should not say that there is less regulation with generic medications, as this is not true. Generic medications are required to meet the same standards of safety, efficacy, and quality as brand name drugs by the Food and Drug Administration (FDA). They must also have the same active ingredient, strength, dosage form, and route of administration as the brand name drug.

Choice C reason: This statement is false. The nurse should not say that it makes no difference, the doctor just gets more money when you buy the brand name, as this is not true and unethical. The doctor does not get any financial benefit from prescribing the brand name drug, and the client may pay more for the brand name drug than the generic one. The doctor may have a valid reason for preferring the brand name drug, such as the client's response, preference, or allergy.

Choice D reason: This statement is false. The nurse should not say that brand name drugs are always better because they are made by major pharmaceutical companies, as this is not true and biased. Brand name drugs are not necessarily better than generic drugs, as they have the same active ingredient and therapeutic effect. However, some brand name drugs may have advantages over generic drugs, such as patent protection, innovation, or formulation.