Nursing practice questions with comprehensive rationales
NurseDive Free Nursing Practice Question
A nurse is caring for a client who has hypertension and is taking hydrochlorothiazide. The client reports muscle weakness and fatigue. Which of the following responses should the nurse make?
A. “You should drink more fluids to prevent dehydration.”
Choice A is wrong because drinking more fluids can increase blood volume and blood pressure, which is not desirable for a client who has hypertension. Dehydration is not a common side effect of hydrochlorothiazide.
B. “You should eat more foods that are high in potassium.”
Hydrochlorothiazide is a thiazide diuretic that lowers blood pressure by increasing urine output. However, it also causes potassium loss, which can lead to muscle weakness and fatigue. Therefore, the client should consume foods that are rich in potassium, such as bananas, oranges, potatoes, and spinach.
C. “You should check your blood sugar level regularly.”
Choice C is wrong because hydrochlorothiazide does not affect blood sugar levels directly. However, it can interact with some antidiabetic medications and increase the risk of hypoglycemia. Therefore, the client should monitor blood sugar levels regularly if taking both medications.
D. “You should avoid exposure to sunlight.”.
Choice D is wrong because hydrochlorothiazide does not increase sensitivity to sunlight. However, it can cause photosensitivity reactions in some clients, such as rash, itching, or redness of the skin. Therefore, the client should use sunscreen and wear protective clothing when exposed to sunlight.
E. “You should avoid exposure to sunlight.”.
None
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Full Explanation
Hydrochlorothiazide is a thiazide diuretic that lowers blood pressure by increasing urine output. However, it also causes potassium loss, which can lead to muscle weakness and fatigue. Therefore, the client should consume foods that are rich in potassium, such as bananas, oranges, potatoes, and spinach.
Choice A is wrong because drinking more fluids can increase blood volume and blood pressure, which is not desirable for a client who has hypertension. Dehydration is not a common side effect of hydrochlorothiazide.
Choice C is wrong because hydrochlorothiazide does not affect blood sugar levels directly. However, it can interact with some antidiabetic medications and increase the risk of hypoglycemia. Therefore, the client should monitor blood sugar levels regularly if taking both medications.
Choice D is wrong because hydrochlorothiazide does not increase sensitivity to sunlight. However, it can cause photosensitivity reactions in some clients, such as rash, itching, or redness of the skin. Therefore, the client should use sunscreen and wear protective clothing when exposed to sunlight.
Similar Questions
A nurse is assessing a client who has hypertension and is taking an angiotensin-converting enzyme (ACE) inhibitor. Which of the following findings should the nurse report to the provider?
A. A dry cough
Choice A is wrong because a dry cough is a common and benign side effect of ACE inhibitors. It does not indicate a serious problem and does not require reporting to the provider.
B. A heart rate of 72/min
Choice B is wrong because a heart rate of 72/min is within the normal range of 60 to 100 beats per minute. It does not indicate any adverse effect of ACE inhibitors or hypertension.
C. A serum potassium level of 5.2 mEq/L
A serum potassium level of 5.2 mEq/L. The nurse should report this finding to the provider because it indicates hyperkalemia, which is a potential adverse effect of ACE inhibitors. Hyperkalemia can cause cardiac arrhythmias and muscle weakness, and it requires prompt treatment.
D. A blood pressure of 130/80 mm Hg.
Choice D is wrong because a blood pressure of 130/80 mm Hg is within the target range for a client who has hypertension. It indicates that the ACE inhibitor is effective in lowering the blood pressure and does not require reporting to the provider.
Full Explanation
A serum potassium level of 5.2 mEq/L. The nurse should report this finding to the provider because it indicates hyperkalemia, which is a potential adverse effect of ACE inhibitors. Hyperkalemia can cause cardiac arrhythmias and muscle weakness, and it requires prompt treatment.
Choice A is wrong because a dry cough is a common and benign side effect of ACE inhibitors. It does not indicate a serious problem and does not require reporting to the provider.
Choice B is wrong because a heart rate of 72/min is within the normal range of 60 to 100 beats per minute. It does not indicate any adverse effect of ACE inhibitors or hypertension.
Choice D is wrong because a blood pressure of 130/80 mm Hg is within the target range for a client who has hypertension. It indicates that the ACE inhibitor is effective in lowering the blood pressure and does not require reporting to the provider.
A nurse is providing dietary education to a client who has hypertension and hyperlipidemia. Which of the following foods should the nurse recommend to the client?
A. Whole milk
Choice A is wrong because whole milk is high in saturated fat, which can increase cholesterol levels and the risk of cardiovascular disease. A client who has hypertension and hyperlipidemia should choose low-fat or skim milk instead.
B. Salted nuts
Choice B is wrong because salted nuts are high in sodium, which can increase blood pressure and fluid retention. A client who has hypertension and hyperlipidemia should choose unsalted nuts or seeds, which are rich in healthy fats, protein, and fiber.
C. Oatmeal
Oatmeal is a good source of soluble fiber, which can help lower cholesterol levels and blood pressure. Oatmeal also has a low glycemic index, which means it does not cause rapid spikes in blood sugar levels. A client who has hypertension and hyperlipidemia should avoid foods that are high in saturated fat, sodium, and sugar, as they can worsen these conditions.
D. Bacon.
Choice D is wrong because bacon is high in saturated fat, sodium, and nitrates, which can increase cholesterol levels, blood pressure, and inflammation. A client who has hypertension and hyperlipidemia should limit or avoid processed meats and choose lean sources of protein instead.
E. Bacon.
Full Explanation
Oatmeal is a good source of soluble fiber, which can help lower cholesterol levels and blood pressure. Oatmeal also has a low glycemic index, which means it does not cause rapid spikes in blood sugar levels. A client who has hypertension and hyperlipidemia should avoid foods that are high in saturated fat, sodium, and sugar, as they can worsen these conditions.
Choice A is wrong because whole milk is high in saturated fat, which can increase cholesterol levels and the risk of cardiovascular disease. A client who has hypertension and hyperlipidemia should choose low-fat or skim milk instead.
Choice B is wrong because salted nuts are high in sodium, which can increase blood pressure and fluid retention. A client who has hypertension and hyperlipidemia should choose unsalted nuts or seeds, which are rich in healthy fats, protein, and fiber.
Choice D is wrong because bacon is high in saturated fat, sodium, and nitrates, which can increase cholesterol levels, blood pressure, and inflammation. A client who has hypertension and hyperlipidemia should limit or avoid processed meats and choose lean sources of protein instead.
A nurse is reviewing the medication history of a client who has hypertension and is prescribed a calcium channel blocker. Which of the following medications should the nurse instruct the client to avoid? (Select all that apply.)
A. Grapefruit juice
Grapefruit juice can increase the blood levels of calcium channel blockers, which can lead to adverse effects such as hypotension, bradycardia, and edema.
B. Ibuprofen
Ibuprofen, digoxin, and warfarin are not contraindicated with calcium channel blockers, but they should be used with caution and monitored closely for potential interactions.
C. St. John’s wort
St.John’s wort can decrease the effectiveness of calcium channel blockers by inducing their metabolism in the liver. This can reduce the therapeutic effect of lowering blood pressure and preventing angina.
D. Digoxin
Ibuprofen, digoxin, and warfarin are not contraindicated with calcium channel blockers, but they should be used with caution and monitored closely for potential interactions. Ibuprofen can increase the risk of bleeding when taken with warfarin, digoxin can increase the risk of arrhythmias when taken with calcium channel blockers, and warfarin can increase the risk of bleeding when taken with calcium channel blockers.
E. Warfarin.
Full Explanation
The nurse should instruct the client to avoid grapefruit juice and St. John’s wort when taking a calcium channel blocker.
Here is why:
• Grapefruit juice can increase the blood levels of calcium channel blockers, which can lead to adverse effects such as hypotension, bradycardia, and edema.
The normal blood pressure range is 90/60 mmHg to 120/80 mmHg, and the normal heart rate range is 60 to 100 beats per minute.
• St. John’s wort can decrease the effectiveness of calcium channel blockers by inducing their metabolism in the liver.
This can reduce the therapeutic effect of lowering blood pressure and preventing angina.
• Ibuprofen, digoxin, and warfarin are not contraindicated with calcium channel blockers, but they should be used with caution and monitored closely for potential interactions.
Ibuprofen can increase the risk of bleeding when taken with warfarin, digoxin can increase the risk of arrhythmias when taken with calcium channel blockers, and warfarin can increase the risk of bleeding when taken with calcium channel blockers.