An older adult client with hypertension has recently been prescribed a beta-adrenergic blocker and a thiazide diuretic. When educating the client about preventing and managing adverse effects, the nurse will provide which instruction?
"Change positions slowly to prevent lightheadedness or dizziness."
"Reduce your fluid intake initially, to prevent excessive urination."
"Identify and eliminate any high-potassium foods from your diet."
"Expect your blood pressure to increase for several days before it begins to decrease."
The Correct Answer is A
A. Changing positions slowly is critical for older adults taking beta-adrenergic blockers and diuretics to prevent orthostatic hypotension, which can lead to lightheadedness or dizziness.
B. Reducing fluid intake is not advisable, as thiazide diuretics can lead to dehydration, and maintaining adequate fluid intake is essential for overall health and to avoid excessive urinary output.
C. Identifying and eliminating high-potassium foods is unnecessary unless there is a specific indication of hyperkalemia, particularly since thiazide diuretics do not typically cause potassium retention, and beta-blockers are not potassium-specific.
D. Expecting blood pressure to increase before it decreases is misleading; clients should see a gradual reduction in blood pressure with proper medication adherence, and any sudden increases should be reported.
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Correct Answer is A
Explanation
A. Reye syndrome is correct because administering aspirin to children, especially during viral illnesses like the flu, can lead to this serious and potentially fatal condition characterized by acute encephalopathy and liver failure.
B. Excess antiplatelet action is incorrect; while aspirin does have antiplatelet effects, this is not the primary concern in a child with a viral illness.
C. Asthma is incorrect; while some individuals with asthma may have sensitivity to aspirin, it is not specifically related to the child's flulike illness.
D. Salicylate poisoning is incorrect; while high doses of aspirin can lead to toxicity, the immediate risk in the context of flu-like illness is Reye syndrome, which is a more specific concern.
Correct Answer is C
Explanation
A. Metformin does not stimulate the pancreas to produce more insulin; that action is characteristic of sulfonylureas.
B. Metformin does not increase the absorption of glucose in the intestines; rather, it works by reducing the amount of glucose released into the bloodstream.
C. Metformin primarily decreases glucose production in the liver and improves insulin sensitivity in peripheral tissues, which helps lower blood sugar levels. This makes it effective for managing type 2 diabetes.
D. While metformin can have effects on fat metabolism, its primary action is not to decrease fat breakdown but to manage blood glucose levels.