A client has a new prescription for spironolactone. The client should avoid which of the following foods?

Correct Answer: A

Rationale: In pharmacology, understanding drug-food interactions is crucial to ensure optimal therapeutic outcomes. In the case of spironolactone, a potassium-sparing diuretic, choosing the right foods is important due to its potential to increase serum potassium levels. The correct answer is A) Salt substitutes. Salt substitutes often contain potassium chloride, which can further elevate potassium levels when consumed with spironolactone, leading to hyperkalemia, a serious condition. Option B) Apples and option D) Bananas are high-potassium foods. Consuming these foods in excess while taking spironolactone can also contribute to elevated potassium levels, increasing the risk of adverse effects. Option C) Chicken, on the other hand, does not pose a significant risk of increasing potassium levels when consumed with spironolactone. It is a low-potassium food choice that can be safely included in the client's diet. Educationally, this scenario emphasizes the importance of patient education regarding dietary restrictions when taking specific medications. Healthcare providers must inform patients about potential drug-food interactions to prevent complications and promote safe medication use.

Correct Answer: C

Rationale: In this scenario, the nurse should report the herbal supplement Kava to the provider. Kava has been associated with hepatotoxicity, which can further worsen the client's already increased liver enzymes. The other options, Glucosamine, Saw palmetto, and St. John's wort, do not typically have strong hepatotoxic effects. Glucosamine is commonly used for joint health and is not known to significantly impact liver enzymes. Saw palmetto is often used for benign prostatic hyperplasia and has not been linked to liver enzyme elevations. St. John's wort is used for depression but is more commonly associated with drug interactions rather than liver toxicity. Educationally, this question highlights the importance of understanding the potential hepatotoxic effects of herbal supplements, especially in clients with pre-existing liver issues. It emphasizes the need for nurses to be vigilant in monitoring and reporting any concerning signs or symptoms related to herbal supplement use to ensure patient safety and well-being.

Correct Answer: B

Rationale: Isosorbide is an organic nitrate used to manage angina. Concurrent use of sildenafil with organic nitrates, like isosorbide, is contraindicated due to the risk of fatal hypotension. It is essential for clients to avoid taking nitrate medications within 24 hours of using isosorbide to prevent serious complications.

Correct Answer: B

Rationale: In this scenario, the correct answer is B) The subcutaneous site for redness following injection. Adalimumab is typically administered via subcutaneous injection for the treatment of Rheumatoid Arthritis. Monitoring the injection site for redness is crucial as it can indicate local inflammation or an allergic reaction, which are important considerations in the management of the medication. Option A) is incorrect as Adalimumab is not administered intravenously, so monitoring the vein for thrombophlebitis is not relevant. Option C) is incorrect as Adalimumab is not administered orally, so monitoring the oral mucosa for ulceration is not necessary. Option D) is incorrect as Adalimumab is not administered via a transdermal patch, so monitoring the skin for irritation following patch removal is not applicable. In an educational context, understanding the route of administration of medications is vital for nursing practice to ensure safe and effective patient care. Monitoring for and recognizing potential side effects or complications associated with specific routes of administration is essential in providing quality nursing care and promoting positive patient outcomes.

Correct Answer: B

Rationale: In this scenario, the correct medication to anticipate administering to a young adult client with a serum calcium level of 8.8 mg/dL is option B) Calcium carbonate. Calcium carbonate is a common treatment for hypocalcemia, which is characterized by low serum calcium levels. It works by providing supplemental calcium to raise the serum levels back to normal. In this case, the client's low serum calcium level indicates a need for a calcium supplement like calcium carbonate. The other options are not appropriate for a client with low serum calcium. A) Calcitonin-salmon is used to treat hypercalcemia (high serum calcium levels) by inhibiting bone resorption. C) Zoledronic acid and D) Ibandronate are both bisphosphonates used in the treatment of osteoporosis by inhibiting bone breakdown, not for increasing serum calcium levels. In an educational context, understanding the rationale behind choosing the correct medication based on the client's condition is crucial for safe and effective pharmacological interventions. It also highlights the importance of assessing and interpreting lab values to guide medication choices in clinical practice.