What side effect should be monitored for in a patient with chronic heart failure taking spironolactone?

Correct Answer: B

Rationale: The correct answer is B: Hyperkalemia. Spironolactone is a potassium-sparing diuretic commonly used in patients with heart failure. It works by blocking the aldosterone receptor, leading to potassium retention and potential hyperkalemia. Monitoring potassium levels is crucial as hyperkalemia can increase the risk of arrhythmias and other cardiac complications in heart failure patients. A: Hypokalemia is incorrect because spironolactone typically causes potassium retention. C: Hyponatremia and D: Hypernatremia are incorrect as spironolactone does not directly affect sodium levels. In summary, monitoring for hyperkalemia is essential in patients with heart failure taking spironolactone to prevent adverse cardiac events.

Correct Answer: C

Rationale: The correct answer is C: Before meals. Omeprazole is a proton pump inhibitor that works by reducing stomach acid production. Taking it before meals allows the medication to be most effective in inhibiting the proton pumps before they are stimulated by food intake. This timing optimizes the drug's ability to reduce acid secretion during the digestion process. Choice A (With meals) is incorrect because taking omeprazole with meals may reduce its effectiveness as it will not have enough time to inhibit acid production before food intake. Choice B (At bedtime) is also incorrect as omeprazole works best when taken before meals to prevent acid production. Choice D (After meals) is incorrect because waiting until after meals to take omeprazole means that acid production has already been stimulated by the food consumed, reducing the drug's effectiveness in inhibiting acid secretion.

Correct Answer: A

Rationale: Step-by-step rationale: 1. Atorvastatin is a statin medication commonly known to potentially cause liver damage. 2. Monitoring liver function tests periodically helps assess for any liver abnormalities. 3. Elevated liver enzymes may indicate liver injury from atorvastatin. 4. Monitoring liver function tests allows for early detection and management of adverse effects. Summary: A: Monitoring liver function tests is crucial due to atorvastatin's potential hepatotoxicity. B: Complete blood count is not typically affected by atorvastatin. C: Blood glucose levels are not directly related to atorvastatin use. D: Serum potassium is not specifically monitored for atorvastatin-related adverse effects.

Correct Answer: B

Rationale: The correct answer is B: Maintain a consistent salt intake. Lithium can affect sodium levels in the body, so it's important to maintain a consistent salt intake to prevent lithium toxicity or imbalance. Increasing caffeine intake (choice A) can worsen symptoms of bipolar disorder. Avoiding dairy products (choice C) is not necessary for lithium therapy. Increasing intake of green leafy vegetables (choice D) is generally healthy but not specifically recommended for lithium therapy. Maintaining a consistent salt intake is crucial in managing the effects of lithium on sodium levels.

Correct Answer: B

Rationale: The correct answer is B: Rinse the mouth after using the inhaler. This instruction is crucial because corticosteroid inhalers can lead to oral thrush, a fungal infection in the mouth. Rinsing the mouth helps prevent this side effect. A: Using the inhaler only during asthma attacks is incorrect as corticosteroid inhalers are typically used regularly to manage asthma symptoms. C: Taking a double dose if symptoms worsen is dangerous and can lead to overdose. Patients should follow the prescribed dosage. D: Avoiding using a spacer with the inhaler is not a universal instruction. Spacers can actually improve the effectiveness of the medication delivery.