When monitoring a patient who is taking hydrochlorothiazide (HydroDIURIL), the nurse notes that which drug is most likely to cause a severe interaction with the diuretic?

Correct Answer: A

Rationale: Hydrochlorothiazide (HydroDIURIL) is a diuretic that can cause electrolyte imbalances, particularly hypokalemia (low potassium levels). Digitalis (digoxin) is a medication commonly used to treat heart conditions, and its therapeutic effect is dependent on adequate potassium levels. If a patient taking hydrochlorothiazide becomes hypokalemic and then takes digitalis, it can lead to an increased risk of digitalis toxicity. This severe interaction highlights the importance of monitoring potassium levels and potential drug interactions when patients are taking hydrochlorothiazide. Potassium supplements would help counteract the potassium loss caused by hydrochlorothiazide and minimize the risk of interactions with digitalis.

Correct Answer: A

Rationale: A. You need to have your blood pressure checked once a week and keep track of the readings. - This statement is correct because monitoring blood pressure regularly is essential when taking antihypertensive medications to ensure they are effectively controlling hypertension.

Correct Answer: C

Rationale: When medications are bound to proteins in the bloodstream, they are inactive and unable to exert their therapeutic effects. Only the unbound (free) fraction of the drug is pharmacologically active. Therefore, the more a drug is bound to protein, the less available it is for its desired effect. Protein binding also affects the drug's distribution and metabolism, but it does not enhance availability or increase liver metabolism. Rapid distribution to receptor sites is influenced by other factors, such as blood flow and tissue permeability.

Correct Answer: C

Rationale: Oxymetazoline treats nasal congestion in allergic rhinitis by acting as an α-adrenergic agonist. Option , increased nasal blood flow, is incorrect-vasoconstriction reduces flow. Option , increased arterial pressure, doesn't directly relieve congestion. Option , receptor stimulation on nasal vasculature, is correct-oxymetazoline stimulates α-receptors, causing vasoconstriction, shrinking swollen mucosa, and improving airflow. Option , transmembrane conductance change, is unrelated to its action. Option (E), understimulation, contradicts its agonist role. This vasoconstrictive effect rapidly alleviates congestion, explaining the symptom improvement. Unlike antihistamines or steroids, oxymetazoline targets vascular tone, not inflammation or histamine, making it ideal for quick relief in rhinitis. Prolonged use risks rebound congestion, but the question focuses on initial efficacy, where receptor-mediated vasoconstriction is key.

Correct Answer: A

Rationale: The correct statement by the nurse is to instruct the patient to "stop taking the diuretic for a few days, and then restart it when you feel better." This is because the patient has been experiencing vomiting due to influenza, which can cause dehydration. Continuing the diuretic while experiencing such significant fluid loss can lead to further dehydration and electrolyte imbalances. It is important for the patient to pause the diuretic temporarily to allow the body to recover and then resume once the vomiting has subsided and hydration has improved. It's always best for patients to follow specific instructions given by healthcare providers in such situations.