When teaching a client with a new prescription for spironolactone, which instruction should the nurse include?

Correct Answer: D

Rationale: The correct answer is to instruct the client to monitor for signs of hyperkalemia when taking spironolactone since it is a potassium-sparing diuretic. Hyperkalemia is a potential adverse effect due to the medication's mechanism of action. Advising the client to increase potassium-rich foods (Choice A) would be incorrect as it can further elevate potassium levels, which could lead to hyperkalemia. Avoiding grapefruit juice (Choice B) is not directly related to spironolactone use. Though taking the medication with food (Choice C) can help reduce gastrointestinal upset, it is not the most critical instruction when initiating spironolactone therapy.

Correct Answer: B

Rationale: The correct answer is B: Tremors. Tremors are a sign of lithium toxicity and should be reported immediately. Increased urination is a common side effect of lithium but not an urgent concern requiring immediate reporting. Weight gain is also a common side effect of lithium but does not indicate toxicity. Blurred vision is not typically associated with lithium toxicity; therefore, it is not the priority finding to report.

Correct Answer: C

Rationale: The correct answer is choice C, the State Board of Nursing for each state, because these boards establish the legal scope of practice for nurse practitioners, including prescriptive authority, which varies by state due to differing regulations. Choice A, the National Council of State Boards of Nursing, is incorrect as it provides guidelines and licensure standards but doesn't directly regulate state-specific authority. Choice B, the U.S. Drug Enforcement Administration, is wrong because it oversees controlled substances, not general prescribing rights. Choice D, the State Board of Pharmacy, is also incorrect since it governs pharmacists, not NPs, and has no jurisdiction over their prescriptive authority.

Correct Answer: B

Rationale: Choice B is correct because dosing cephalexin every 8 hours aligns with its biological half-life, the time it takes for half the drug to be eliminated, ensuring steady therapeutic levels. Choice A is incorrect as ‘propensity to target receptor' isn't a standard pharmacokinetic term for dosing decisions. Choice C is wrong because pharmacodynamics (drug effects) informs efficacy, not timing. Choice D is incorrect since safety and side effects influence drug choice, not specifically the 8-hour interval.

Correct Answer: B

Rationale: Choice B is correct because synergy means the combined effect exceeds the sum of individual effects, enhancing therapeutic outcomes beyond additive results. Choice A is incorrect as it describes an additive, not synergistic, effect. Choice C is wrong because synergy doesn't reduce efficacy below individual effects. Choice D is incorrect since synergy is a predictable pharmacological principle, not entirely variable.