# A 55-year-old client newly prescribed hydrochlorothiazide (HCTZ) 25 mg orally every morning for hypertension is being given discharge teaching. Which statement by the client indicates a need for further teaching?

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=374909&lang=en  
> language: en  
> subject: Medical Emergencies  
> category: PA

## Question

A 55-year-old client newly prescribed hydrochlorothiazide (HCTZ) 25 mg orally every morning for hypertension is being given discharge teaching. Which statement by the client indicates a need for further teaching?

## Option

1. "I will use sunscreen and a wide-brimmed hat because the medication can make my skin more sensitive to the sun."
2. "I will let the provider know if I develop muscle cramps, weakness, or palpitations because my potassium might be low."
3. "I will report any new joint pain or swelling because this drug can raise my uric acid."
4. "I will take my dose at 9 PM with my evening meal so the medication will be most active overnight." **✔ Correct answer**

**Correct answer: 4**

## Explanation

HCTZ teaching priorities
Hydrochlorothiazide is a thiazide diuretic that inhibits the Na/Cl symporter in the distal convoluted tubule and is first-line for HTN. Important teaching: take in the morning to prevent nocturia and sleep disruption; report electrolyte symptoms — hypokalemia (cramps, weakness, palpitations, arrhythmia), hyponatremia (HA, confusion, falls in elderly), and hypomagnesemia; expect hypercalcemia (clinically used in osteoporosis) but report bone pain, kidney stones; report hyperuricemia/gout flare; expect mild hyperglycemia (matters in DM); use sunscreen for photosensitivity; check sulfonamide allergy. Evening dosing is wrong because of nocturia. Therapeutic effect on BP takes 2-4 weeks.

## In-depth explanation

Clinical reasoning summary
HCTZ teaching priorities
Hydrochlorothiazide is a thiazide diuretic that inhibits the Na/Cl symporter in the distal convoluted tubule and is first-line for HTN. Important teaching: take in the morning to prevent nocturia and sleep disruption; report electrolyte symptoms — hypokalemia (cramps, weakness, palpitations, arrhythmia), hyponatremia (HA, confusion, falls in elderly), and hypomagnesemia; expect hypercalcemia (clinically used in osteoporosis) but report bone pain, kidney stones; report hyperuricemia/gout flare; expect mild hyperglycemia (matters in DM); use sunscreen for photosensitivity; check sulfonamide allergy. Evening dosing is wrong because of nocturia. Therapeutic effect on BP takes 2-4 weeks.

## Related questions

- [A nurse is caring for an alert adult client with type 1 diabetes who reports tremors, swea…](https://mymerci.kr/pages/nclex_q.php?qn_id=360524&lang=en)
- [A 68-year-old client with COPD is admitted with shortness of breath and SpO2 86% on room a…](https://mymerci.kr/pages/nclex_q.php?qn_id=362940&lang=en)
- [A 58-year-old client arrives at the emergency department with crushing substernal chest pa…](https://mymerci.kr/pages/nclex_q.php?qn_id=362976&lang=en)
- [A 72-year-old client is brought to the emergency department by family who report that the …](https://mymerci.kr/pages/nclex_q.php?qn_id=363003&lang=en)
- [A 79-year-old client is admitted from a long-term care facility with diarrhea, decreased o…](https://mymerci.kr/pages/nclex_q.php?qn_id=363089&lang=en)
- [A 76-year-old female with chronic heart failure and atrial fibrillation receives digoxin 0…](https://mymerci.kr/pages/nclex_q.php?qn_id=374883&lang=en)
- [A 70-year-old client on long-term digoxin therapy reports new yellow-green halos around li…](https://mymerci.kr/pages/nclex_q.php?qn_id=374884&lang=en)
- [A 58-year-old client with type 2 diabetes mellitus and migraine prophylaxis is taking prop…](https://mymerci.kr/pages/nclex_q.php?qn_id=374893&lang=en)

## Read in another language

- [en](https://mymerci.kr/pages/nclex_q.php?qn_id=374909&lang=en)
- [ko](https://mymerci.kr/pages/nclex_q.php?qn_id=374909&lang=ko)
- [ja](https://mymerci.kr/pages/nclex_q.php?qn_id=374909&lang=ja)
- [zh-TW](https://mymerci.kr/pages/nclex_q.php?qn_id=374909&lang=zh-tw)
- [vi](https://mymerci.kr/pages/nclex_q.php?qn_id=374909&lang=vi)

---

More free questions: [NCLEX-RN Practice](https://mymerci.kr/pages/nclex_bank.php?lang=en)

_For study reference only. Always follow current clinical guidelines and your institution’s protocols._