# A client with post-MI HFrEF has a new eplerenone prescription. Potassium is 5.8 mEq/L and creatinine clearance is 28 mL/min. Which action should the nurse take?

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=522063&lang=en  
> language: en  
> subject: Adverse Effects/Contraindications/Interactions  
> category: PPT

## Question

A client with post-MI HFrEF has a new eplerenone prescription. Potassium is 5.8 mEq/L and creatinine clearance is 28 mL/min. Which action should the nurse take?

## Option

1. Administer the first dose with a potassium supplement
2. Give half the dose and recheck in 1 month
3. Hold the medication and clarify the prescription immediately **✔ Correct answer**
4. Administer it because eplerenone lowers potassium

**Correct answer: 3**

## Explanation

Eplerenone is contraindicated at initiation when potassium exceeds 5.5 mEq/L or creatinine clearance is 30 mL/min or less.

## In-depth explanation

Quick answer
Hold and clarify because both potassium and renal contraindications are present.

Why this is correct
Eplerenone blocks mineralocorticoid effects and can raise potassium. Current labeling requires baseline potassium and renal assessment and lists these values as contraindications.

Easy analogy or mental picture
The drug closes a potassium exit pathway; high potassium and low clearance make the room unsafe before the first dose.

Memory hook
Eplerenone start: potassium 5.5 or lower and CrCl above 30.

NCLEX decision rule
Check hard contraindication thresholds before applying the heart-failure benefit.

Why the other choices are wrong
Dose reduction or delayed monitoring does not override two initiation contraindications, and potassium supplementation worsens risk.References
1DailyMed: EplerenonePotassium and renal contraindications, monitoring, and post-MI HFrEF therapy

## Clinical scenario

Mineralocorticoid antagonist check
Verify potassium, creatinine clearance, ACE or ARB use, NSAIDs, supplements, CYP3A inhibitors, blood pressure, and monitoring dates.

## Related questions

- [A nurse is reviewing the morning lab results for an adult client receiving warfarin for at…](https://mymerci.kr/pages/nclex_q.php?qn_id=360515&lang=en)
- [A client is admitted to the emergency department after ingesting an unknown amount of acet…](https://mymerci.kr/pages/nclex_q.php?qn_id=362720&lang=en)
- [A client with chronic heart failure is prescribed metoprolol 25 mg orally twice daily. Bef…](https://mymerci.kr/pages/nclex_q.php?qn_id=362756&lang=en)
- [A 28-year-old client with type 1 diabetes receives regular insulin 6 units and NPH insulin…](https://mymerci.kr/pages/nclex_q.php?qn_id=362792&lang=en)
- [A client receives IV vancomycin 1 g every 12 hours for MRSA bacteremia. Before the next do…](https://mymerci.kr/pages/nclex_q.php?qn_id=362833&lang=en)
- [A client with bipolar disorder has been taking lithium carbonate 600 mg orally three times…](https://mymerci.kr/pages/nclex_q.php?qn_id=362894&lang=en)
- [An 80-year-old male with heart failure is prescribed digoxin 0.125 mg daily. During mornin…](https://mymerci.kr/pages/nclex_q.php?qn_id=372686&lang=en)
- [A 38-year-old female with rheumatoid arthritis is being discharged with a new prescription…](https://mymerci.kr/pages/nclex_q.php?qn_id=372687&lang=en)

## Read in another language

- [en](https://mymerci.kr/pages/nclex_q.php?qn_id=522063&lang=en)
- [ko](https://mymerci.kr/pages/nclex_q.php?qn_id=522063&lang=ko)
- [ja](https://mymerci.kr/pages/nclex_q.php?qn_id=522063&lang=ja)
- [zh-TW](https://mymerci.kr/pages/nclex_q.php?qn_id=522063&lang=zh-tw)
- [vi](https://mymerci.kr/pages/nclex_q.php?qn_id=522063&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._