quiz 51
d
A client is diagnosed with increased intracranial pressure. Which of the following would the nurse expect to be ordered? a) Bumetanide b) Furosemide c) Amiloride d) Mannitol
c
A client is receiving hydrochlorothiazide. The nurse would expect this drug to begin acting within which time frame? a) 3 hours b) 4 hours c) 2 hours d) 1 hour
c
A client is taking spironolactone (Aldactone) for edema. The nurse identifies that the client's potassium level is 5.4 mEq/L. Which of the following questions would be appropriate for the nurse to ask the client? a) "Are you experiencing any leg cramps?" b) "Is your urine dark?" c) "Do you use a salt substitute?" d) "Are you weighing yourself daily?"
d
A client receives a dose of furosemide intravenously at 8:00 AM. The nurse would expect this drug to exert is peak effects at which time? a) 9:00 AM b) 8:15 AM c) 8:45 AM d) 8:30 AM
d
A client who has been taking hydrochlorothiazide arrives at the clinic for his 1-month follow-up appointment. The client tells the nurse that he feels weaker since he began taking the drug. What should the nurse consider as a possible cause of these symptoms? a) Hypercalcemia b) Hyperkalemia c) Hypocalcemia d) Hypokalemia
d
A female client is diagnosed with chronic congestive heart failure and hypertension. The nurse would expect the physician to order what type of diuretic? a) Osmotic b) Potassium wasting c) Loop d) Thiazide
c
A female client is diagnosed with hyponatremia. What type of diuretic would most likely cause this symptom? a) Osmotic b) Thiazide c) Loop d) Potassium sparing
a
A female patient reports that she has frequent muscle cramps while on hydrochlorothiazide therapy. The nurse will advise her to a) eat potassium-rich foods. b) take calcium supplements. c) include high-sodium foods in her diet. d) drink plenty of fluids.
a
A male client has cirrhosis and is receiving diuretic therapy. The nurse knows that what drug will help prevent metabolic alkalosis or hypokalemia in this client? a) Spironolactone b) Dyazide c) Hydrochlorothiazide d) Bumetanide
c
A male client is excited because it is football season. He has season tickets and attends most games with his friends. At his latest appointment, the client's blood pressure is elevated. What does the nurse suspect is the cause? a) He is anxious about his team. b) He has become a vegetarian until his team wins the championship. c) He is consuming excessive salty foods at the games. d) He is developing comorbidities.
c
A nurse administered a patient's scheduled oral dose of 20 mg furosemide (Lasix) at 8 AM this morning. This drug administration would have a bearing on which of the following assessments? a) Intracranial pressure (ICP) and cognition b) Heart rate and rhythm c) Pedal pulses and ankle circumference d) Assessment of food and fluid intake
a
A nurse is caring for a patient with acute renal failure. The physician has prescribed a diuretic therapy for the patient to promote dieresis. What intervention should the nurse perform to prevent the inconvenience caused by increased urination? a) Administer the drug early in the day. b) Encourage the patient to exercise. c) Gradually increase the drug dosage. d) Ask the patient to decrease fluid intake.
b
A nurse understands that loop diuretics are considered high ceiling diuretics because of which of the following? a) They require large doses to achieve effect. b) They cause a greater diuresis. c) They cause a greater loss of potassium. d) They are associated with more adverse effects.
b
A patient has been prescribed digoxin (Lanoxin) and furosemide (Lasix) for treatment of congestive heart failure. What is the patient at risk for developing with this combination of medications? a) Hyperkalemia b) Digoxin toxicity c) Hyperglycemia d) Tachycardia
d
A patient has edema of the lower extremities and abdomen. What is the reason to administer a stronger diuretic than a thiazide diuretic to this patient? a) A thiazide diuretic will reabsorb potassium in the distal tubule. b) A thiazide diuretic will be excreted in more than 72 hours. c) A thiazide diuretic will provide peak effects in 2 hours. d) A thiazide diuretic will be ineffective for immediate diuresis.
c
A patient is administered furosemide (Lasix) 20 mg every morning. What effect will a diet high in sodium have on the patient? a) Hyperglycemia b) Hyperkalemia c) Decreased diuresis d) Increased diuresis
a
A patient is admitted the hospital with congestive heart failure. The patient is ordered to receive furosemide (Lasix) 40 mg IV. How soon will diuretic effects occur after administration? a) 5 minutes b) 2 hours c) 1 minute d) 30 minutes
a
A patient is admitted to the emergency and is unconscious as a result of a head injury. The patient's intracranial pressure is increased. What diuretic will be administered to the patient? a) Osmotic diuretic b) Potassium-sparing diuretic c) Thiazide diuretic d) Loop diuretic
a
A patient is receiving acetazolamide in a sustained release form. The nurse would anticipate the onset of drug action in approximately which time frame? a) 2 hours b) 4 hours c) 3 hours d) 1 hour
d
A patient is switched from furosemide (Lasix) to spironolactone (Aldactone). The patient asks the nurse why she has been switched to a new medicine. What is the best answer that will provide patient education regarding the change? a) "You will have greater sodium losses with spironolactone than with furosemide." b) "You will have greater water losses with spironolactone than with furosemide." c) "You will have greater potassium losses with spironolactone than with furosemide." d) "You will lose less potassium with spironolactone than with furosemide."
a
A patient with a longstanding diagnosis of chronic renal failure has experienced a significant decline in urine output in recent days, prompting him to seek care at a local clinic. A nurse at the clinic has suggested to a colleague that the administration of a diuretic such as hydrochlorothiazide may improve the patient's urine output. How should the colleague best respond to this suggestion? a) "Actually, patients with renal failure usually can't take hydrochlorothiazide." b) "That would only work if he could come in twice a day to get it intravenously." c) "That would probably help, but we'd have to do blood work first." d) "Maybe, but hydrochlorothiazide affects the bladder more than the kidneys."
a
A physician has prescribed triamterene to a patient with renal disease. The patient informs the nurse that he is taking potassium supplements to overcome cardiovascular problems. What effect of the interaction between these two drugs should the nurse look for in the patient? a) Increased risk of hyperkalemia b) Decreased diuretic effectiveness c) Increased risk of bleeding d) Increased risk of arrhythmias
b
A physician prescribes spironolactone, a potassium-sparing diuretic, for a patient with cirrhosis. For which of the following categories of patients is the use of potassium-sparing diuretics contraindicated? a) Patients with diabetes b) Patients with hyperkalemia c) Patients with liver disease d) Patients with gout
d
After reviewing information about thiazide diuretics, a group of students demonstrate the need for additional teaching when they identify which of the following as a possible adverse effect? a) Hyperuricemia b) Hypokalemia c) Hyperglycemia d) Hypocalcemia
a
After teaching a patient about the action of spironolactone, the nurse determines that the teaching was successful when the patient states which of the following? a) "I need to make sure I don't eat too many high potassium foods." b) "I need to take the drug on an empty stomach." c) "I can still use my salt substitute if I want to." d) "I should take the medicine around dinnertime for the best effect."
d
An elderly patient with a history of congestive heart failure has been admitted to hospital with failure to thrive and admission blood work reveals a hemoglobin level of 6.9 g/dL. The care team has consequently administered two units of packed red blood cells, but auscultation of the client's lungs now reveals diffuse crackles. Administration of what drug is likely to resolve the patient's pulmonary edema? a) Hydrochlorothiazide b) Triamterene c) Mannitol d) Furosemide
a, c, d, e
Choice Multiple question - Select all answer choices that apply. A patient is receiving bumetanide. The nurse would instruct the patient to be alert for which of the following? Select all that apply. a) Weakness b) Irreversible hearing loss c) Muscle cramps d) Hypotension e) Dizziness
a, c, d
Choice Multiple question - Select all answer choices that apply. The nurse is caring for a client who is receiving mannitol. The nurse knows that it is used to manage oliguria or anuria. The nurse knows that it is also used for what other conditions? (Select all that apply.) a) Reduction of intraocular pressure b) Reduction of mild to moderate swelling of the extremities c) Urinary excretion of toxic substances d) Reduction of intracranial pressure e) Reduction of venous jugular pressure
b, e
Choice Multiple question - Select all answer choices that apply. Which of the following drugs causes dieresis by increasing the density of filtrate in the glomerulus? Select all that apply: a) Torsemide b) Mannitol c) Amiloride d) Ethacrynic acid e) Urea
c
Ms. Crampton is prescribed furosemide for chronic heart failure. The nurse knows that furosemide can cause electrolyte imbalances and what other serious side effect? a) Compensated respiratory alkalosis b) Compensated respiratory acidosis c) Metabolic alkalosis d) Metabolic acidosis
c
The nurse is monitoring the results of laboratory testing for a client receiving chlorthalidone. Which of the following would be a cause for concern? a) Hypercalcemia b) Decreased uric acid levels c) Hyperkalemia d) Anemia
d
The pharmacology instructor is discussing the differences among the various diuretic agents. Which of the following would the instructor cite as a difference between spironolactone and hydrochlorothiazide? a) Spironolactone is more likely to be taken with a potassium supplement. b) Potassium losses are greater with spironolactone than with hydrochlorothiazide. c) The two diuretics act in different parts of the nephron. d) Potassium losses are greater with hydrochlorothiazide than with spironolactone.
d
Upon her visit to your primary care physician's office, your patient presents with 14 pounds of additional weight since her visit 3 weeks ago. Her lower extremities are quite swollen, and her facial features are puffy. The physician prescribes a diuretic and requests a follow-up visit in 3 days. Two days later, the patient contacts the office so dyspneic she is hard to understand over the phone. An ambulance is dispatched, and she is admitted to the hospital for rapid diuresing. Which diuretic will most likely be the initial drug of choice? a) Thiazide b) Potassium-sparing diuretic c) Osmotic diuretic d) Loop diuretic
d
When describing the action of chlorothiazide, which of the following would a nurse include? a) Blocking of potassium secretion through the tubule b) Acting as an aldosterone antagonist c) Blocking the action of carbonic anhydrase d) Blocking of the chloride pump
b
When describing where bumetanide acts, which of the following would the nurse include? a) Collecting tubule b) Loop of Henle c) Proximal convoluted tubule d) Glomerulus
b
Which of the following diuretics exerts its effect by inhibiting the enzyme carbonic anhydrase? (Choose one) a) Spironolactone (Aldactone) b) Acetazolamide (Diamox) c) Furosemide (Lasix) d) Hydrochlorothiazide (Microzide)
b
Which of the following instructions would be most appropriate for a client who is taking a diuretic? a) "Limit the amount of fluids you drink." b) "It's okay to take it with food." c) "Lie down after taking the drug." d) "Take the daily dose around dinnertime."
c
Which of the following would be most important for the nurse to assess before initiating furosemide therapy in a patient with chronic heart failure and pulmonary edema? a) Measuring blood pressure b) Measuring fluid intake and urinary output c) Auscultating breath sounds d) Assessing skin turgor and mucous membranes
c
Which of the following would contraindicate the use of indapamide? a) Diabetes b) Systemic lupus erythematosus c) Hypokalemia d) Gout
c
You are an ED nurse caring for a patient who is receiving furosemide for treatment of pulmonary edema. Which of the following will you monitor to observe for adverse effects of the drug? a) Bone marrow function b) Blood oxygen saturation c) Potassium levels d) Temperature
d
You are caring for a 68-year-old female client with type 1 diabetes mellitus whose physician has ordered hydrochlorothiazide. As a consequence of taking the diuretic, the client may need to a) decrease her consumption of potassium-rich foods. b) decrease her insulin dose. c) increase her consumption of sodium-rich foods. d) increase her insulin dose.
b
You are caring for a patient who is experiencing elevated intracranial pressure following neurosurgery. The physician orders an osmotic diuretic to reduce pressure. Which of the following agents would the physician select? a) Spironolactone b) Mannitol c) Bumetanide d) Ethacrynic acid
b
You are evaluating an 82-year-old client who is receiving hydrochlorothiazide. What abnormal laboratory result might you see related to the medication? a) Elevated serum magnesium levels b) Elevated uric acid levels c) Elevated serum potassium levels d) Reduced blood glucose levels
d
Your 91-year-old patient, who is being prepared for discharge, has been prescribed the diuretic spironolactone. While teaching your patient about the drug, what major adverse effect should you be sure to mention? a) Hyperkalemia b) Angina c) Hypokalemia d) Hypertension
c
Your 91-year-old patient, who is being prepared for discharge, has been prescribed the diuretic spironolactone. While teaching your patient about the drug, what major adverse effect should you be sure to mention? a) Hypertension b) Angina c) Hyperkalemia d) Hypokalemia
c
Your 92-year-old patient is being seen for follow-up after her latest hospital discharge in her 15-year history of HF. To decrease her cardiac workload, what type of diuretic has she most likely been using in the management of her long-term HF? a) Potassium-sparing diuretic b) Osmotic diuretic c) Thiazide d) Loop diuretic
c
Your patient is a 36-year-old man who undergoes dialysis three times weekly while waiting for renal transplant. A diuretic has been added to his current medications to combat developing edema. Why would potassium-sparing diuretics be contraindicated? a) They are strong diuretics. b) The promote excretion of potassium. c) They may cause hyperkalemia. d) They may cause rebound edema.
