KARCH Chapter: Chapter 51: Diuretic Agents PREP U

After teaching a group of students about loop diuretics, the instructor determines that the teaching has been successful when the students identify which agent as the safest for use in the home? a) Furosemide b) Bumetanide c) Ethacrynic acid d) Torsemide

a) Furosemide

The nurse understands that the action of most diuretics typically results in which of the following? Select all that apply. a) Loss of water b) Loss of chloride c) Loss of calcium d) Retention of potassium e) Retention of sodium

a) Loss of water b) Loss of chloride

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) Mannitol b) Bumetanide c) Ethacrynic acid d) Spironolactone

a) Mannitol

A client is receiving hydrochlorothiazide. The nurse would expect to administer this drug by which route? a) Oral b) Intravenous c) Subcutaneous d) Intramuscular

a) Oral

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) Loop diuretic d) Thiazide diuretic

a) Osmotic diuretic

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 hyperkalemia b) Patients with liver disease c) Patients with gout d) Patients with diabetes

a) Patients with hyperkalemia

The physician orders furosemide for a pediatric client. The nurse knows that the established dose of the drug should not exceed how many milligrams per kilogram of body weight per day? a) 4 b) 6 c) 8 d) 10

b) 6

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 developing comorbidities. b) He is consuming excessive salty foods at the games. c) He is anxious about his team. d) He has become a vegetarian until his team wins the championship.

b) He is consuming excessive salty foods at the games.

A nurse is caring for a patient with increased intraocular pressure. The physician prescribes urea to the patient. Which of the following adverse reactions to the drug administration should the nurse closely observe for in the patient? a) Blurred vision b) Syncope c) Cramping d) Photosensitivity

b) Syncope

A female patient reports that she has frequent muscle cramps while on hydrochlorothiazide therapy. The nurse will advise her to a) include high-sodium foods in her diet. b) eat potassium-rich foods. c) take calcium supplements. d) drink plenty of fluids.

b) eat potassium-rich foods.

A group of students are reviewing the various classes of diuretics. The students demonstrated understanding of the information when they identify which of the following as a loop diuretic? a) Indapamide b) Mannitol c) Furosemide d) Triamterene

c) Furosemide

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 should take the medicine around dinnertime for the best effect." b) "I can still use my salt substitute if I want to." c) "I need to make sure I don't eat too many high potassium foods." d) "I need to take the drug on an empty stomach."

d) "I need to make sure I don't eat too many high potassium foods."

Which of the following instructions would be most appropriate for a client who is taking a diuretic? a) "Take the daily dose around dinnertime." b) "Lie down after taking the drug." c) "Limit the amount of fluids you drink." d) "It's okay to take it with food."

d) "It's okay to take it with food."

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 water losses with spironolactone than with furosemide." b) "You will have greater potassium losses with spironolactone than with furosemide." c) "You will have greater sodium losses with spironolactone than with furosemide." d) "You will lose less potassium with spironolactone than with furosemide."

d) "You will lose less potassium with spironolactone than with furosemide."

A patient has edema of the lower extremities with crackles in the lung bases. The patient is prescribed furosemide 40 mg two times per day orally. What is the recommended weight loss per day? a) 5 pounds per day b) 10 pounds per day c) 1 pound per day d) 2 pounds per day

d) 2 pounds per day

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) Encourage the patient to exercise. b) Gradually increase the drug dosage. c) Ask the patient to decrease fluid intake. d) Administer the drug early in the day.

d) Administer the drug early in the day.

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) Hypokalemia b) Hypertension c) Angina d) Hyperkalemia

d) Hyperkalemia

A physician has prescribed a loop diuretic for a patient with hypertension. The patient also has diabetes mellitus. What condition should the nurse monitor for in this patient after administering the prescribed drug? a) Sudden increase in weight b) Sudden pain in the joints c) Occurrence of gout attacks d) Increased blood glucose levels

d) Increased blood glucose levels

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) Decreased diuretic effectiveness b) Increased risk of arrhythmias c) Increased risk of bleeding d) Increased risk of hyperkalemia

d) Increased risk of hyperkalemia

A client with renal impairment is in need of a diuretic. Because of the renal problem, potassium-sparing diuretics are contraindicated but may be used if there is no other option. If they are used at all, what nursing intervention would be most important for this client? a) Monitoring of CBC and serum albumin b) Administration of a thiazide diuretic c) Administration of concurrent potassium d) Monitoring of serum electrolytes, creatinine, and BUN

d) Monitoring of serum electrolytes, creatinine, and BUN

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) The promote excretion of potassium. b) They may cause rebound edema. c) They are strong diuretics. d) They may cause hyperkalemia.

d) They may cause hyperkalemia.