Chapter 51 practice questions- PrepU

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? "Actually, patients with renal failure usually can't take hydrochlorothiazide." "That would probably help, but we'd have to do blood work first." "Maybe, but hydrochlorothiazide affects the bladder more than the kidneys." "That would only work if he could come in twice a day to get it intravenously."

"Actually, patients with renal failure usually can't take hydrochlorothiazide."

After teaching a patient about the action of spironolactone, the nurse determines that the teaching was successful when the patient states: "I need to take the drug on an empty stomach." "I need to make sure I don't eat too many high potassium foods." "I should take the medicine around dinnertime for the best effect." "I can still use my salt substitute if I want to."

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

A male client has been ordered spironolactone (Aldactone) for hypertension. Which statement by the client indicates a need for further education? "I do not need to increase my potassium intake with this medication." "I will weigh myself daily." "I may experience breast enlargement." "I will take the medication when my blood pressure is elevated."

"I will take the medication when my blood pressure is elevated."

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

"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? "You will lose less potassium with spironolactone than with furosemide." "You will have greater water losses with spironolactone than with furosemide." "You will have greater potassium losses with spironolactone than with furosemide." "You will have greater sodium losses with spironolactone than with furosemide."

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

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? "You will have greater water losses with spironolactone than with furosemide." "You will have greater potassium losses with spironolactone than with furosemide." "You will have greater sodium losses with spironolactone than with furosemide." "You will lose less potassium with spironolactone than with furosemide."

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

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 thiazide diuretic will reabsorb potassium in the distal tubule. A thiazide diuretic will provide peak effects in 2 hours. A thiazide diuretic will be ineffective for immediate diuresis. A thiazide diuretic will be excreted in more than 72 hours.

A thiazide diuretic will be ineffective for immediate diuresis.

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? Measuring fluid intake and urinary output Measuring blood pressure Assessing skin turgor and mucous membranes Auscultating breath sounds

Auscultating breath sounds

A patient is prescribed a thiazide diuretic that is to be administered intravenously. Which agent would this most likely be? Methylchlothiazide Chlorothiazide Hydrochlorothiazide Bendroflumethazide

Chlorothiazide

A group of students are reviewing the various classes of diuretics. The students demonstrated understanding of the information when they identify what as a loop diuretic? Mannitol Furosemide Indapamide Triamterene

Furosemide

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

He is consuming excessive salty foods at the games.

A 91-year-old patient, who is being prepared for discharge, has been prescribed the diuretic spironolactone. While teaching the patient about the drug, what major adverse effect should the nurse be sure to mention? Angina Hypokalemia Hypertension Hyperkalemia

Hyperkalemia

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? Hypercalcemia Hypokalemia Hypocalcemia Hyperkalemia

Hypokalemia

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? Occurrence of gout attacks Sudden increase in weight Increased blood glucose levels Sudden pain in the joints

Increased blood glucose levels

A physician has prescribed triamterene to a male 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? Decreased diuretic effectiveness Increased risk of hyperkalemia Increased risk of arrhythmias Increased risk of bleeding

Increased risk of hyperkalemia

When describing where bumetanide acts, what would the nurse include? Glomerulus Collecting tubule Loop of Henle Proximal convoluted tubule

Loop of Henle

A client is diagnosed with increased intracranial pressure. Which would the nurse expect to be ordered? Furosemide Mannitol Amiloride Bumetanide

Mannitol

The nurse is caring for a patient who is experiencing elevated intracranial pressure following neurosurgery. The physician orders an osmotic diuretic to reduce pressure. Which agent would the physician select? Mannitol Ethacrynic acid Spironolactone Bumetanide

Mannitol

Which drug exerts its diuretic effects by increasing the density of the filtrate in the glomerulus? Hydrochlorothiazide (Microzide) Mannitol (Osmitrol) Furosemide (Lasix) Spironolactone (Aldactone)

Mannitol (Osmitrol)

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? Monitoring of serum electrolytes, creatinine, and BUN Monitoring of CBC and serum albumin Administration of a thiazide diuretic Administration of concurrent potassium

Monitoring of serum electrolytes, creatinine, and BUN

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

Oral

A patient is admitted to 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? Thiazide diuretic Potassium-sparing diuretic Osmotic diuretic Loop diuretic

Osmotic diuretic

A physician prescribes spironolactone, a potassium-sparing diuretic, for a patient with cirrhosis. For which category of patients is the use of potassium-sparing diuretics contraindicated? Patients with diabetes Patients with gout Patients with hyperkalemia Patients with liver disease

Patients with hyperkalemia

An ED nurse is caring for a patient who is receiving furosemide for treatment of pulmonary edema. What will the nurse monitor to observe for adverse effects of the drug? Blood oxygen saturation Temperature Potassium levels Bone marrow function

Potassium levels

The physician has ordered the patient hydrochlorothiazide. What assessment should the nurse make before administering the first dose of hydrochlorothiazide? Sodium level Pulse rate Sulfonamide allergy Potassium level

Sulfonamide allergy

A 36-year-old male client 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? They are strong diuretics. They may cause hyperkalemia. They may cause rebound edema. They promote excretion of potassium.

They may cause hyperkalemia.

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

eat potassium-rich foods.

The nurse is 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: decrease her consumption of potassium-rich foods. decrease her insulin dose. increase her insulin dose. increase her consumption of sodium-rich foods.

increase her insulin dose.

A nurse is caring for a 78-year-old patient with renal insufficiency and chronic heart failure who is receiving rapid infusions of high-dose furosemide. It will be a priority for the nurse to monitor for: dehydration. hepatic encephalopathy. ototoxicity. vascular thrombosis.

ototoxicity.