PrepU Pharm Ch 34

What best describes the structure of the kidneys? -The renal pelvises drain urine into the ureters. -The renal arteries arise from the renal cortex. -The cortical nephrons concentrate urine. -The glomerulus produces erythropoietin.

The renal pelvises drain urine into the ureters.

A health care provider is considering ordering hydrochlorothiazide for a client. This drug must be used cautiously, if at all, if the client has a history of: stable angina. hypersensativity to sulfonamides. obesity. hypertension.

hypersensativity to sulfonamides.

A health care provider has prescribed triamterene to a male client with renal disease. The client informs the nurse that he is taking potassium supplements to address some heart problems. The nurse would be alert for: -increased risk of bleeding. -increased risk of arrhythmias. -increased risk of hyperkalemia. -decreased diuretic effectiveness.

increased risk of hyperkalemia.

A patient has just been diagnosed with acute renal failure. The patient asks for information about the kidneys' functional unit. What would the nurse reply? Renal capsule Renal pelvises Glomerulus Nephron

nephron

A group of students are reviewing the function of the kidneys and demonstrate understanding when they identify that the kidneys receive what portion of the cardiac output? 1/10 ½ ¼ 1/5

1/4

A patient who has just been told that they need to go on dialysis asks the nurse what the normal output of urine is per day. What would be the nurse's best response? 2,000 mL 3,000 mL 4,000 mL 5,000 mL

2,000 mL

A clinic nurse has been assigned to follow up with a group of patients on hydrochlorothiazide therapy. Which patient will the nurse most closely monitor for hyponatremia? -A 71-year-old female who has advanced arteriosclerosis -A 42-year-old male who has advanced arteriosclerosis -A 23-year-old male who has diabetes -A 36-year-old female who has diabetes

A 71-year-old female who has advanced arteriosclerosi

Aldosterone levels would be affected if which gland was dysfunctional? Pancreas Pituitary Thyroid Adrenal

Adrenal

A nurse is caring for a patient who is in renal failure. When reviewing the patient's laboratory values, what would the nurse expect to find? -High white blood cell count -Increased hematocrit -Decreased hemoglobin -Increased platelet count

Decreased hemoglobin

The nurse is preparing to hang an intermittent infusion of furosemide. To prevent accelerated degradation of furosemide, the nurse knows that the medication should be mixed in what IV solution? D51/2 NS Lactated Ringer's solution D51/4 NS D5W

Lactated Ringer's solution

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

Mannitol

The pharmacology instructor is discussing the differences among the various diuretic agents. Which would the instructor cite as a difference between spironolactone and hydrochlorothiazide? -Spironolactone is more likely to be taken with a potassium supplement. -Potassium losses are greater with spironolactone than with hydrochlorothiazide. -The two diuretics act in different parts of the nephron. -Potassium losses are greater with hydrochlorothiazide than with spironolactone.

Potassium losses are greater with spironolactone than with hydrochlorothiazide.

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? Spironolactone Dyazide Bumetanide Hydrochlorothiazide

Spironolactone

What is the expected outcome when the glomerular membrane is damaged? -The chemical reaction that results in the formation of sodium bicarbonate is impaired -The reabsorption of substances from the renal tubule back into the vascular system is altered -The kidney's ability to regulate the concentration of urine is impaired -The filtration of fluid from the blood into the kidney's nephron tubule is impaired

The filtration of fluid from the blood into the kidney's nephron tubule is impaired

Why would potassium-sparing diuretics be contraindicated for clients experiencing renal failure? They are the strongest form of diuretics. They promote excretion of potassium. They may cause hyperkalemia. They may cause rebound edema.

They may cause hyperkalemia.

Which substances are moved from the glomerulus into the tubule due to hydrostatic pressure? Water Proteins Blood cells Lipids

Water

The nurse, who works in the emergency department, is aware that the renin-angiotensin-aldosterone system works to maintain blood flow in the kidneys. What vital sign would signify the initiation of this system in a trauma client? Decreased pulse Decreased blood pressure Increased temperature Pain level of 3 on a scale of 1 to 10

decreased blood pressure

A 91-year-old patient is being discharged on the diuretic spironolactone (Aldactone). What is the major adverse effect of this type of medication? Gastric irritation Hyperkalemia Hypertension Hypokalemia

hyperkalemia

The nurse is caring for a patient in the Emergency Department (ED) who is in pulmonary edema. The patient is treated with furosemide (Lasix). What should the nurse monitor? Sodium levels Bone narrow function Potassium levels Calcium levels

potassium levels

The students are studying the male reproductive system. The instructor tells the students that in the male, the urethra leaves the urinary bladder and passes through the: prostate gland. renal calyx. renal cortex. vas deferens.

prostate gland

What substance is reabsorbed in the ascending limb of the loop of Henle? water sodium glucose amino acids

sodium

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? "That would probably help, but we'd have to do blood work first." "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." "Maybe, but hydrochlorothiazide affects the bladder more than the kidneys."

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

The nurse is teaching a 62-year-old client about hydrochlorothiazide, which the health care provider has prescribed for treatment of hypertension. What statement, made by the client, suggests that the client understands the teaching? "I must take my medication on an empty stomach." "I can jump right into action!" "I will need to stand slowly." "I will need to make sure that I am consuming enough sodium."

"I will need to stand slowly."

A 10-year-old child has edema caused by a heart defect. The patient is taking furosemide (Lasix). The dosage is 6 mg/kg per day. The child weighs 76 pounds. How many mg does the child receive in each dose? 50 mg 20 mg 210 mg 105 mg

210 mg

The amount of fluid excreted as urine each day averages approximately less than how many liters? 1 L 2 L 3 L 4 L

2L

You are monitoring serum electrolyte levels in a 55-year-old patient who has been prescribed digoxin and a potassium-sparing diuretic for treatment of heart failure. Which of the following potassium levels would you hope to see for this patient? 4.0 mEq/L 2.5 mEq/L 3.0 mEq/L 6.0 mEq/L

4.0 mEq/L

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? 8:15 AM 8:30 AM 8:45 AM 9:00 AM

8:30 AM

A nurse is caring for a client with acute renal failure. The health care provider has prescribed a diuretic therapy for the client to promote dieresis. What intervention should the nurse perform to prevent the inconvenience caused by increased urination? Ask the client to decrease fluid intake. Administer the drug early in the day. Gradually increase the drug dosage. Encourage the client to exercise.

Administer the drug early in the day.

The students are discussing the electrolytes in the body. What should the students know has the greatest influence on potassium loss from the body? Aldosterone Renin Antidiuretic hormone Carbonic anhydrase

Aldosterone

You have been prescribed HydroDIURIL. What will the nurse tell you is considered a contraindication to the administration of hydrochlorothiazide (HydroDIURIL)? BP 160/96 Blood glucose level of 140 mg/dL Allergy to codeine Allergy to sulfa drugs

Allergy to sulfa drugs

A 71-year-old male client is hospitalized with pulmonary edema; he is discharged with a prescription for a loop diuretic. He presents to the health care provider's office 1 week later with symptoms indicating excessive diuresis. The nurse knows that this client is also at risk for which condition? Embolism Rebound hypertension Gastric ulcer disease Hypervolemia

Embolism

When explaining the underlying mechanisms associated with renal failure, which would be most important for the nurse to keep in mind? -Manifestations occur when a small number of nephrons become nonfunctional. -Nephron damage is not associated with the development of signs and symptoms. -Renal failure typically involves some injury to the protective layers of the kidneys. -Extensive kidney damage has usually occurred by the time the patient is symptomatic.

Extensive kidney damage has usually occurred by the time the patient is symptomatic.

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? Hydrochlorothiazide Triamterene Mannitol Furosemide

Furosemide

Which drugs cause diuresis by inhibiting re-absorption of sodium and chloride ions in the distal and proximal tubules and in the loop of Henle? (Select all that apply.) Chlorothiazide (Diuril) Mannitol (Osmitrol) Furosemide (Lasix) Bumetanide (Bumex) Spironolactone (Aldactone)

Furosemide (Lasix) Bumetanide (Bumex)

The nurse is caring for a patient suspected of having renal dysfunction. When reviewing laboratory results for this patient, the nurse recalls that several substances are filtered from the blood by the glomerulus and these substances are then excreted in the urine. The nurse identifies the presence of which substances in the urine as abnormal findings? Bicarbonate and urea Glucose and protein Potassium and sodium Creatinine and chloride

Glucose and protein

The nurse is caring for a patient suspected of having renal dysfunction. When reviewing laboratory results for this patient, the nurse recalls that several substances are filtered from the blood by the glomerulus and these substances are then excreted in the urine. The nurse identifies the presence of which substances in the urine as abnormal findings? Creatinine and chloride Potassium and sodium Bicarbonate and urea Glucose and protein

Glucose and protein

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

He is consuming excessive salty foods at the games.

A 91-year-old patient is being discharged on the diuretic spironolactone (Aldactone). What is the major adverse effect of this type of medication? Hypokalemia Gastric irritation Hyperkalemia Hypertension

Hyperkalemia

A client comes to the clinic for a 1-month follow-up appointment. The client states taking chlorothiazide (Diruil) for the month it has been prescribed and now has leg cramps and "feels tired all the time." What will the nurse consider as the cause of the patient's symptoms? Hypercalcemia Hypocalcemia Hyperkalemia Hypokalemia

Hypokalemia

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

The nurse is caring for a client who is experiencing elevated intracranial pressure following neurosurgery. The health care provider orders an osmotic diuretic to reduce pressure. Which medication would the nurse expect to be ordered? Mannitol Bumetanide Ethacrynic acid Spironolactone

Mannitol

Ms. Crampton is prescribed furosemide for chronic heart failure. The nurse knows that furosemide can cause electrolyte imbalances and what other serious side effect? Compensated respiratory acidosis Metabolic alkalosis Compensated respiratory alkalosis Metabolic acidosis

Metabolic alkalosis

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

After teaching a group of students about the renal system, the instructor determines that the teaching was successful when the students state: Most fluid that is filtered by the kidneys is returned to the body. The renal system includes the kidneys, which have two protective layers. Blood pressure regulation is a primary function of the system. The urinary tract is separate from the kidneys.

Most fluid that is filtered by the kidneys is returned to the body.

A client began taking hydrochlorothiazide one week ago and is reporting occasional dizziness when she stands up quickly from sitting or lying. What is the nurse's best action? -Arrange for the client's potassium levels to be assessed as soon as possible -Teach the client about the blood pressure effects of the medication and relevant safety measures -Educate the client about the need for bedrest until her body adjusts to the new medication -Tell the client to withhold the next scheduled dose until she can be assessed by the provider

Teach the client about the blood pressure effects of the medication and relevant safety measures

A student asks the physiology instructor where chloride is primarily reabsorbed. What would be the instructor's best answer? The kidney The distal convolute tubule The loop of Henle The nephron

The loop of Henle

When describing the process of tubular reabsorption, which substances would the instructor include as being reabsorbed regularly? (Select all that apply.) Proteins Vitamins Glucose Lipids Sodium bicarbonate Water

vitamins sodium bicarbonate water glucose