Question 1

To avoid ototoxicity,intravenous (IV)frusemide must be injected no faster than 4 mg/min.If the dose ordered is 20 mg IV,how quickly can it be administered?&#10;A) Over at least 5 minutes&#10;B) Over at least 4 minutes&#10;C) Over at least 12 seconds&#10;D) Over at least 10 minutes

Accepted Answer

Since the maximum injection rate is 4 mg/min, to administer a 20 mg dose, it should be injected over at least 5 minutes (20 mg divided by 4 mg/min). This slower administration rate helps to prevent ototoxicity, which is damage to the hearing or balance systems caused by the drug's toxicity.

Question 2

Which of the following diuretic agents is not recommended to be given with an ACE inhibitor?&#10;A) Chlorothiazide&#10;B) Frusemide&#10;C) Ethacrynic acid&#10;D) Spironolactone

Accepted Answer

Spironolactone is a potassium sparing diuretic and when given with an ACE inhibitor, there is an increased risk of hyperkalemia. Therefore, spironolactone is not recommended to be given with an ACE inhibitor. Chlorothiazide, frusemide, and ethacrynic acid are thiazide, loop, and high-ceiling diuretics respectively, and are commonly given with ACE inhibitors to manage hypertension and edema.

Question 3

Which diuretics promote the greatest diuresis?&#10;A) Thiazides&#10;B) Loop diurectics&#10;C) Aldosterone inhibitors&#10;D) Potassium-sparing diuretics

Accepted Answer

Loop diuretics promote the greatest diuresis by inhibiting the Na/K/Cl co-transporter in the thick ascending loop of Henle, which results in increased excretion of sodium, chloride, and water. Thiazides promote diuresis by inhibiting the Na/Cl co-transporter in the distal convoluted tubule, while aldosterone inhibitors and potassium-sparing diuretics work on different mechanisms and typically promote less diuresis compared to loop diuretics.

Question 4

Explain why acidification of urine might be undertaken in individuals with urinary tract infections or urinary catheters.

Accepted Answer

The answer of Explain why acidification of urine might be...

Question 5

The hypokalaemia that may be induced by a loop diuretic can be lessened or prevented by concurrent use of:&#10;A) potassium chloride.&#10;B) an angiotensin II receptor antagonist.&#10;C) an ACE inhibitor.&#10;D) all of the above.

Accepted Answer

All of the options listed can help lessen or prevent hypokalemia induced by a loop diuretic. Potassium chloride supplements directly replace the potassium lost. Both ACE inhibitors and angiotensin II receptor antagonists can reduce the amount of potassium lost in the urine.

Question 6

The main site of action of the potassium-sparing diuretic spironolactone is the:&#10;A) proximal convoluted tubule.&#10;B) ascending limb of Henle.&#10;C) distal convoluted tubule.&#10;D) glomerulus.

Accepted Answer

The main site of action of spironolactone is the distal convoluted tubule, where it blocks the action of aldosterone, a hormone that promotes sodium reabsorption and potassium excretion. As a result, spironolactone promotes sodium and water excretion while conserving potassium.

Question 7

Metabolic imbalances associated with thiazides can be avoided by:&#10;A) starting off with a small dose and titrating according to therapeutic response.&#10;B) starting off with a high dose and gradually titrating according to therapeutic response.&#10;C) administering the dose once a day.&#10;D) administering the dose two times a day.

Accepted Answer

Starting off with a small dose and titrating according to therapeutic response can help avoid metabolic imbalances associated with thiazides. This allows for a gradual adjustment of the dosage based on the individual patient's response to the medication. Starting with a high dose or administering the dose once or twice a day does not necessarily address the issue of potential metabolic imbalances.

Question 8

A mannitol infusion bag appears to crystallise.What should the health professional know about this phenomenon?&#10;A)The bag should be discarded immediately.&#10;B)This is normal if the temperature of the bag is too high-the bag should be chilled.&#10;C)This is normal if the temperature of the bag is too low-the bag should be warmed.&#10;D)The infusion should proceed with no action taken.

Accepted Answer

Mannitol is known to crystallize if exposed to low temperatures. Therefore, the bag should be warmed to its recommended temperature to dissolve the crystals and proceed with the infusion. Discarding the bag is not necessary as long as the crystals can be dissolved. Cooling the bag further may exacerbate the problem, and continuing with the infusion without addressing the crystals may result in blockages or incorrect dosages.

Question 9

The purpose of the nephron includes:&#10;A)maintaining homeostasis.&#10;B)eliminate waste.&#10;C)forming filtrate.&#10;D)all of the above.

Accepted Answer

The nephron is responsible for all three functions listed - maintaining homeostasis by regulating the balance of electrolytes and water, eliminating waste products from the blood, and forming filtrate through filtration, reabsorption, and secretion. Therefore, option D, "all of the above," is the correct answer.

Question 10

Urinary alkalisation is possible only if creatinine clearance is at what level?&#10;A)At least 20 mL/min&#10;B)At least 30 mL/min&#10;C)No more than 30 mL/min&#10;D)No more than 20 mL/min

Accepted Answer

Urinary alkalisation requires a minimum creatinine clearance of 30 mL/min. This is because alkalinizing agents such as sodium bicarbonate can cause metabolic alkalosis and fluid overload in patients with impaired renal function. Therefore, it is important to monitor creatinine clearance before initiating urinary alkalisation therapy.

Question 11

Which of these diuretics promotes potassium retention?&#10;A) Spironolactone&#10;B) Frusemide&#10;C) Chlorothiazide&#10;D) Ethacrynic acid

Accepted Answer

The answer of Which of these diuretics promotes potassium retention?&#10;A)...

Deck 48: Diuretics and Other Renal Medicines