Question 1

________ is a common complication in the use of loop diuretics.&#10;A)Hypokalemia&#10;B)Volume overload&#10;C)Hyperlipidemia&#10;D)Hypoglycemia

Accepted Answer

Because diuretics promote sodium and fluid excretion,elimination may exceed intake,resulting in hypovolemia.Preserving potassium balance has emerged as one of the most important factors in the management of hypertension.Potassium is exchanged for sodium in the distal convoluted tubule and collecting duct.Any diuretic that increases sodium delivery to those regions may potentially induce hypokalemia.In addition to a direct potassium loss,diuretic-induced volume depletion produces reabsorption of sodium via release of aldosterone in the distal tubule in an effort to bolster intravascular volume.Loop and thiazide diuretics have been associated with hyperglycemia.

Question 2

Diuretics that produce their effect by inhibiting the reabsorption of chloride and sodium in the ascending limb of the loop of Henle are known as&#10;A)potassium-sparing.&#10;B)osmotic.&#10;C)loop.&#10;D)thiazide.

Accepted Answer

Loop diuretics are often called "high-ceiling" diuretics because they can cause 20% of the filtered load of NaCl and water to be excreted in the urine.They inhibit the reabsorption of NaCl at the thick ascending limb of the loop of Henle,where about 20% of filtered NaCl is usually reabsorbed.

Question 3

The most common adverse reactions associated with diuretics include
1)ototoxicity.
2)volume depletion.
3)diarrhea.
4)allergic reactions.
5)electrolyte abnormalities.

A)1 only
B)2 and 5 only
C)2,3,and 4 only
D)2,3,4,and 5 only

2 and 5 only

Accepted Answer

Most complications associated with diuretic use can be anticipated as an extension of their pharmacologic activity,with hypovolemia and electrolyte and acid-base abnormalities being the most common.

Question 4

Your patient has mild hypertension.Which group of diuretic agents would you expect the physician to prescribe?&#10;A)Loop&#10;B)Osmotic&#10;C)Carbonic anhydrase inhibitors&#10;D)Thiazide

Accepted Answer

Thiazide diuretics are considered first-line therapy for mild hypertension.

Question 5

Which group of diuretic agents is the most potent?&#10;A)Potassium-sparing&#10;B)Osmotic&#10;C)Loop&#10;D)Thiazide

Accepted Answer

Loop diuretics are often called "high-ceiling" diuretics because they can cause 20% of the filtered load of sodium chloride and water to be excreted in the urine.

Question 6

Your patient is receiving intravenous furosemide and complains of a ringing in her ears.What steps could you take to help alleviate this side effect without changing the medication itself?&#10;A)Speed up the rate of infusion&#10;B)Slow the rate of infusion&#10;C)Deliver the medication as an intravenous bolus&#10;D)Both A and C

Accepted Answer

Loop diuretics may cause a dose-related ototoxicity consisting of tinnitus and clinical or subclinical hearing loss.Ototoxicity results from anatomic and chemical abnormalities produced within the inner ear.Ototoxicity is related to the blood level of these agents.Rapid infusion and drug accumulation with large parenteral doses in renal failure predispose patients to ototoxicity.Reducing the infusion rate or administering the drug orally may alleviate the hearing loss.

Question 7

Any substance that increases urine flow is termed&#10;A)a corticosteroid.&#10;B)a diuretic.&#10;C)a vasopressor.&#10;D)an antihypertensive.

Accepted Answer

The main purpose of diuretics,or agents that increase urine output,is to eliminate excess fluid from the body.Introduced into medicine in 1958,diuretics are drugs that increase the excretion of solutes and water by directly increasing urine output.The preceding definition excludes agents,such as digitalis,that promote urine output without a direct action on the kidney.Generally,the primary goal of diuretic therapy is to reduce extracellular fluid volume to lower blood pressure or rid the body of excess interstitial fluid.

Question 8

Your patient has cerebral edema.Which group of diuretic agents would you expect to be administered?&#10;A)Loop&#10;B)Osmotic&#10;C)Carbonic anhydrase inhibitors&#10;D)Thiazide

Accepted Answer

Osmotic diuretics are often used in the management of cerebral edema.Of the four currently available osmotic diuretics (glycerin,isosorbide,mannitol,and urea),mannitol is the typically selected agent because of its lower toxicity.Mannitol has a relatively short half-life and manifests with a rapid onset and quick offset of action.To maintain a continued diuretic action,the drug is frequently administered via continuous infusion.

Question 9

Which of the following is the most selected osmotic diuretic agent?&#10;A)Urea&#10;B)Furosemide&#10;C)Chlorothiazide&#10;D)Mannitol

Accepted Answer

Of the four currently available osmotic diuretics (glycerin,isosorbide,mannitol,and urea),mannitol is the typically selected agent because of its lower toxicity.Mannitol has a relatively short half-life and a rapid onset and quick offset of action.To maintain a continued diuretic action,the drug is frequently administered via continuous infusion.Osmotic diuretics are often used in the management of cerebral edema.

Question 10

Which ions are filtered and exchanged in the kidney tubules? 1)Na⁺ 2)H₂O 3)K⁺ 4)Cl^- 5)HCO₃^- A)1 and 4 only B)2,3,and 5 only C)1,3,4,and 5 only D)1,2,3,4,and 5

Accepted Answer

The following ions are filtered and exchanged in the tubules. •Sodium: About 70% of Na⁺ in the filtrate is reabsorbed in the proximal tubules,20% is reabsorbed in the loops of Henle,and about 10% is reabsorbed in the distal tubules.There is an exchange of Na⁺ for H⁺ or K⁺ in the distal tubules. •Potassium: Most filtered K⁺ is reabsorbed in the proximal tubules.K⁺ found in the urine is that secreted by the distal tubule. •Chloride and bicarbonate: Cl^- and HCO₃^- are passively reabsorbed in the proximal and distal tubules.

Question 11

Approximately what percentage of cardiac output flows through the renal system per minute?&#10;A)10&#10;B)20&#10;C)30&#10;D)40

Accepted Answer

The answer of Approximately what percentage of cardiac output flows...

Question 12

Which diuretics have been associated with hyperglycemia?&#10;A)Loop and osmotic&#10;B)Osmotic and thiazide&#10;C)Thiazide and loop&#10;D)Carbonic anhydrase inhibitors and loop

Accepted Answer

The answer of Which diuretics have been associated with hyperglycemia?&#10;A)Loop...

Question 13

Thiazide diuretics work by&#10;A)blocking reabsorption of sodium and bicarbonate from the proximal tubule.&#10;B)blocking reabsorption of sodium and chloride in the ascending limb of the loop of Henle.&#10;C)blocking reabsorption of NaCl in the proximal tubule and loop of Henle.&#10;D)blocking sodium and chloride reabsorption in the distal tubule.

Accepted Answer

The answer of Thiazide diuretics work by&#10;A)blocking reabsorption of sodium...

Question 14

The use of carbonic anhydrase inhibitors (CAIs)typically results in&#10;A)metabolic alkalosis.&#10;B)metabolic acidosis.&#10;C)respiratory alkalosis.&#10;D)respiratory acidosis.

Accepted Answer

The answer of The use of carbonic anhydrase inhibitors (CAIs)typically...

Question 15

The functional unit of the kidney is the&#10;A)loop of Henle.&#10;B)proximal tubule.&#10;C)glomerulus.&#10;D)nephron.

Accepted Answer

The answer of The functional unit of the kidney is...

Question 16

Which of the following electrolyte imbalances would force Na⁺ to exchange for H⁺,producing metabolic alkalosis?
1)Hypochloremia
2)Hyperchloremia
3)Hypokalemia
4)Hyperkalemia
5)HCO₃^-

A)1 and 3 only
B)2,4,and 5 only
C)1,3,4,and 5 only
D)1,2,3,4,and 5

Accepted Answer

The answer of Which of the following electrolyte imbalances would...

Question 17

Aldosterone&#10;A)increases sodium and water reabsorption.&#10;B)decreases sodium and water reabsorption.&#10;C)increases glomerular blood flow.&#10;D)increases urine output.

Accepted Answer

The answer of Aldosterone&#10;A)increases sodium and water reabsorption.&#10;B)decreases sodium and...

Question 18

Agents that block reabsorption of sodium in the distal tubule are&#10;A)osmotic diuretics.&#10;B)thiazide diuretics.&#10;C)potassium-sparing diuretics.&#10;D)loop diuretics.

Accepted Answer

The answer of Agents that block reabsorption of sodium in...

Question 19

Loop diuretics can cause which of the following?&#10;A)Increased pulmonary capillary wedge pressure and increased blood pressure&#10;B)Decreased pulmonary capillary wedge pressure and increased blood pressure&#10;C)Increased pulmonary capillary wedge pressure and decreased blood pressure&#10;D)Decreased pulmonary capillary wedge pressure and decreased blood pressure

Accepted Answer

The answer of Loop diuretics can cause which of the...

Question 20

Osmotic diuretics function by&#10;A)blocking reabsorption of sodium and chloride in the distal tubule.&#10;B)blocking reabsorption in the ascending limb of the loop of Henle.&#10;C)blocking reabsorption of NaCl in the proximal tubule and descending limb of the loop of Henle.&#10;D)blocking reabsorption of sodium and bicarbonate from the proximal tubule.

Accepted Answer

The answer of Osmotic diuretics function by&#10;A)blocking reabsorption of sodium...

Question 21

Diuretic combinations may be used in an attempt to obtain a(n)_______________effect in patients not responding to one agent.&#10;A)synergistic&#10;B)complementary&#10;C)potency&#10;D)ototoxic

Accepted Answer

The answer of Diuretic combinations may be used in an...

Question 22

Your pregnant patient has mild hypertension and has been taking diuretics.Which group of diuretic agents would you expect the physician to prescribe while she is pregnant?&#10;A)Loop&#10;B)Thiazide&#10;C)Carbonic anhydrase inhibitors&#10;D)None are recommended for pregnant women

Accepted Answer

The answer of Your pregnant patient has mild hypertension and...

Deck 19: Diuretic Agents