Question 1

When monitoring a patient who has diabetes and is receiving a carbonic anhydrase inhibitor for edema, the nurse will monitor for which possible adverse effect?&#10;A) Metabolic alkalosis&#10;B) Elevated blood glucose&#10;C) Hyperkalemia&#10;D) Mental alertness

Accepted Answer

An undesirable effect of carbonic anhydrase inhibitors is that they elevate the blood glucose level and cause glycosuria in diabetic patients. They induce metabolic acidosis, making their effectiveness diminishes in 2 to 4 days. In addition, hypokalemia and drowsiness may occur.

Question 2

A patient is to receive furosemide (Lasix) via a percutaneous endoscopic gastrostomy (PEG) tube. The order reads, "Give furosemide, 80 mg, per PEG tube once daily." The medication is available in a liquid form, 40 mg/5 mL. Identify how many milliliters the nurse will administer for each dose. _______

10 mL
40 mg:5 mL :: 80 mg:x mg
(40 × x) = (5 × 80); 40x = 400; x = 10 mL

Accepted Answer

10 mL&#10;40 mg:5 mL :: 80 mg:x mg&#10;(40 &#215; x) = (5 &#215; 80); 40x = 400; x = 10 mL

Question 3

The nurse is monitoring a patient who is taking a potassium-sparing diuretic. Which of the drugs or drug classes may have an interaction with this type of diuretic?&#10;A) Lithium&#10;B) Vancomycin&#10;C) Potassium supplements&#10;D) NSAIDs&#10;E) Antidiabetic drugs&#10;F) ACE inhibitors

Accepted Answer

Taking lithium with potassium-sparing diuretics may cause lithium toxicity; taking ACE inhibitors or potassium supplements may lead to hyperkalemia. Taking NSAIDs with potassium-sparing diuretics may cause a decreased diuretic response. There are no interactions with vancomycin or antidiabetic drugs and potassium-sparing diuretics.

Question 4

A patient in the neurologic intensive care unit is being treated for cerebral edema. Which class of diuretic is used to reduce intracranial pressure?&#10;A) Loop diuretics&#10;B) Osmotic diuretics&#10;C) Thiazide diuretics&#10;D) Vasodilators

Accepted Answer

Mannitol, an osmotic diuretic, is commonly used to reduce intracranial pressure and cerebral edema resulting from head trauma.

Question 5

The order for a child reads, &#34;Give furosemide (Lasix) 2 mg/kg IV STAT.&#34; The child weighs 33 pounds. Identify how many milligrams the child will receive for this dose. _______

Accepted Answer

The answer of The order for a child reads, &#34;Give...

Question 6

A 79-year-old patient is taking a diuretic for treatment of hypertension. This patient is very independent and wants to continue to live at home. The nurse will know that which teaching point is important for this patient?

A) He should take the diuretic with his evening meal.
B) He should skip the diuretic dose if he plans to leave the house.
C) If he feels dizzy while on this medication, he needs to stop taking it and take potassium supplements instead.
D) He needs to take extra precautions when standing up because of possible orthostatic hypotension and resulting injury from falls.

Accepted Answer

Caution must be exercised in the administration of diuretics to the older adults because they are more sensitive to the therapeutic effects of these drugs and are more sensitive to the adverse effects of diuretics, such as dehydration, electrolyte loss, dizziness, and syncope. Taking the diuretic with the evening meal may disrupt sleep because of nocturia. Doses should never be skipped or stopped without checking with the prescriber.

Question 7

Furosemide (Lasix) is prescribed for a patient who is about to be discharged, and the nurse provides instructions to the patient about the medication. Which statement by the nurse is correct?&#10;A) &#34;Take this medication in the evening.&#34;&#10;B) &#34;Avoid foods high in potassium, such as bananas, oranges, fresh vegetables, and dates.&#34;&#10;C) &#34;If you experience weight gain, such as 5 pounds or more per week, be sure to tell your physician during your next routine visit.&#34;&#10;D) &#34;Be sure to change positions slowly and rise slowly after sitting or lying so as to prevent dizziness and possible fainting because of blood pressure changes.&#34;

Accepted Answer

Orthostatic hypotension is a possible problem with diuretic therapy. Foods high in potassium should be eaten more often, and the drug needs to be taken in the morning so that the diuretic effects do not interfere with sleep. A weight gain of 5 pounds or more per week must be reported immediately.

Question 8

Mannitol (Osmitrol) has been ordered for a patient with acute renal failure. The nurse will administer this drug using which procedure?&#10;A) Intravenously, through a filter&#10;B) By rapid intravenous bolus&#10;C) By mouth in a single morning dose&#10;D) Through a gravity intravenous drip with standard tubing

Accepted Answer

Mannitol is administered via intravenous infusion through a filter because of possible crystallization. It is not available in oral form. The other options are incorrect.

Question 9

When reviewing the mechanisms of action of diuretics, the nurse knows that which statement is true about loop diuretics?&#10;A) They work by inhibiting aldosterone.&#10;B) They are very potent, having a diuretic effect that lasts at least 6 hours.&#10;C) They have a rapid onset of action and cause rapid diuresis.&#10;D) They are not effective when the creatinine clearance decreases below 25 mL/min.

Accepted Answer

The loop diuretics have a rapid onset of action; therefore, they are useful when rapid onset is desired. Their effect lasts for about 2 hours, and a distinct advantage they have over thiazide diuretics is that their diuretic action continues even when creatinine clearance decreases below 25 mL/min.

Question 10

A patient is being discharged to home on a single daily dose of a diuretic. The nurse instructs the patient to take the dose at which time so it will be least disruptive to the patient's daily routine?

A) In the morning
B) At noon
C) With supper
D) At bedtime

Accepted Answer

It is better to take the diuretic medication early in the morning to prevent urination during the night. Taking the diuretic at the other times may cause nighttime urination and disrupt sleep.

Question 11

The nurse will monitor a patient for signs and symptoms of hyperkalemia if the patient is taking which of these diuretics?&#10;A) Hydrochlorothiazide (HydroDIURIL)&#10;B) Furosemide (Lasix)&#10;C) Acetazolamide (Diamox)&#10;D) Spironolactone (Aldactone)

Accepted Answer

The answer of The nurse will monitor a patient for...

Question 12

When a patient is receiving diuretic therapy, which of these assessment measures would best reflect the patient's fluid volume status?&#10;A) Blood pressure and pulse&#10;B) Serum potassium and sodium levels&#10;C) Intake, output, and daily weight&#10;D) Measurements of abdominal girth and calf circumference

Accepted Answer

The answer of When a patient is receiving diuretic therapy,...

Question 13

A patient is started on a diuretic for antihypertensive therapy. The nurse expects that a drug in which class is likely to be used initially?&#10;A) Loop diuretics&#10;B) Osmotic diuretics&#10;C) Thiazide diuretics&#10;D) Potassium-sparing diuretics

Accepted Answer

The answer of A patient is started on a diuretic...

Question 14

When monitoring a patient who is taking hydrochlorothiazide (HydroDIURIL), the nurse notes that which drug is most likely to cause a severe interaction with the diuretic?&#10;A) Digitalis&#10;B) Penicillin&#10;C) Potassium supplements&#10;D) Aspirin

Accepted Answer

The answer of When monitoring a patient who is taking...

Question 15

When assessing a patient who is receiving a loop diuretic, the nurse looks for the manifestations of potassium deficiency, which would include what symptoms?&#10;A) Dyspnea&#10;B) Constipation&#10;C) Tinnitus&#10;D) Muscle weakness&#10;E) Anorexia&#10;F) Lethargy

Accepted Answer

The answer of When assessing a patient who is receiving...

Deck 28: Diuretic Drugs