Deck 23: Diuretic Therapy and Drugs for Renal Failure

Question 1

The physician has ordered hydrochlorothiazide (HCTZ)for the patient in chronic renal failure.The nurse suspects the patient is experiencing an ineffective response to the medication.Which assessment is a priority for this patient?
1)Reviewing the lab work for hypokalemia and hyponatremia
2)Assessing the vital signs for hypertension
3)Assessing the skin for moisture and turgor
4)Auscultating breath sounds for wheezes

Answer 1

4

Question 2

The patient is receiving hydrochlorothiazide (HCTZ).The patient asks the nurse what the best fluid to drink to avoid dehydration is.What is the best response by the nurse?
1)"Iced teas,especially the green teas."
2)"Any kind of fluid is okay,but avoid alcohol."
3)"Plain water is really the best."
4)"Electrolyte-replacement drinks like Gatorade."

Answer 2

3

Question 3

Which of the following is a common adverse effect of furosemide (Lasix)?
1)Weight gain
2)Bradycardia
3)Hypotension
4)Vomiting

Answer 3

3

Question 4

The hospitalized patient is receiving spironolactone (Aldactone).A consulting physician sees the patient and orders lisinopril (Prinivil).What will be the primary assessment by the nurse?
1)Decreased effect of spironolactone (Aldactone)
2)Hypokalemia
3)Hyperkalemia
4)Decreased effect of lisinopril (Prinivil)

Question 5

The patient is receiving spironolactone (Aldactone).The nurse has completed dietary education and evaluates that the patient needs additional education when the patient makes which statement?
1)"I am really happy that I can have my cranberry juice."
2)"Thank goodness I can still have my orange juice and bananas for breakfast."
3)"I need an apple a day to stay regular;I'm glad I can still have this."
4)"I am German,so I could not give up my cabbage and mushrooms."

Question 6

The nurse is managing care for a group of patients on a renal failure unit.What does the nurse recognize as the most important patient safety precaution with regard to medication administration?
1)Know that patients will require less-than-average doses of medications.
2)Know which drugs will increase fluid retention.
3)Ensure that each patient's intake and output is measured precisely.
4)Be aware of what drugs are nephrotoxic.

Question 7

A patient with chronic kidney failure is taking a loop diuretic.The nurse will advise the patient to take the drug
1)with food.
2)in the morning.
3)at bedtime.
4)in the late afternoon.

Question 8

The patient has a routine urinalysis done,and the results show protein in the urine.What does the nurse correctly conclude about this result?
1)The patient is in acute renal failure,and needs to be hospitalized.
2)The patient probably has kidney damage;protein should not be present in the urine.
3)There could be a mistake with the results;the patient should have another test done.
4)The results probably mean nothing if the amount of protein is very small.

Question 9

The diuretic drug that will most likely be used to reduce mortality in heart failure is
1)chlorothiazide (Diuril).
2)acetazolamide (Diamox).
3)furosemide (Lasix).
4)spironolactone (Aldactone).

Question 10

The patient is receiving bumetanide (Bumex)and asks the nurse,"What is all this about 'loops' in my medicine?" What is the best response by the nurse?
1)"This medication reabsorbs potassium in the loop of Henle in your kidney.It is safer than other diuretics."
2)"This is a loop diuretic,which means it works in the proximal loop of your kidney.Not all diuretics work the same way."
3)"This is a loop diuretic,which refers to where it acts in your kidney.Not all diuretics work the same way."
4)"This medication blocks sodium reabsorption in what is known as Bowman's capsule.Not all diuretics work the same way."

Question 11

The elderly patient is receiving chlorothiazide (Diuril).What does the best teaching by the nurse include with this medication?
1)"Take the medication early in the morning."
2)"Avoid foods that are high in potassium."
3)"It is alright to have a glass of wine with this medication."
4)"Take the medication on an empty stomach."

Question 12

Several patients have been seen in the acute-care clinic.The nurse will plan to administer diuretic therapy to which patients? Credit will be given only if all correct choices and no incorrect choices are selected.
1)The patient experiencing visual and auditory hallucinations
2)The patient with confusion and ataxia
3)The patient with a blood pressure of 200/98 mmHg
4)The patient with generalized edema and decreased urine output
5)The patient with pinpoint pupils and extreme paranoia

Question 13

The most appropriate food for the patient taking loop diuretics is
1)meat.
2)bananas.
3)cheese.
4)Yogurt.

Question 14

The patient is receiving chlorothiazide (Diuril).The nurse assesses the patient for hypokalemia.What does the best assessment include?
1)Confusion and decreased urine output
2)Muscle weakness or cramps
3)General irritability and increased urine output
4)Diarrhea and projectile vomiting

Question 15

Loop diuretics
1)inhibit reabsorption of sodium and chloride in the loop of Henle.
2)block sodium in the distal and proximal loops.
3)block aldosterone.
4)promote excretion of water by adding sodium to the filtrate.

Question 16

Four patients arrive at the emergency department.All have attempted suicide by overdosing on medication.Which patient will the nurse plan to transfer to the renal failure unit?
1)The patient who overdosed on lorazepam (Ativan)
2)The patient who overdosed on amitriptyline (Elavil)
3)The patient who overdosed on ibuprofen (Advil)
4)The patient who overdosed on quetiapine (Seroquel)

Question 17

The patient has been diagnosed with chronic renal failure and is receiving hydrochlorothiazide (HCTZ).The nurse has taught the patient about the importance of kidney function,and evaluates that learning has occurred when the patient makes which statements? Credit will be given only if all correct choices and no incorrect choices are selected.
1)"Kidneys help my heart by balancing potassium."
2)"Kidneys balance the fluid and electrolytes in my body."
3)"Kidneys keep blood pressure from getting too low."
4)"Kidneys help decrease infections by excreting bacteria."
5)"Kidneys help regulate the oxygen levels in my blood."

Question 18

Pharmacotherapy with diuretics can cause which of the following general adverse effects?
1)Constipation
2)Orthostatic hypotension
3)Weight gain
4)Hypertension

Question 19

The primary functional unit of the kidney is the
1)loop of Henle.
2)Bowman's capsule.
3)nephron.
4)distal tubule.

Question 20

The elderly patient is receiving ethacrynic acid (Edecrin)and tells the nurse he doesn't hear as well as he used to.What is the best response by the nurse?
1)"You may be dehydrated;are you drinking enough fluid?"
2)"I will let your doctor know about this;it could be a side effect of your medication."
3)"How long have you been having difficulty hearing?"
4)"I will schedule a hearing exam;this could be a side effect of your medication."

Question 21

A home care nurse is instructing a patient with congestive heart failure on daily self-monitoring between home care visits.The nurse should instruct the patient to monitor and record Credit will be given only if all correct choices and no incorrect choices are selected.
1)weight.
2)pulse.
3)temperature.
4)blood pressure.
5)respiratory rate.

Question 22

The nurse is assessing a patient prior to the administration of a diuretic.The nurse knows it is essential to assess which vital signs at this time? Credit will be given only if all correct choices and no incorrect choices are selected.
1)Temperature
2)Pulse
3)Respirations
4)Blood pressure
5)Pain

Question 23

The nurse is preparing to discharge a patient who has been placed on a loop diuretic for the treatment of congestive heart failure.Which foods should the nurse encourage the patient to consume to prevent serious adverse effects associated with the medication? Credit will be given only if all correct choices and no incorrect choices are selected.
1)Bananas
2)Red meat
3)Oranges
4)Dried dates
5)Green,leafy vegetables

Question 24

The nurse is instructing a patient on the importance of eating foods rich in potassium while taking a diuretic that causes hypokalemia.Which diuretics do not require potassium supplements? Credit will be given only if all correct choices and no incorrect choices are selected.
1)Furosemide (Lasix)
2)Chlorothiazide (Diuril)
3)Amiloride (Midamor)
4)Mannitol (Osmitrol)
5)Spironolactone (Aldactone)

Question 25

Which substances enter the filtrate by active secretion? Credit will be given only if all correct choices and no incorrect choices are selected.
1)Hydrogen
2)Potassium
3)Phosphate
4)Chloride
5)Sodium

Question 26

The nurse is caring for a patient who is experiencing acute renal failure.The nurse knows that this patient may experience problems regulating Credit will be given only if all correct choices and no incorrect choices are selected.
1)fluid balance.
2)electrolyte composition.
3)the pH of body fluids.
4)heart rate.
5)blood pressure.