Question 1

The nurse is caring for four clients on a renal failure unit and recognizes which drug as safe to administer to a client with hypokalemia?

Accepted Answer

Hypokalemia is a condition in which the potassium level in the blood is decreased. Amiloride is a potassium-sparing diuretic that can be safely administered to clients with hypokalemia because it helps to retain potassium in the body. The other options, Chlorothiazide (Diuril), Bumetanide (Bumex), and Ethacrynic acid (Edecrin), are all loop diuretics that can cause potassium loss and are not recommended for clients with hypokalemia.

Question 2

A client prescribed bumetanide (Bumex)asks the nurse,"What is all this about 'loops' in my medicine?" Which response by the nurse is the most appropriate?

Accepted Answer

Loop diuretics act on the thick ascending limb of Henle's loop in the kidney, which is why they are called "loop" diuretics. Option A is partially correct but misleading because the medication doesn't reabsorb potassium, it actually increases potassium excretion. Option B is incorrect because Bowman's capsule is not part of the loop of Henle. Option D is incorrect because loop diuretics do not work in the proximal tubule, but in the loop of Henle.

Question 3

The nurse is caring for a client with a brain tumor who is prescribed mannitol (Osmitrol)IV.Which laboratory finding represents a potential adverse effect of this drug?

Accepted Answer

Mannitol is an osmotic diuretic used to reduce cerebral edema. It works by drawing water from the brain into the bloodstream, increasing urine output and decreasing intracranial pressure. However, excessive use or rapid infusion of mannitol can lead to serum sodium depletion, which can cause hyponatremia. A serum sodium level of 104 mEq/L is significantly low and represents a potential adverse effect of the drug. The other laboratory values are not specifically related to the use of mannitol.

Question 4

The nurse is reviewing results of a routine urinalysis that indicate the presence of protein in the urine.How does the nurse interpret this finding?

Accepted Answer

The presence of protein in the urine is abnormal and indicates possible kidney damage or disease. The amount of protein can help determine the severity of the issue, but even a small amount should be investigated further.

Question 5

The nurse is teaching a client about spironolactone (Aldactone),and recognizes which statement as an indication that the client needs further teaching about this drug?

Accepted Answer

Spironolactone is a potassium-sparing diuretic, which means it can cause potassium levels in the blood to increase. Consuming high-potassium foods like orange juice and bananas while on spironolactone could lead to hyperkalemia (high potassium levels), indicating the client needs further teaching about dietary restrictions.

Question 6

A client with cancer is secreting excessive amounts of antidiuretic hormone.The nurse will monitor the client for which consequence of excess antidiuretic hormone secretion?

Accepted Answer

Excessive secretion of antidiuretic hormone (ADH) leads to retention of water in the body, resulting in fluid volume excess. This can lead to symptoms such as edema, decreased urine output, and hyponatremia. Hyperkalemia and hypernatremia are not typically associated with excess ADH secretion. Dehydration is a consequence of decreased ADH secretion.

Question 7

A client is diagnosed with chronic renal failure and is receiving hydrochlorothiazide (HCTZ).The nurse has taught the client about the importance of kidney function and evaluates that learning has occurred when the client makes which statements?
Select all that apply.

Accepted Answer

The answer of A client is diagnosed with chronic renal...

Question 8

The nurse is preparing to administer furosemide (Lasix)40 mg IV to a client on complete bed rest who has renal failure and pulmonary edema.Which action is most appropriate prior to administering furosemide (Lasix)to this client?

Accepted Answer

Prior to administering furosemide (Lasix) to a client with renal failure and pulmonary edema, the nurse should monitor the client's apical heart rate and rhythm. This medication can cause electrolyte imbalances, which can lead to cardiac arrhythmias. It is important to ensure that the client's heart rate and rhythm are within normal limits before administering the medication. Measurement of urine output, auscultation of bowel sounds, and lowering the head of the bed are important interventions for clients with renal failure and pulmonary edema, but they are not directly related to the administration of furosemide.

Question 9

The nurse is instructing a client on the importance of eating foods rich in potassium while taking a diuretic that causes hypokalemia.Which diuretics do not require potassium supplements?
Select all that apply.

Accepted Answer

Amiloride (Midamor) and Spironolactone (Aldactone) are potassium-sparing diuretics, meaning they do not cause the body to lose potassium, unlike other types of diuretics. Therefore, patients taking these medications typically do not need to take potassium supplements.

Question 10

The nurse caring for a client with renal failure will the use of a usual dose of which medication?

Accepted Answer

Digoxin (Lanoxin) is primarily excreted by the kidneys, and in the case of renal failure, its usual dose can lead to toxicity due to decreased excretion.

Question 11

Which substances enter the filtrate by active secretion?
Select all that apply.

Accepted Answer

Hydrogen, potassium, and phosphate are actively secreted into the filtrate in the nephron of the kidney. This process helps in regulating pH, potassium levels, and removing excess phosphate from the body. Chloride and sodium primarily enter the filtrate through filtration at the glomerulus, not active secretion.

Question 12

The nurse is caring for a client admitted to the medical-surgical unit with hypervolemia that has resulted from renal failure.Which medications does the nurse anticipate will be prescribed for this client based on the diagnosis?
Select all that apply.

Accepted Answer

Furosemide (Lasix) and Hydrochlorothiazide (Microzide) are both diuretics that can help remove excess fluid from the body, which is important in treating hypervolemia. Epoetin alfa (Procrit) is used to stimulate red blood cell production and would not be helpful in treating hypervolemia. Polystyrene sulfate (Kayexalate) is a medication used to treat high potassium levels in the blood and would not be used to directly treat hypervolemia. Sodium bicarbonate is sometimes used to treat acidosis, but would not directly address the fluid overload seen in hypervolemia.

Question 13

The nurse caring for a client in renal failure should an order for which drug?

Accepted Answer

The answer of The nurse caring for a client in...

Question 14

The nurse is managing care for a client diagnosed with acute renal failure.What does the nurse recognize as the most important safety precaution with regard to medication administration?

Accepted Answer

The nurse should review the client's medication regimen to identify any nephrotoxic drugs, which could further damage the already compromised kidneys. The other options are important considerations in the care of a client with acute renal failure, but identifying nephrotoxic drugs is the most important safety precaution with regard to medication administration.

Question 15

A client diagnosed with chronic renal failure and has gained 4 pounds in the past 24 hours.The nurse anticipates that the client will receive which diuretic?

Accepted Answer

Ethacrynic acid (Edecrin) is a loop diuretic, which is often used in cases of chronic renal failure where there is a need for rapid diuresis, such as when a patient has gained a significant amount of weight in a short period due to fluid retention. Loop diuretics are effective even when kidney function is significantly impaired.

Question 16

The nurse is caring for a client who is experiencing acute renal failure.The nurse knows that this client may experience problems regulating which items?
Select all that apply.

Accepted Answer

Acute renal failure affects the kidneys' ability to regulate fluid balance, electrolyte composition, and pH of body fluids. It can also lead to hypertension and fluid overload, which can impact blood pressure. Heart rate is not directly regulated by the kidneys, but the effects of electrolyte imbalances can impact the heart's function.

Question 17

The formation of urine begins at which structure?

Accepted Answer

The formation of urine begins at the glomerulus which is a network of tiny blood vessels in the kidney. Blood is filtered through the glomerulus and the filtered fluid then travels through the rest of the urinary system to eventually become urine.

Question 18

A client has severe protein malnutrition and is taking a drug that is 99% bound to albumin.Which alteration of drug concentration in the urinary filtrate will occur?

Accepted Answer

In severe protein malnutrition, there is a decrease in the amount of albumin in the blood, which results in a decrease in the amount of drug that is bound to albumin. This, in turn, leads to an increase in the amount of free drug that is filtered into Bowman's capsule during glomerular filtration. The other options (A, B, and D) are not directly affected by the decrease in protein levels and albumin binding.

Question 19

Spironolactone (Aldactone)is prescribed for a client diagnosed with hypertension.The nurse recognizes which information as providing the most support for the use of this drug?

Accepted Answer

The answer of Spironolactone (Aldactone)is prescribed for a client diagnosed...

Question 20

The nurse is caring for clients on a renal failure unit and recognizes which are indications for diuretic therapy?
Select all that apply.

Accepted Answer

C) High blood pressure (hypertension) is a common indication for diuretic therapy to help reduce the workload on the heart and lower blood pressure. D) Generalized edema and decreased urine output are signs of fluid overload, which diuretics can help alleviate by promoting the excretion of excess fluid.

Quiz 32: Diuretic Therapy and the Pharmacotherapy of Renal Failure

The nurse is caring for four clients on a renal failure unit and recognizes which drug as safe to administer to a client with hypokalemia?

A client prescribed bumetanide (Bumex) asks the nurse,"What is all this about 'loops' in my medicine?" Which response by the nurse is the most appropriate?

The nurse is caring for a client with a brain tumor who is prescribed mannitol (Osmitrol) IV.Which laboratory finding represents a potential adverse effect of this drug?

The nurse is reviewing results of a routine urinalysis that indicate the presence of protein in the urine.How does the nurse interpret this finding?

The nurse is teaching a client about spironolactone (Aldactone) ,and recognizes which statement as an indication that the client needs further teaching about this drug?

A client with cancer is secreting excessive amounts of antidiuretic hormone.The nurse will monitor the client for which consequence of excess antidiuretic hormone secretion?

A client is diagnosed with chronic renal failure and is receiving hydrochlorothiazide (HCTZ) .The nurse has taught the client about the importance of kidney function and evaluates that learning has occurred when the client makes which statements? Select all that apply.

The nurse is preparing to administer furosemide (Lasix) 40 mg IV to a client on complete bed rest who has renal failure and pulmonary edema.Which action is most appropriate prior to administering furosemide (Lasix) to this client?

The nurse is instructing a client on the importance of eating foods rich in potassium while taking a diuretic that causes hypokalemia.Which diuretics do not require potassium supplements? Select all that apply.

The nurse caring for a client with renal failure will the use of a usual dose of which medication?

Which substances enter the filtrate by active secretion? Select all that apply.

The nurse is caring for a client admitted to the medical-surgical unit with hypervolemia that has resulted from renal failure.Which medications does the nurse anticipate will be prescribed for this client based on the diagnosis? Select all that apply.

The nurse caring for a client in renal failure should an order for which drug?

The nurse is managing care for a client diagnosed with acute renal failure.What does the nurse recognize as the most important safety precaution with regard to medication administration?

A client diagnosed with chronic renal failure and has gained 4 pounds in the past 24 hours.The nurse anticipates that the client will receive which diuretic?

The nurse is caring for a client who is experiencing acute renal failure.The nurse knows that this client may experience problems regulating which items? Select all that apply.

The formation of urine begins at which structure?

A client has severe protein malnutrition and is taking a drug that is 99% bound to albumin.Which alteration of drug concentration in the urinary filtrate will occur?

Spironolactone (Aldactone) is prescribed for a client diagnosed with hypertension.The nurse recognizes which information as providing the most support for the use of this drug?

The nurse is caring for clients on a renal failure unit and recognizes which are indications for diuretic therapy? Select all that apply.