Deck 15: Drugs That Affect Urine Output

Question 1

A patient is prescribed spironolactone (Aldactone).Why should you advise the patient to avoid the use of salt substitutes?

A) They increase a patient's risk for a high potassium level.
B) They can increase the patient's risk for hypertension.
C) They may lead to hypokalemia.
D) They can cause water retention.

Answer 1

They increase a patient's risk for a high potassium level.

Question 2

A patient taking a thiazide diuretic has the following blood laboratory values for kidney function.Which value will you report to the prescriber immediately?

A) Sodium 136 mEq/L
B) Potassium 2.6 mEq/L
C) Creatinine 0.9 mg/dL
D) Blood urea nitrogen 6 mg/dL

Answer 2

Potassium 2.6 mEq/L

Question 3

How do antispasmodic drugs for overactive bladder work?

A) They reduce the urine-making action of the kidney.
B) They relax the muscles of the bladder.
C) They shrink the prostate gland.
D) They reduce the thirst reflex.

Answer 3

They relax the muscles of the bladder.

Question 4

Which side effect is associated only with loop diuretics?

A) Dizziness
B) Hearing loss
C) Urinary frequency
D) Increased sun sensitivity

Question 5

For which complication should you remain alert when a patient is taking any type of diuretic?

A) Loss of appetite
B) Bladder spasms
C) Hypertension
D) Dehydration

Question 6

Which laboratory value is always checked before giving a dose of furosemide (Lasix)?

A) Calcium
B) Magnesium
C) Creatinine
D) Potassium

Question 7

A patient who has been taking a diuretic for the past 2 weeks now experiences all of the following changes.Which change indicates that the diuretic is effective?

A) Weight loss of 7 lb
B) Heart rate increased from 72 to 80 beats/min
C) Respiratory rate decreased from 20 to 16 breaths/min
D) Morning blood glucose decreased from 142 to 110 mg/dL

Question 8

Which diuretic is potassium-sparing?

A) Chlorothiazide (Oretic)
B) Furosemide (Lasix)
C) Ethacrynic acid (Edecrin)
D) Spironolactone (Aldactone)

Question 9

Which diuretic can cause breast enlargement?

A) Amiloride
B) Bumetanide
C) Chlorothiazide
D) Torsemide

Question 10

What is the most common health problem treated by diuretic drugs?

A) High blood pressure
B) Tongue swelling
C) Constipation
D) Obesity

Question 11

Which diuretic may cause an adverse effect of a higher than normal serum potassium level?

A) Spironolactone (Aldactone)
B) Bumetanide (Bumex)
C) Chlorothiazide (Diuril)
D) Furosemide (Lasix)

Question 12

Which type of diuretic can cause higher than normal blood calcium levels?

A) Loop diuretics
B) Osmotic diuretics
C) Thiazide diuretics
D) Potassium-sparing diuretics

Question 13

You are teaching a patient about diuretic therapy.Which statement made by the patient indicates that more teaching is needed?

A) "I am so thankful that my high blood pressure has been cured by this drug."
B) "I always try to drink just about the same amount of fluid that I urinate each day."
C) "I will call my health care provider if my heart rate is less than 60 beats/min."
D) "I have been taking this drug early in the day so that I don't have to get up during the night."

Question 14

Which class of diuretics is the most powerful?

A) Loop diuretics
B) Osmotic diuretics
C) Thiazide diuretics
D) Potassium-sparing diuretics

Question 15

Why should you teach a patient who is prescribed a thiazide diuretic to change positions slowly?

A) Moving rapidly from a standing position to a sitting position can raise blood pressure and increase the patient's risk for a stroke.
B) Moving rapidly from a standing position to a sitting position can cause excess body fluids to collect in the feet and ankles increasing the patient's risk for edema.
C) Moving rapidly from a sitting position to a standing position can put pressure on the bladder and increase the patient's risk for incontinence.
D) Moving rapidly from a sitting position to a standing position can cause blood pressure to drop and increase the patient's risk for falling.

Question 16

A patient prescribed a once-daily diuretic calls the prescriber's office to report that yesterday's drug dose was missed.What is your best advice?

A) "Take today's dose now and restrict today's fluid intake to 1 L."
B) "Take yesterday's dose now and take today's dose after another 6 hours."
C) "Take today's dose now and maintain your normal intake of food and fluids."
D) "Skip today's doses of all your medications and then begin everything fresh tomorrow."

Question 17

What is the main intended action of any type of diuretic drug?

A) Weight loss
B) Potassium loss
C) Increased urine output
D) Decreased sense of thirst

Question 18

You are to administer 20 mg of furosemide (Lasix)to a patient by the intravenous (IV)route.Which action is most important for you to take?

A) Give the drug slowly over at least 2 minutes.
B) Check the patient carefully for symptoms of low blood glucose levels.
C) Mix the drug with potassium chloride to prevent a rapid drop in serum potassium levels.
D) Monitor the IV site after giving the drug because furosemide causes severe tissue damage if infiltration occurs.

Question 19

What is a common side effect of antispasmodic drugs for overactive bladder (OAB)?

A) Dry mouth
B) Diarrhea
C) Insomnia
D) Incontinence

Question 20

Which symptom indicates too much sodium has been lost when a loop diuretic has been used?

A) Blood pressure gets higher as the day passes.
B) Blood levels of potassium are increased every morning.
C) The patient's urine is a light yellow color and has no perceptible odor.
D) The patient becomes light-headed and dizzy when moving from a sitting to a standing position.

Question 21

You prepare to give a second dose of furosemide (Lasix)to a patient by intravenous (IV)push.Before the injection is started,the patient reports having chest pain since the last dose of the drug.What is your best action?

A) Assist the patient to lay flat and encourage him or her to take slow,deep breaths.
B) Document the report as the only action for this expected side effect.
C) Slow the IV drip rate and examine the infusion site for infiltration.
D) Hold the dose and notify the prescriber immediately.

Question 22

A patient who has diabetes is now prescribed the thiazide diuretic metolazone (Zaroxolyn).In addition to the usual precautions,what else should you teach this patient about the new drug therapy?

A) Always carry a simple sugar with you.
B) Check your blood glucose level more frequently.
C) Be sure to restrict your fluid intake after 6:00 p.m.
D) Tell your dentist you are taking this drug before any dental work is performed.

Question 23

Which class of drugs can increase the blood potassium level when taken with triamterene (Dyrenium)?

A) High-ceiling "loop" diuretics
B) Metabolism inhibiting antibacterials
C) Angiotensin-converting enzyme inhibitors
D) Nonnucleoside analogue reverse transcriptase inhibitors

Question 24

A 10-year-old child is prescribed a one-time dose of oral furosemide (Lasix)2 mg/kg.The child's weight is 75 lb.How many milligrams will you give the child?

Question 25

The adult patient is prescribed 100 mg of hydrochlorothiazide (HCTZ [Oretic])in 2 divided doses per day.HCTZ is available on 25 mg tablets.How many tablets per dose will you give the patient?

Question 26

A hospitalized patient has received furosemide (Lasix),40 mg orally,30 minutes ago.To prevent injury to the patient,what should you do?

A) Assist the patient to the bathroom
B) Keep the patient on bed rest
C) Place all four side rails in the elevated position
D) Provide the patient with a bedpan or urinal

Question 27

What must you teach any patient who is taking a diuretic drug?

A) Avoid foods that are rich in potassium such as bananas and broccoli.
B) Sit on the side of the bed for 1 to 2 minutes before getting out of bed.
C) Notify the prescriber if the heart rate is less than 70 beats/min.
D) Keep a record of dietary intake for a few weeks.

Question 28

For which diuretic should you teach a patient to wear long sleeves,a hat,and sunscreen when going outdoors?

A) Furosemide (Lasix)
B) Ethacrynic acid (Edecrin)
C) Torsemide (Demadex)
D) Spironolactone (Aldactone)

Question 29

A patient is prescribed an extended-release drug for overactive bladder.Which precaution is most important for you to teach the patient?

A) "Avoid taking this drug at bedtime."
B) "Drink at least 3 L of fluid daily."
C) "Swallow the tablet or capsule whole."
D) "Perform a home pregnancy test monthly."

Question 30

A patient taking tolterodine (Detrol)reports decreased urination,ankle swelling,and a weight gain of 5 lb over the past 2 days.What should you do next?

A) Hold the dose and notifies the prescriber.
B) Check the patient's blood pressure and heart rate.
C) Give the next dose as prescribed.
D) Document the finding as the only action.

Question 31

Which are common signs and symptoms when a patient is dehydrated? (Select all that apply. )

A) Decreased pulse rate
B) Low blood pressure
C) Thirst
D) Swollen eyeballs
E) Dry mouth

Question 32

A patient is prescribed a urinary antispasmodic drug for overactive bladder.Which instruction should you provide to prevent a serious complication?

A) "Be sure to let your prescriber know if your symptoms do not improve."
B) "When using the patch,press it firmly to make sure it stays in place."
C) "Use alcohol in moderation while taking this drug."
D) "Avoid becoming overheated or dehydrated."

Question 33

A patient is prescribed a diuretic drug twice a day.When should you advise him or her to take the last dose each day?

A) Around noon with lunch
B) Before 6:00 p.m.
C) At 9:00 p.m.or bedtime
D) Twelve hours after the first dose

Question 34

A patient prescribed a drug for overactive bladder (OAB)tells you that he or she regularly exercises throughout the year.What would you be sure to teach him or her about exercising during summer heat?

A) "When the weather is hot,you are at increased risk for heat stroke."
B) "During summer always exercise early in the day or after the sun goes down."
C) "Exercise will help you lose weight which will help decrease your OAB symptoms."
D) "Be sure to wear disposable pads to absorb any urine that leaks from your bladder while exercising."

Question 35

A patient who has been prescribed amiloride (Midamor)for the past 3 months reports that she must shave her legs more frequently.What is your best action?

A) Hold the next dose and notify the prescriber immediately.
B) Instruct the patient to stop taking oral contraceptives while she is taking this drug.
C) Document the response and reassure the patient that this is an expected side effect.
D) Ask the patient whether she has noticed any changes in the thickness of her scalp hair.

Question 36

During medication reconciliation,the patient tells you that he takes Luvox daily as a "water pill." You note that this drug is not on his current list of ordered drugs.How should you proceed?

A) Ask him what strength or dose of Luvox he takes.
B) Request that the prescriber add Luvox to the patient's orders.
C) Ask the patient to have all his drugs brought from home to the hospital.
D) Check with the pharmacist to determine whether Luvox interacts with his ordered drugs.

Question 37

Why would a child be prescribed oxybutynin (Ditropan)?

A) To reduce bed-wetting
B) To prevent urinary retention
C) To increase elimination of urea
D) To decrease the risk for urinary tract infection

Question 38

A patient with overactive bladder has been prescribed tolterodine (Detrol).While assessing the patient,you discover the presence of the following health problems.For which problem should you contact the prescriber and question the drug order?

A) Asthma
B) Glaucoma
C) Hypotension
D) Diabetes mellitus

Question 39

A patient who is prescribed hydrochlorothiazide (HCTZ)informs you that she plans to become pregnant.What should you teach the patient about this drug?

A) This drug is safe for use during pregnancy and breastfeeding.
B) The prescriber will most likely decrease your dose while you are pregnant.
C) You may take this drug during pregnancy,but should not use it if you plan to breastfeed.
D) This drug should be avoided both during pregnancy and the time when you are breastfeeding.