Question 1

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 should be administered intravenously through a filter to prevent particulate matter from entering the bloodstream. It should not be given by rapid IV bolus or by mouth. Gravity IV drip with standard tubing may also not be ideal as it may not provide accurate and consistent dosing.

Question 2

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

Spironolactone (Aldactone) is a potassium-sparing diuretic, meaning it can cause hyperkalemia (elevated potassium levels). The other diuretics listed can cause hypokalemia (low potassium levels) and would not require monitoring for hyperkalemia.

Question 3

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

There is an increased risk for digitalis toxicity in the presence of hypokalemia, which may develop with hydrochlorothiazide therapy. Potassium supplements are often prescribed with hydrochlorothiazide therapy to prevent hypokalemia. The other options do not have interactions with hydrochlorothiazide.

Question 4

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

Thiazide diuretics are often the first choice for antihypertensive therapy because they are effective at reducing blood pressure and have a low risk of adverse effects. Loop diuretics are more often used for edema or congestive heart failure, and may cause electrolyte imbalances. Osmotic diuretics are used to reduce intracranial pressure or edema, and may cause fluid and electrolyte imbalances. Potassium-sparing diuretics are often used in combination with other diuretics to prevent hypokalemia, but may cause hyperkalemia.

Question 5

A patient on diuretic therapy calls the clinic because he's had the flu,with "terrible vomiting and diarrhea," and he has not kept anything down for 2 days.He feels weak and extremely tired.Which statement by the nurse is correct?

A) "It's important to try to stay on your prescribed medication.Try to take it with sips of water."
B) "Stop taking the diuretic for a few days,and then restart it when you feel better."
C) "You will need an increased dosage of the diuretic because of your illness.Let me speak to the physician."
D) "Please come into the clinic for an evaluation to make sure there are no complications."

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Accepted Answer

The patient's symptoms suggest dehydration, which can lead to low blood pressure and electrolyte imbalances, both of which can be exacerbated by diuretic therapy. Therefore, a physical evaluation by a healthcare provider is necessary to assess the patient's fluid and electrolyte status and determine if any medication adjustments need to be made. Option A is incorrect because the patient is unable to keep anything down, making it difficult to take medication. Option B is incorrect because stopping diuretic therapy suddenly can lead to fluid retention and worsen symptoms. Option C is incorrect because increasing the dosage of the diuretic can further exacerbate dehydration and electrolyte imbalances.

Question 6

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

Intake and output measures the amount of fluids that the patient is taking in and excreting, while daily weight provides an indication of fluid retention or loss. These measures reflect the patient's fluid volume status and can help to guide adjustments to diuretic therapy. Blood pressure, pulse, and serum electrolyte levels are important assessments, but they do not provide a direct measure of fluid volume status. Measurements of abdominal girth and calf circumference may be useful in cases of edema, but are not as reliable or frequently used as intake, output, and daily weight.

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

Furosemide is a diuretic medication that can cause a drop in blood pressure and dizziness. Therefore, it is important for the patient to change positions slowly to avoid these adverse effects. The medication can be taken in the morning, and there is no need to avoid potassium-rich foods unless otherwise instructed by the physician. Rapid weight gain should be reported immediately to the physician, rather than waiting for the next routine visit.

Question 8

A patient is to receive hydrochlorothiazide (HydroDIURIL)via a percutaneous endoscopic gastrostomy (PEG)tube.The order reads,&#34;Give hydrochlorothiazide,25 mg,per PEG tube once daily.&#34; The medication is available in a liquid form,50 mg/5 mL.Identify how many milliliters will the nurse administer for each dose._______

Accepted Answer

The answer of A patient is to receive hydrochlorothiazide (HydroDIURIL)via...

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

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

Carbonic anhydrase inhibitors can elevate blood glucose levels, especially in patients with diabetes. This occurs because these medications can interfere with the body's ability to regulate blood sugar levels. Monitoring of blood glucose should be performed regularly in diabetic patients receiving these medications. Metabolic alkalosis, hyperkalemia, and mental alertness are not common adverse effects of carbonic anhydrase inhibitors.

Question 11

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

The answer of A 79-year-old patient is taking a diuretic...

Question 12

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

The answer of A patient in the neurologic intensive care...

Question 13

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 will the child receive for this dose._______

Accepted Answer

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

Question 14

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?&#10;A) In the morning&#10;B) At noon&#10;C) With supper&#10;D) At bedtime

Accepted Answer

The answer of A patient is being discharged to home...

Deck 28: Diuretic Drugs