Deck 33: Diuretics
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Deck 33: Diuretics
1
For the client who develops acute renal failure and has worsening heart failure,the nurse expects to administer which of the following diuretics?
A) Furosemide (Lasix)
B) Amiloride (Midamor)
C) Spironolactone (Aldactone)
D) Triamterene (Dyrenium)
A) Furosemide (Lasix)
B) Amiloride (Midamor)
C) Spironolactone (Aldactone)
D) Triamterene (Dyrenium)
Spironolactone (Aldactone)
2
The nurse expects that a client with which of the following conditions will be treated with a loop diuretic?
A) Glaucoma
B) Hypernatremia
C) Cirrhosis
D) Hepatic disease
A) Glaucoma
B) Hypernatremia
C) Cirrhosis
D) Hepatic disease
Cirrhosis
3
While a client is taking potassium-sparing diuretics,the nurse should avoid administration of which of the following to prevent hyperkalemia?
A) Acetaminophen (Tylenol)
B) Acetylsalicylic acid (aspirin)
C) Blood from a blood bank
D) Sodium replacements
A) Acetaminophen (Tylenol)
B) Acetylsalicylic acid (aspirin)
C) Blood from a blood bank
D) Sodium replacements
Blood from a blood bank
4
The nurse would have greatest concern about the risk for drug toxicity when a client with a mental health problem takes furosemide (Lasix)with which psychotropic drug?
A) Lithium carbonate (Eskalith)
B) Haloperidol (Haldol)
C) Fluoxetine (Prozac)
D) Bupropion (Wellbutrin)
A) Lithium carbonate (Eskalith)
B) Haloperidol (Haldol)
C) Fluoxetine (Prozac)
D) Bupropion (Wellbutrin)
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5
When a client is taking furosemide (Lasix),the nurse would be least concerned about coadministration of which of the following drugs?
A) Heparin
B) Amphotericin B
C) Acetaminophen (Tylenol)
D) Lithium
A) Heparin
B) Amphotericin B
C) Acetaminophen (Tylenol)
D) Lithium
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6
The nurse asks the client to immediately report which of the following as a speed-related complication during the administration of an intravenous dose of bumetanide (Bumex)?
A) Headache
B) Dizziness
C) Ringing in the ears
D) Palpitations
A) Headache
B) Dizziness
C) Ringing in the ears
D) Palpitations
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7
The nurse concludes that a client is experiencing the most common adverse effects of furosemide (Lasix)after noting which of the following assessment findings?
A) Sleepiness and general fatigue
B) Confusion and a decline in blood pressure while standing
C) Increase in serum potassium and magnesium
D) Thirst and concentrated urine
A) Sleepiness and general fatigue
B) Confusion and a decline in blood pressure while standing
C) Increase in serum potassium and magnesium
D) Thirst and concentrated urine
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8
A client asks about taking potassium supplements while taking chlorothiazide (Diuril).Your best response would be
A) "We will make sure that you can get some right away."
B) "I will call your doctor and let him know of your request."
C) "Potassium supplements are usually not necessary with this type of diuretic."
D) "You are on a diuretic that is potassium sparing,so supplements are not needed."
A) "We will make sure that you can get some right away."
B) "I will call your doctor and let him know of your request."
C) "Potassium supplements are usually not necessary with this type of diuretic."
D) "You are on a diuretic that is potassium sparing,so supplements are not needed."
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9
The nurse assesses a client's laboratory test results for which of the following serum electrolyte changes as a result of drug therapy with furosemide (Lasix)?
A) Hypomagnesemia and hypocalcemia
B) Hypermagnesemia and hypercalcemia
C) Hyperkalemia and hypomagnesemia
D) Hypokalemia and hypercalcemia
A) Hypomagnesemia and hypocalcemia
B) Hypermagnesemia and hypercalcemia
C) Hyperkalemia and hypomagnesemia
D) Hypokalemia and hypercalcemia
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10
The nurse places high priority on assessing clients taking triamterene (Dyrenium)for the development of which of the following?
A) Hyperkalemia
B) Hypernatremia
C) Hypokalemia
D) Hypocalcemia
A) Hyperkalemia
B) Hypernatremia
C) Hypokalemia
D) Hypocalcemia
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11
In addition to blocking the reabsorption of sodium and chloride,the nurse understands that furosemide (Lasix)also demonstrates which of the following benefits?
A) It increases ADH secretion
B) It enhances the release of renin
C) It decreases vascular resistance
D) It minimizes renal blood flow
A) It increases ADH secretion
B) It enhances the release of renin
C) It decreases vascular resistance
D) It minimizes renal blood flow
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12
While taking chlorothiazide (Diuril),the nurse teaches the client to be cautious about taking which of the following medications?
A) Aspirin preparations
B) Digoxin
C) Tylenol
D) Tetracyclines
A) Aspirin preparations
B) Digoxin
C) Tylenol
D) Tetracyclines
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13
The nurse concludes that which of the following trends in laboratory results for a client taking hydrochlorothiazide is a result of drug therapy?
A) Increase in serum potassium
B) Increase in uric acid level
C) Decrease in triglyceride level
D) Decrease in blood glucose level
A) Increase in serum potassium
B) Increase in uric acid level
C) Decrease in triglyceride level
D) Decrease in blood glucose level
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14
The nurse would be most concerned about the risk of which of the following in a client receiving torsemide (Demadex)?
A) Hyperkalemia
B) Hypervolemia
C) Hypoglycemia
D) Hyponatremia
A) Hyperkalemia
B) Hypervolemia
C) Hypoglycemia
D) Hyponatremia
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15
When assessing for the adverse effects of chlorothiazide (Diuril),which of the following laboratory studies should the nurse be monitoring?
A) SGOT,SGPT,LDH
B) Hgb,Hct,WBC
C) BUN,Mg,Ca
D) K,Na,glucose
A) SGOT,SGPT,LDH
B) Hgb,Hct,WBC
C) BUN,Mg,Ca
D) K,Na,glucose
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16
The nurse anticipates that a client with which of the following conditions will receive a carbonic anhydrase inhibitor-type diuretic?
A) Cerebrovascular edema
B) Urinary calculi
C) Longstanding heart failure
D) Open-angle glaucoma
A) Cerebrovascular edema
B) Urinary calculi
C) Longstanding heart failure
D) Open-angle glaucoma
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17
The nurse would use extreme caution during the administration of which loop diuretic because of the risk of irreversible ototoxicity?
A) Furosemide (Lasix)
B) Bumetanide (Bumex)
C) Torsemide (Demadex)
D) Ethacrynic acid (Edecrin)
A) Furosemide (Lasix)
B) Bumetanide (Bumex)
C) Torsemide (Demadex)
D) Ethacrynic acid (Edecrin)
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18
A client with heart failure is being treated with both digoxin (Lanoxin)and furosemide (Lasix).The nurse makes it a priority to assess for which of the following in this client that could occur because of drug interactions?
A) Lung crackles
B) Irregular cardiac rhythm
C) Increase in edema
D) Weight loss of 1 lb per day
A) Lung crackles
B) Irregular cardiac rhythm
C) Increase in edema
D) Weight loss of 1 lb per day
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19
The nurse anticipates an order for mannitol (Osmitrol)for which of the following purposes with an assigned client?
A) Adjunct therapy for mild hypertension
B) Treatment of cerebral edema
C) Daily management of chronic heart failure
D) Long-term cataract treatment
A) Adjunct therapy for mild hypertension
B) Treatment of cerebral edema
C) Daily management of chronic heart failure
D) Long-term cataract treatment
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20
The nurse anticipates that a client with hyperaldosteronism will have an order for which of the following diuretics?
A) Spironolactone (Aldactone)
B) Amiloride (Midamor)
C) Triamterene (Dyrenium)
D) Bumetanide (Bumex)
A) Spironolactone (Aldactone)
B) Amiloride (Midamor)
C) Triamterene (Dyrenium)
D) Bumetanide (Bumex)
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21
The nurse interprets that which abnormal laboratory value is most likely induced by the effects of amiloride (Midamor)ordered for a client with heart failure?
A) Potassium 5.6 mEq/L
B) Potassium 3.2 mEq/L
C) Sodium 148 mEq/L
D) Sodium 132 mEq/L
A) Potassium 5.6 mEq/L
B) Potassium 3.2 mEq/L
C) Sodium 148 mEq/L
D) Sodium 132 mEq/L
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22
A client has a new order to receive acetazolamide (Diamox).The nurse assesses this client for a recurrence or increase in which of the following urinary problems noted in the health history?
A) Urinary calculi
B) Bladder infection
C) Renal stenosis
D) Renal insufficiency
A) Urinary calculi
B) Bladder infection
C) Renal stenosis
D) Renal insufficiency
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23
The nurse determines that a client understands hypokalemia as an adverse effect of hydrochlorothiazide when the client reports which of the following symptoms to the prescribing physician?
A) Dry mouth and constipation
B) Irregular heartbeat and muscle weakness
C) Urticaria and thrombocytopenia
D) Bradycardia and reduced skin turgor
A) Dry mouth and constipation
B) Irregular heartbeat and muscle weakness
C) Urticaria and thrombocytopenia
D) Bradycardia and reduced skin turgor
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24
A client taking a thiazide diuretic needs to increase intake of potassium-rich foods.Which of the following would the nurse recommend as being highest in potassium?
A) Apples
B) Pears
C) Cantaloupe
D) Pineapple
A) Apples
B) Pears
C) Cantaloupe
D) Pineapple
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25
The nurse would question an order for spironolactone (Aldactone)for a client who has which of the following health problems?
A) Primary hyperaldosteronism
B) Hyperaldosteronism secondary to ascites
C) Heart failure
D) Renal insufficiency
A) Primary hyperaldosteronism
B) Hyperaldosteronism secondary to ascites
C) Heart failure
D) Renal insufficiency
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26
The nurse is administering a diuretic to a client with ascites secondary to cirrhosis of the liver.The nurse measures which of the following for optimal evaluation of effectiveness of drug therapy?
A) Intake,output,and daily weight
B) Abdominal girth and blood pressure
C) Breath sounds and urine output
D) Results of liver function studies
A) Intake,output,and daily weight
B) Abdominal girth and blood pressure
C) Breath sounds and urine output
D) Results of liver function studies
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27
A client receiving a thiazide diuretic and potassium supplements has a low serum sodium level on follow-up laboratory work.The nurse assesses this client for which of the following signs of this adverse effect?
A) Irregular pulse,mental changes,and weakness
B) Confusion,fatigue,and irritability
C) Fever,low back pain,and dysuria
D) Unusual bleeding and bruising
A) Irregular pulse,mental changes,and weakness
B) Confusion,fatigue,and irritability
C) Fever,low back pain,and dysuria
D) Unusual bleeding and bruising
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28
A client being discharged home is receiving a newly prescribed once-daily diuretic drug.The nurse explains that the best time to take this medication is
A) early morning.
B) early afternoon.
C) just after supper.
D) bedtime.
A) early morning.
B) early afternoon.
C) just after supper.
D) bedtime.
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29
The nurse anticipates that acetazolamide (Diamox)may be ordered for an assigned client with which of the following acid-base imbalances?
A) Respiratory acidosis
B) Respiratory alkalosis
C) Metabolic acidosis
D) Metabolic alkalosis
A) Respiratory acidosis
B) Respiratory alkalosis
C) Metabolic acidosis
D) Metabolic alkalosis
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30
The nurse determines that which of the following drugs listed on the client's medication administration record poses the least risk of harmful interaction with spironolactone (Aldactone)?
A) Lithium (Eskalith)
B) Lisinopril (Prinivil)
C) Potassium chloride (K-Dur)
D) Ibuprofen (Motrin)
A) Lithium (Eskalith)
B) Lisinopril (Prinivil)
C) Potassium chloride (K-Dur)
D) Ibuprofen (Motrin)
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31
The nurse would question an order for urea (Ureaphil)for a client with which of the following health problems?
A) Increased intracranial pressure
B) Aspirin overdose
C) Liver disease
D) Acute glaucoma attack
A) Increased intracranial pressure
B) Aspirin overdose
C) Liver disease
D) Acute glaucoma attack
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32
The nurse explains to a nursing student that a carbonic anhydrase inhibitor ordered for an assigned client works on what part of the nephron?
A) Proximal tubule
B) Loop of Henle
C) Ascending tubule
D) Collecting duct
A) Proximal tubule
B) Loop of Henle
C) Ascending tubule
D) Collecting duct
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33
The nurse would assess the client for which of the following allergies before beginning drug therapy with acetazolamide (Diamox)?
A) Aspirin
B) Penicillin
C) Sulfonamides
D) Opioids
A) Aspirin
B) Penicillin
C) Sulfonamides
D) Opioids
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34
The nurse determines that which laboratory value is of little concern when identifying a client's baseline before starting diuretic therapy with spironolactone (Aldactone)?
A) Uric acid
B) Blood urea nitrogen
C) Serum potassium
D) Prothrombin time
A) Uric acid
B) Blood urea nitrogen
C) Serum potassium
D) Prothrombin time
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35
A client who is new to diuretic drug therapy indicates an understanding of how to prevent effects from possible volume depletion by doing which of the following?
A) Sitting and standing up slowly
B) Adding more bulk to the diet
C) Limiting fluid intake after midday
D) Eating cantaloupe or bananas more frequently
A) Sitting and standing up slowly
B) Adding more bulk to the diet
C) Limiting fluid intake after midday
D) Eating cantaloupe or bananas more frequently
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36
The nurse anticipates that the drug mannitol (Osmitrol)would be useful in treating an assigned client with which of the following health problems?
A) Cerebral hypoxia
B) Cerebral edema
C) Chronic renal failure
D) Cataracts
A) Cerebral hypoxia
B) Cerebral edema
C) Chronic renal failure
D) Cataracts
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37
A client with diabetes mellitus is starting drug therapy with acetazolamide (Diamox)for treatment of glaucoma.The nurse explains to the client that this drug is likely to have which effect on blood glucose levels?
A) Increase
B) No effect
C) Slight decrease
D) Severe decrease
A) Increase
B) No effect
C) Slight decrease
D) Severe decrease
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38
The nurse teaches a client taking a loop diuretic that electrolyte imbalance caused by drug therapy may be reduced by adding which of the following items to the diet?
A) Canned soups
B) Smoked meats
C) Salt substitutes
D) Eggs
A) Canned soups
B) Smoked meats
C) Salt substitutes
D) Eggs
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