Deck 24: Diuretic Therapy and Drugs for Kidney Failure

Question 1

The nurse is preparing the education for a client prescribed chlorothiazide (Diuril). Which information should the nurse include in the teaching?

A) Consumption of foods high in potassium
B) Assessment of blood glucose daily
C) Daily weights with a report of a gain of more than 1 pound in 24 hours
D) Report change in hearing

Answer 1

Consumption of foods high in potassium

Question 2

The nurse suspects a client receiving chlorothiazide (Diuril) is experiencing side effects from the prescription. Which assessment finding supports the nurse's suspicion?

A) Ataxia and frequent diarrhea
B) Serum potassium level of 3.0 mEq/L and low blood pressure
C) Serum sodium level of 160 mEq/L and headaches
D) Mental confusion and dependent edema

Answer 2

Serum potassium level of 3.0 mEq/L and low blood pressure

Question 3

The healthcare provider has prescribed hydrochlorothiazide (HCTZ) for a client with chronic renal failure. Which assessment finding indicates the treatment is ineffective?

A) Weak pulses
B) Hypotension
C) Poor skin turgor
D) Wheezing

Answer 3

Wheezing

Question 4

Which initial treatment prescribed should the nurse anticipate for the client that has overdosed on hydrochlorothiazide?

A) Electrolyte replacement
B) Intravenous normal saline
C) Vasopressor
D) Furosemide (Lasix)

Question 5

A client prescribed spironolactone (Aldactone) asks the nurse which fluids they should drink to prevent dehydration. Which response should the nurse provide?

A) "Citrus juices are very good for rehydration."
B) "Any kind of fluid is okay, but avoid alcohol."
C) "Plain water is really the best."
D) "Electrolyte-replacement drinks like sports drinks."

Question 6

Which prescription is nephrotoxic if an overdose occurs?

A) Lorazepam (Ativan)
B) Amitriptyline (Elavil)
C) Ibuprofen (Advil)
D) Quetiapine (Seroquel)

Question 7

An older adult receiving ethacrynic acid (Edecrin) tells the nurse he or she doesn't hear as well as he or she used to. Which statement should the nurse include in the response?

A) "You may be dehydrated; are you drinking enough fluid?"
B) "I will let your healthcare provider know about this; it could be a side effect of your medication."
C) "How long have you been having difficulty hearing?"
D) "I will schedule a hearing exam; this could be a side effect of your medication."

Question 8

The nurse has provided client education about the function of the renal system. Which statements made by the client indicate an understanding of the teaching? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) "Kidneys help the heart by balancing potassium."
B) "Kidneys balance the fluid and electrolytes in my body."
C) "Kidneys keep blood pressure from getting too low."
D) "Kidneys help decrease infections by excreting bacteria."
E) "Kidneys help regulate the oxygen levels in my blood."

Question 9

Which is the most appropriate food for the nurse to recommend to a client to eat that is prescribed a loop diuretic?

A) Meat
B) Bananas
C) Cheese
D) Yogurt

Question 10

A patient receiving chlorothiazide (Diuril) has developed hypokalemia. Which assessment findings support the diagnosis?

A) Hyperglycemia
B) Heart palpitations
C) Increased urine output
D) Diarrhea

Question 11

A client prescribed bumetanide (Bumex) asks the nurse how the drug works. Which response should the nurse provide the client?

A) "This prescription causes your kidneys to reabsorb potassium."
B) "This prescription causes your kidneys to block the reabsorption of sodium."
C) "This prescription causes your kidneys to reabsorb calcium."
D) "This prescription causes your kidneys to reabsorb chloride."

Question 12

The nurse has completed the dietary teaching for a client prescribed spironolactone (Aldactone). Which statement made by the client indicates further teaching is required?

A) "I am really happy that I can have my cranberry juice."
B) "I can still have my orange juice and bananas for breakfast."
C) "I usually eat an apple a day to stay regular."
D) "I love to eat eggs and toast in the morning."

Question 13

The nurse is reviewing the medical history of a client prescribed hydrochlorothiazide (Microzide). Which condition should the nurse be concerned about?

A) Hypertension
B) Asthma
C) Gout
D) Hypothyroidism

Question 14

Which should the nurse recognize are important safety precautions when administering a prescription to a client with renal failure? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) The client will require lower dosages.
B) Some prescriptions increase fluid retention.
C) Measure hourly intake and output.
D) Some prescriptions are nephrotoxic.
E) Some prescriptions are bound to plasma proteins

Question 15

Which general adverse effect is associated with the use of diuretics?

A) Constipation
B) Orthostatic hypotension
C) Weight gain
D) Hypertension

Question 16

Which information should the nurse include when providing education for an older client prescribed chlorothiazide (Diuril)?

A) "Take the medication early in the morning."
B) "Avoid foods that are high in potassium."
C) "It is alright to have a glass of wine with this medication."
D) "Take the medication on an empty stomach."

Question 17

Which should the nurse suspect after noting the presence of protein on a routine urinalysis?

A) Acute kidney injury
B) Structural damage
C) Kidney infection
D) Chronic kidney injury

Question 18

Which is the client at risk for that is receiving spironolactone (Aldactone)?

A) Pancytopenia
B) Aplastic anemia
C) Hyperkalemia
D) Hyponatremia

Question 19

Which is the primary functional unit of the kidney?

A) Loop of Henle
B) Bowman's capsule
C) Nephron
D) Distal tubule

Question 20

Which conditions should the nurse anticipate the healthcare provider to possibly prescribe a diuretic? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) Heart failure
B) Cerebrovascular accident
C) Hypertension
D) Acute kidney injury
E) Ketoacidosis

Question 21

The nurse is preparing to provide education on daily self-monitoring for a client with congestive heart failure prescribed a diuretic. Which information should the nurse plan to include in the teaching? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) Weight
B) Pulse
C) Temperature
D) Blood pressure
E) Respiratory rate

Question 22

The educator is reviewing the physiology of the renal system with a nurse. Which statement made by the nurse indicates further teaching is required?

A) "The kidneys stimulate white blood cell production."
B) "The kidneys help regulate blood pressure."
C) "The kidneys regulate the acid-base balance of body fluids."
D) "The kidneys produce the active form of vitamin D."

Question 23

The nurse is reviewing the laboratory reports for a client with chronic kidney failure. Which lab should the nurse understand reflects the progression of the kidney disease?

A) Glomerular filtration rate (GFR)
B) Serum creatinine
C) Blood urea nitrogen (BUN)
D) Urinalysis

Question 24

The educator is preparing to review the diuretics that do not require potassium supplements with a nurse. Which diuretics should the educator include? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) Furosemide (Lasix)
B) Chlorothiazide (Diuril)
C) Amiloride (Midamor)
D) Mannitol (Osmitrol)
E) Spironolactone (Aldactone)

Question 25

Which diuretic is most effective in reducing the mortality of a client with heart failure?

A) Chlorothiazide (Diuril)
B) Acetazolamide (Diamox)
C) Furosemide (Lasix)
D) Spironolactone (Aldactone)

Question 26

Which should the nurse recognize a client with acute renal failure cannot effectively regulate? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) Fluid balance
B) Electrolyte balance
C) The pH of body fluids
D) Heart rate
E) Blood pressure

Question 27

The nurse has provided dietary education for a client prescribed furosemide (Lasix). Which statement made by the client indicates an understanding of the information?

A) "I will increase my consumption of green, leafy vegetables."
B) "I will increase my consumption of poultry."
C) "I will try and eat an orange daily."
D) "I will try and incorporate more grains in my diet."

Question 28

The nurse has provided education for a client with diabetes type I prescribed hydrochlorothiazide (Microzide). Which statement made by the client indicates an understanding of the information?

A) "I expect my blood glucose to be elevated."
B) "I anticipate to monitor my blood glucose more frequently."
C) "I can expect my hemoglobin A1C to be elevated."
D) "I expect I will need more insulin to help control my glucose."

Question 29

Which should the nurse recognize is associated with chronic kidney disease (CKD)? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) Hypertension
B) Inflammation
C) Diabetes
D) Hypoperfusion
E) Sepsis

Question 30

Which vital signs should the nurse assess prior to the administration of a diuretic? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) Temperature
B) Pulse
C) Respirations
D) Blood pressure
E) Pain