Mastery EAQ Ch. 28

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Question #1

Which therapeutic goal would be used for a patient undergoing mannitol therapy?

A Decreased serum osmolality

B Increased urine osmolality

C Decreased intracranial pressure

D Decreased excretion of medications

Question #2

A patient is taking hydrochlorothiazide. On assessment, the nurse notices the patient has muscle weakness and hypotension. Which intervention would the nurse initiallytake?

A Administer calcium supplements.

B Give a lower dose of the medication.

C Reduce salt in the patient’s food.

D Assess the serum potassium level.

Question #3

The nurse is assessing a patient who has been prescribed diuretics. On reviewing the patient’s laboratory reports, the nurse finds that the patient’s creatinine clearance rate is 20 mL/min. Which dosage regimen would the nurse expect the provider to prescribe?

A Hydrochlorothiazide 5 mg/kg/day by mouth in a single dose

B Hydrochlorothiazide 10 mg/kg/day intravenous in divided doses

C Furosemide 5 mg/kg/day by mouth in the morning in a single dose

D Furosemide 7 mg/kg/day via the intravenous route in two divided doses

Question #4

Which intervention would the nurse incorporate while caring for a patient who experiences furosemide toxicity?

A Replace the indwelling urinary catheter.

B Replace fluids and electrolytes.

C Administer activated charcoal.

D Administer deferoxamine.

Question #5

The nurse is caring for a patient who is undergoing diuretic therapy to relieve hypertension. Which intervention is used by the nurse to assess hypotensive episodes?

A Ask the patient about signs like tingling of fingers and dizziness.

B Check the serum sodium levels.

C Monitor the pedal pulses of the patient periodically.

D Check the elasticity and flexibility of the patient’s skin.

Question #6

A patient asks the nurse about taking potassium supplements while taking triamterene. Which statement would the nurse respond with?

A “I will call your health care provider to discuss your concerns.”

B “You are correct about potassium. I will make sure that you get some right away.”

C “Your potassium level was normal in this morning’s laboratory report, so no supplement is needed.”

D “You are on a diuretic that is potassium-sparing, so there is no need for extra potassium.”

Question #7

Which intervention would the nurse perform when monitoring a patient receiving triamterene?

A Monitor for side effects of hypoglycemia.

B Assess potassium levels.

C Assess urinary output every other day.

D Monitor for hypernatremia.

Question #8

A patient with acute pulmonary edema is receiving furosemide. Which assessment finding indicates to the nurse that the intervention is working?

A Lungs clear

B Output 30 mL/hr

C Improvement in mental status

D Potassium level decreased from 4.5 to 3.5 mEq/L

Question #9

A nurse is caring for a patient receiving acetazolamide. Which assessment finding would require immediate nursing intervention?

A A decrease in arterial pH

B A decrease in bicarbonate level

C An increase in urinary output

D An increase in PaO2

Question #10

Which laboratory value would the nurse report to the health care provider as a potential adverse response to hydrochlorothiazide?

A Calcium level of 9 mg/dL

B Chloride level of 100 mEq/L

C Sodium level of 140 mEq/L

D Fasting blood glucose level of 140 mg/dL

Question #11

Which diuretic is a poor choice for a patient who has gout?

A Acetazolamide

B Hydrochlorothiazide

C Mannitol

D Spironolactone

Question #12

Which action in preparation of administering mannitol places the patient at risk for an embolism from a precipitant of the medication?

A Using an intravenous route for administration

B Drawing medication from a vial that was refrigerated

C Using a concentration of 10 grams per 100 mL

D Administration of the medication to treat toxic substances

Question #13

A patient with heart failure has pulmonary edema. After reviewing the patient’s medical history, the nurse informs the primary health care provider that the patient has taken sulfa drugs in the past for pneumonia. Which drug may the nurse expect to be initially prescribed for the patient?

A Acetazolamide, Spironolactone

B Mannitol, Acetazolamide

C Spironolactone, Mannitol

D Bumetanide, Chlorthalidone

Question #14

A patient has recently undergone kidney transplantation and is receiving cyclosporine therapy. On the follow-up visit, the nurse finds that the patient has severe ocular pain as a result of an accumulation of aqueous humor. Which treatment would the nurse anticipate the primary health care provider will prescribe for the patient?

A Refer the patient to an optometrist. Obtain a STAT serum creatinine level.

B Give intravenous torsemide. Refer the patient to an optometrist.

C Obtain a STAT serum creatinine level. Lower the dose of cyclosporine.

D Lower the dose of cyclosporine. Give an oral dose of acetazolamide.

Question #15

After reviewing the laboratory reports of a male patient who is taking amiloride, the nurse finds that the patient has renal dysfunction but not hepatic dysfunction. Which finding enabled the nurse to make this conclusion?

A The serum creatinine level of the patient is 2.0 mg/100 mL.
The blood urea nitrogen (BUN) level of the patient is 40 mg/100 mL.
The aspartate aminotransferase (AST) level of the patient is 42 units/L.

B The alkaline phosphatase (ALP) level of the patient is 10 units/L.
The lactic dehydrogenase (LDH) level of the patient is 35 units/L.
The blood urea nitrogen (BUN) level of the patient is 6 mg/100 mL.

C The alkaline phosphatase (ALP) level of the patient is 10 units/L.
The serum creatinine level of the patient is 2.0 mg/100 mL.
The blood urea nitrogen (BUN) level of the patient is 6 mg/100 mL.

D The aspartate aminotransferase (AST) level of the patient is 42 units/L.
The lactic dehydrogenase (LDH) level of the patient is 35 units/L.
The blood urea nitrogen (BUN) level of the patient is 6 mg/100 mL.

Question #16

A diabetic patient who is taking an oral hypoglycemic has been prescribed metolazone. Which symptom would the nurse assess for while caring for the patient?

A Hyperkalemia, Ototoxicity

B Ototoxicity, Neurotoxicity,

C Neurotoxicity, Hyperkalemia

D Dizziness, Hyperglycemia

Question #17

The nurse is caring for a patient who has severe hepatic failure. The patient’s blood pressure is 160/100 mm Hg. Which medication would the nurse anticipate that the primary health care provider will prescribe for this patient?

A Furosemide

B Triamterene

C Azathioprine

D Spironolactone

Question #18

A patient has been prescribed hydrochlorothiazide. After reviewing the patient’s laboratory report, the nurse informs the primary health care provider that the patient has hypokalemia. Which drug would the nurse expect to be included in the patient’s prescription?

A Amiloride

B Mannitol

C Acetazolamide

D Furosemide

Question #19

Which information would the nurse obtain prior to administering furosemide to a patient?

A he patient’s serum potassium level. The patient’s baseline renal function. The patient’s fluid intake and urine output. The patient’s level of consciousness.

B The patient’s allergies. The patient’s serum potassium level. The patient’s baseline renal function. The patient’s fluid intake and urine output.

C The patient’s level of consciousness. The patient’s allergies. The patient’s serum potassium level. The patient’s baseline renal function.

D The patient’s baseline renal function. The patient’s fluid intake and urine output. The patient’s level of consciousness. The patient’s allergies.

Question #20

It is prescribed that a patient be given furosemide via intravenous push. Which intervention would the nurse perform?

A Assess blood pressure before and after administration. Monitor electrocardiogram continuously. Insert an arterial line for continuous blood pressure monitoring.

B Monitor electrocardiogram continuously. Maintain accurate intake and output record. Insert an arterial line for continuous blood pressure monitoring.

C Maintain accurate intake and output record. Assess lung sounds before and after administration. Assess blood pressure before and after administration.

D Assess lung sounds before and after administration. Monitor electrocardiogram continuously. Insert an arterial line for continuous blood pressure monitoring.

Question #21

A patient with primary hypertension is prescribed furosemide 60 mg daily. Which action will the nurse take if the patient’s potassium levels results are 3.8 mEq/L?

A Caution the patient to reduce fruits and vegetables

B Review sources to increase dietary potassium

C Review the renal function tests

D Discuss using over-the-counter potassium supplements

Question #22

Which therapeutic action is intended from spironolactone prescribed to an infant for heart failure?

A Strong diuretic effect

B Reduces potassium loss

C Increases renal function

D Aldosterone-inhibiting activity

Question #23

A patient who is undergoing oral therapy with loop diuretics tells the nurse, “I do not feel like eating food after initiating the therapy. I feel nauseous and lethargic.” The blood pressure of the patient is determined to be 100/65 mm Hg. Which intervention will the health care provider prescribe in this situation?

A Psyllium-based bulk-forming laxatives

B Fluid replacement therapy

C Potassium-sparing diuretic with loop diuretic

D Administering the loop diuretics through an intravenous (IV) route

Question #24

A patient taking spironolactone has been taught about the medication. Which menu selection indicates that the patient understands teaching related to this medication?

A Lima beans

B Potatoes

C Carrots

D Tomato juice

Question #25

The nurse applies slight pressure on the fingertips of a patient undergoing diuretic therapy. When the pressure is released, the nurse observes that the patient’s fingertips have slowly turned pink. How would the nurse interpret this situation?

A The patient has decreased extracellular fluid volume.

B The patient has decreased cardiac output.

C The patient has decreased serum sodium levels.

D The patient has decreased hemoglobin levels.

Question #26

The nurse is assessing a patient who is taking furosemide. The patient’s potassium level is 3.4 mEq/L, the chloride level is 90 mmol/L, and the sodium level is 140 mEq/L. Based on the nurse’s understanding of the laboratory results, which prescribed therapy can the nurse anticipate administering?

A Administer 2 mEq potassium chloride per kilogram per day intravenously.

B Mix 40 mEq of potassium in 250 mL D5W and infuse rapidly.

C Administer sodium polystyrene sulfonate.

D Administer calcium acetate, two tablets three times per day.

Question #27

A patient with hypertension is receiving spironolactone therapy. The nurse notices that the patient’s serum potassium level is 6.2 mEq/L. What would the nurse anticipate will be prescribed for the patient?

A Furosemide

B Acetazolamide

C Mannitol

D Amiloride

Question #28

The nurse is caring for a patient who has heart failure that resulted from diastolic dysfunction. The patient’s medical history indicates that the patient has a history of chronic kidney disease. Which drug would the nurse anticipate will be prescribed for the patient?

A Metolazone

B Spironolactone

C Furosemide

D Hydrochlorothiazide

Question #29

Following the assessment of a patient who is receiving furosemide, the nurse informs the primary health care provider that the patient has a serum creatinine of 2.5 mg/dL. The primary health care provider prescribes metolazone for the patient. Which intervention would the nurse follow before administering the new drug?

A Check the drug container for any precipitants.

B Give furosemide 30 minutes before the drug.

C Give the drug 30 minutes before the furosemide.

D Administer the drug using a filter with the tubing.

Question #30

The primary health care provider instructs the nurse to administer a 20% solution of mannitol to a patient who has cerebral edema. Which information would the nurse recall before administering the drug to the patient?

A To give oral rehydration salts with the drug

B To maintain normal room temperature

C To administer potassium supplements

D To store the drug in a brightly lit room

Question #31

When reviewing the laboratory reports of a patient who is taking triamterene, the nurse finds that the creatinine clearance of the patient is 9 mL/min. Which drug would the nurse expect the primary health care provider to prescribe?

A Metolazone

B Furosemide

C Mannitol

D Hydrochlorothiazide

Question #32

A patient with heart failure is prescribed furosemide and amiloride. However, while assessing the patient’s medical record, the nurse observes that the patient is on therapy with lithium carbonate to treat bipolar disorder. Which response would the nurse take in this situation?

A Report to the health care provider about the patient’s bipolar disorder.

B Report to the health care provider about the patient’s lithium carbonate therapy.

C Instruct the patient to take lithium carbonate 1 hour before administering the diuretics.

D Instruct the patient to stop taking lithium carbonate during diuretic therapy.

Question #33

Which symptom would the nurse report to the health care provider for a patient taking spironolactone?

A Nausea/vomiting

B Lethargy

C Hypotension

D Mental confusion

Question #34

The nurse observes that a patient’s vision is not improving after acetazolamide treatment. Which drug would the nurse anticipate will be prescribed for the patient for reducing intraocular pressure?

A Amiloride

B Spironolactone

C Mannitol

D Furosemide

Question #35

The nurse is caring for a patient who is receiving digoxin and acetazolamide therapy. Which action by the nurse is necessary to prevent adverse effects?

A Check the patient’s potassium levels in the lab reports.

B Assess the patient’s heart rate frequently.

C Assess the patient’s skin for any signs of peeling.

D Check the patient’s platelet levels in the blood reports.

Question #36

A patient with hypertension has been prescribed furosemide. On reviewing the patient’s medical history, the nurse learns that the patient is also taking ibuprofen for rheumatoid arthritis. Which action would the nurse anticipate the primary health care provider will prescribe?

A Increased dose of furosemide

B Decreased dose of ibuprofen

C STAT venipuncture for serum calcium

D Alternating doses of both medications

Question #37

The nurse is assessing a patient who has lower-extremity edema. The nurse learns that the patient is a mountain climber and has been suffering from headaches, nausea, and shortness of breath for the last few days. Which drug would the nurse expect the primary health care provider to prescribe for the patient?

A Spironolactone

B Mannitol

C Acetazolamide

D Hydrochlorothiazide

Question #38

What condition determines the potency of a diuretic medication?

A Dosage of the diuretic

B Ability to reabsorb water

C Site of mechanism of action

D Strength of sodium filtration

Question #39

The nurse notices that a patient who is receiving lithium has moderate bilateral pitting edema. The primary health care provider has prescribed a loop diuretic for the patient. For which side effect would the nurse monitor?

A Bloody stools

B Itching and rashes

C Lithium levels

D Amenorrhea

Question #40

Which physiologic change will be observed in a patient after administering diuretics?

A Increased extracellular fluid volume, Increased peripheral vascular resistance

B Decreased cardiac output, Decreased blood pressure

C Increased plasma volume, Increased peripheral vascular resistance

D Increased extracellular fluid volume, Increased plasma volume

Question #41

The nurse is assessing a patient who has been prescribed hydrochlorothiazide. Which information would the nurse give the patient about the medication regimen?

A “You should limit your intake of oats.”

B “Take iron supplements every day.”

C “You should not eat melons or grapes.”

D “Take the dose only in the morning.”

Question #42

How long after intravenous (IV) administration of furosemide would the nurse anticipate the beginning of diuresis?

A 60 minutes

B 30 minutes

C 1 minute

D 5 minutes

Question #43

At which concentration is the intravenous injection of mannitol likely to crystallize?

A 20%

B 15%

C 5%

D 10%

Question #44

Which drug may cause melena as a side effect?

A Mannitol

B Acetazolamide

C Furosemide

D Metolazone

Question #45

Which drug is used cautiously in patients with a sulfa drug allergy?

A Mannitol

B Amiloride

C Furosemide

D Acetazolamide

Question #46

Which side effect is associated with furosemide?

A Hypochondria

B Hypokalemia

C Hypoglycemia

D Hypoxia

Question #47

Which class of diuretics is used to manage increased intracranial pressure?

A Potassium-sparing diuretics

B Carbonic anhydrase inhibitors

C Osmotic diuretics

D Loop diuretics

Question #48

Which drug can be prescribed for the treatment of idiopathic hypercalciuria?

A Furosemide

B Amiloride

C Metolazone

D Mannitol

Question #49

A 10-year-old child who has heart failure has been prescribed furosemide. Which instruction would the nurse give to the child’s parents to prevent adverse effects of the medication?

A “Give the medication to your child before bedtime.”

B “Protect your child from excessive sunlight exposure.”

C “Do not give oral rehydration drinks to your child.”

D “Administer the medication on an empty stomach.”

Question #50

A patient reveals taking daily ibuprofen for chronic back pain. On reviewing the patient’s medical history, the nurse learns that the patient is also taking furosemide for high blood pressure. What would the nurse anticipate that the primary health care provider will prescribe?

A Decreased dose of ibuprofen

B STAT venipuncture for serum calcium

C Increased dose of furosemide

D Alternating doses of both medications

Question #51

Which information would the nurse provide to a patient who is receiving spironolactone and furosemide therapy?

A “This combination promotes diuresis but decreases the risk of hypokalemia.”

B “Using two drugs increases the osmolality of plasma and the glomerular filtration rate.”

C “Moderate doses of two different diuretics are more effective than a large dose of one.”

D “This combination prevents dehydration and hypovolemia.”

Question #52

Which side effect would the nurse include when teaching a patient who is beginning a loop diuretic?

A Insomnia

B Headache

C Muscle pain

D Constipation

Question #53

A patient has abnormal levels of antidiuretic hormone. The nurse knows that this hormone is primarily active in which part of the nephron?

A Distal tubule

B Proximal tubule

C Collecting duct

D Loop of Henle

Question #54

Which drug is the strongest diuretic?

A Acetazolamide

B Triamterene

C Mannitol

D Furosemide

Question #55

Which laboratory value indicates that the administration of hydrochlorothiazide needs to be held until further consultation with the health care provider?
Test / Results
Aspartate aminotransferase_35 units per liter (U/L)
Creatinine clearance_ 35 mL/min
Serum potassium level_ 5.0 mEq/L
Serum sodium level_ 145 mEq/L

A Creatinine clearance

B Serum sodium level

C Aspartate aminotransferase (AST)

D Serum potassium leve

Question #56

Which patient cue indicates the highest risk for complications from the prescribed diuretics?

A Acetazolamide prior to ocular surgery

B Hydrochlorothiazide for hypertension

C Spironolactone with renal failure

D Furosemide to treat hypercalcemia

Question #57

Which action in preparation of administering mannitol places the patient at risk for an embolism from a precipitant of the medication?

A Using an intravenous route for administration

B Administration of the medication to treat toxic substances

C Drawing medication from a vial that was refrigerated

D Using a concentration of 10 grams per 100 mL

Question #58

Which patient cue indicates the highest risk for complications from the prescribed diuretics?

A Furosemide to treat hypercalcemia

B Hydrochlorothiazide for hypertension

C Acetazolamide prior to ocular surgery

D Spironolactone with renal failure

Question #59

Based on a patient’s medication administration record, which cue would the nurse expect from a drug interaction?
Medication Administration Record
o Furosemide 40 mg orally daily
o Triamterene 50 mg orally 2 x a day
o Ibuprofen 600 mg orally 3 x a day

A Reduced relief of pain

B Increased blood pressure

C Increased potassium levels

D Decreased urinary output

Question #60

After reviewing a patient’s medical record, which action will the nurse take before administering acetazolamide as prescribed prior to ocular surgery to a patient?

Patient Health History :
Hypertension
History of open-angle glaucoma
Liver cirrhosis

Medication Allergies:
Sulfa
Penicillin

A Request another medication with less allergy risk

B Report a history of open-angle glaucoma

C Document teaching for continued use after surgery

D Review laboratory values for hepatic function

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