questions and answers already passed

Diuretics pharmacology NCLEX questions and answers already passed

For a patient prescribed hydrochlorothiazide (HydroDIURIL), the nurse should closely monitor which laboratory test value?

• Sodium
• Glucose
• Calcium
• Chloride ✔✔B. Glucose Correct

Thiazide and thiazide-like diuretics are associated with adverse metabolic effects of hyperglycemia; therefore, close monitoring of blood glucose levels are needed. Other metabolic disturbances include hyperlipidemia and hyperuricemia.

The nurse is providing education to a patient prescribed spironolactone (Aldactone) and furosemide (Lasix). What information does the nurse explain to the patient?

• Using two drugs increases blood osmolality and the glomerular filtration rate.
• This combination promotes diuresis but decreases the risk of low levels of potassium.
• The lowest dose of two different types of diuretics are more effective than a large dose of one

type.

• This combination maintains water balance to protect against dehydration and electrolyte

imbalance. ✔✔B. This combination promotes diuresis but decreases the risk of low levels of potassium. Correct

Spironolactone is a potassium-sparing diuretic; furosemide is a potassium-losing diuretic. Giving these together minimizes potassium loss.

Which laboratory test result is a common adverse effect of furosemide (Lasix)?

• Hypokalemia
• Hypernatremia
• Hyperchloremia
• Hypophosphatemia ✔✔A. Hypokalemia Correct

Furosemide is a potent loop diuretic, and the most common adverse effect of loop diuretics is electrolyte imbalances. This results in major electrolyte losses of potassium and sodium and, to a lesser extent, calcium.

Why does the health care provider prescribe furosemide (Lasix) 40 mg twice a day by mouth for a patient with a history of renal insufficiency?

• Furosemide is effective in treating patients withhypoaldosteronism.
• Furosemide helps the kidney with reabsorption of sodium and water.
• Furosemide has an antagonist effect to prevent respiratory alkalosis.
• Furosemide is effective in treating patients with impaired kidney function. ✔✔D. Furosemide

is effective in treating patients with impaired kidney function. Correct

Furosemide effectiveness continues in impaired renal function. When creatinine clearance decreases below 25 L/min (normal is 125 L/min), the loop diuretics can still work.

The nurse would question the use of mannitol (Osmitrol) for which patient condition?

• Increased intraocular pressure
• Oliguria from acute renal failure
• Cerebral edema from head trauma
• Anuria related to end-stage kidney disease ✔✔D. Anuria related to end-stage kidney disease

Correct

Mannitol does not influence urine production; it only increases existing urine output. It is not metabolized but excreted unchanged in the urine by the kidneys. Thus, if no urine is produced (anuria), mannitol is not excreted, which increases

When preparing to administer intravenous furosemide (Lasix) to a patient with renal dysfunction, the nurse will administer the medication no faster than which rate?

• 2 mg/min
• 4 mg/min
• 6 mg/min
• 8 mg/min ✔✔B. 4 mg/min Correct

Furosemide controlled infusion rate should not exceed at a rate of 4 mg/min in patients with renal failure.

A patient asks the nurse about using potassium supplements while taking spironolactone (Aldactone). What is the nurse's best response?

• "I will call your health care provider and discuss your concern."
• "I would recommend that you take two multivitamins every day."
• "This diuretic is potassium sparing, so there is no need for extra potassium."