Clayton’s Basic Pharmacology for Nurses, 19th Edition Ch 28

Question 1

1. Which effect would the nurse anticipate if a patient with a history of type 2 diabetes is
   prescribed a thiazide diuretic?
   a. No change in the antidiabetic regimen
   b. Decreased need for antidiabetic medication
   c. Increased blood sugar levels
   d. Less frequent monitoring of blood sugar level

Answer 1

c. Increased blood sugar levels

Question 2

2. Which electrolyte should the patient prescribed thiazide diuretics be instructed to increase
   theintake of?
   a. Calcium
   b. Sodium
   c. Potassium
   d. Magnesium

Answer 2

c. Potassium

Question 3

3. On admission, a patient with a history of cardiac insufficiency complains of shortness of
   breath. thenurse auscultates thelungs and notes bilateral crackles throughout both fields. In
   addition, there is bilateral +2 edema of thelower extremities. Which medication does thenurse
   anticipate that thehealthcare provider will prescribe?
   a. Allopurinol (Zyloprim)
   b. Diphenhydramine (Benadryl)
   c. Mannitol
   d. Furosemide (Lasix)

Answer 3

d. Furosemide (Lasix)

Question 4

4. Which medication is a potassium sparing diuretic?
   a. Acetazolamide (Diamox)
   b. Spironolactone (Aldactone)
   c. Furosemide (Lasix)
   d. Bumetanide (Bumex)

Answer 4

b. Spironolactone (Aldactone)

Question 5

5. Which time period identifies how soon diuresis will be expected to occur after the nurse has
   administered 20 mg of furosemide (Lasix) intravenously (IV) to a patient with heart failure?
   a. As soon as injected
   b. Within 10 minutes
   c. After 2 hours
   d. After 4 hours

Answer 5

b. Within 10 minutes

Question 6

6. Which foods will the nurse recommend for a patient taking loop diuretics?
   a. Protein-rich foods such as poultry, whole grains, and fish
   b. Fiber-rich foods such as yellow vegetables, nuts, and lentils
   c. Potassium-rich foods such as raisins, figs, and bananas
   d. Sodium-rich foods such as canned vegetables and processed foods

Answer 6

c. Potassium-rich foods such as raisins, figs, and bananas

Question 7

7. Which condition warrants the use of acetazolamide (Diamox) as a diuretic?
   a. Increased intracranial pressure
   b. Increased extravascular fluid pressure
   c. Increased intraocular pressure
   d. Periorbital edema

Answer 7

c. Increased intraocular pressure

Question 8

8. Which serum potassium level is expected in a patient who has severe vomiting and diarrhea?
   a. Less than 3.5 mEq/L
   b. Between 3.5 and 4.5 mEq/L
   c. Between 4.6 and 5 mEq/L
   d. Higher than 5.5 mEq/L

Answer 8

a. Less than 3.5 mEq/L

Question 9

9. Which medication, if administered with spironolactone (Aldactone), will alert the nurse to
   assess the patient for signs and symptoms of hyperkalemia?
   a. Propranolol (Inderal)
   b. Captopril (Capoten)
   c. Furosemide (Lasix)
   d. Ibuprofen (Motrin)

Answer 9

b. Captopril (Capoten)

Question 10

10. Which statement by a patient indicates theneed for further teaching about potassium sparing
    diuretic therapy?
    a. ―I will take my medication in the morning.‖
    b. ―I will report a weight gain of 2 lb in 2 days.‖
    c. ―I will rise slowly when I get up from a sitting position.‖
    d. ―I will use a salt substitute because I limit my salt intake.

Answer 10

d. ―I will use a salt substitute because I limit my salt intake.‖

Question 11

11. Which patient assessment would alert the nurse to withhold a loop diuretic?
    a. Crackles in the lung bases
    b. +2 pitting peripheral edema
    c. Serum potassium of 2.6 mEq/L
    d. Weight gain of 2 lb in 2 days

Answer 11

c. Serum potassium of 2.6 mEq/L

Question 12

12. A 37-year-old male presents at the emergency department reporting severe vomiting for
    the past 48 hours. Which action will thenurse take when assessing skin turgor?
    a. Exert pressure against theshin.
    b. Gently pinch the skin together over the sternum.
    c. Assess for vein distention.
    d. Inspect oral mucous membranes.

Answer 12

b. Gently pinch the skin together over the sternum

Question 13

13. Which lab value will alert thenurse to notify the physician when reviewing lab work received
    on a patient admitted with the diagnosis of dehydration?
    a. Serum sodium level: 115 mEq/L
    b. Serum potassium level: 5.0 mEq/L
    c. Serum sodium level: 140 mEq/L
    d. Serum potassium level: 3.5 mEq/L

Answer 13

a. Serum sodium level: 115 mEq/L

Question 14

1. Which physical assessment(s) indicate(s) fluid volume excess? (Select all that apply.)
   a. Rapid, bounding, irregular pulse rate
   b. Clear lung sounds
   c. 3+ pitting ankle edema
   d. Neck vein engorgement
   e. Shortness of breath

Answer 14

A,C,D,E
a. Rapid, bounding, irregular pulse rate
c. 3+ pitting ankle edema
d. Neck vein engorgement
e. Shortness of breath

Question 15

2. Which premedication assessment(s) would the nurse obtain prior to the initiation of bumetanide
   (Bumex)? (Select all that apply.)
   a. Serum potassium
   b. Bowelsounds
   c. Lung sounds
   d. Orientation level
   e. Blood pressure

Answer 15

A,C,D,E
a. Serum potassium
c. Lung sounds
d. Orientation level
e. Blood pressure

Question 16

3. Which are common signs and symptoms of dehydration? (Select all that apply.)
   a. Furrowed tongue
   b. Decreased intake and output levels
   c. Bounding pulse rate
   d. Mental confusion
   e. Elastic skin turgor

Answer 16

A,B,D
a. Furrowed tongue
b. Decreased intake and output levels
d. Mental confusion

Question 17

4. Which nursing intervention(s) would be performed for a patient who is on diuretic therapy?
   (Select all that apply.)
   a. Auscultation of lung sounds
   b. Assessment of skin turgor
   c. Initiation of electrolyte supplements
   d. Positioning techniques
   e. Monitoring of intake and output

Answer 17

A,B,D,E
a. Auscultation of lung sounds
b. Assessment of skin turgor
d. Positioning techniques
e. Monitoring of intake and output.

Question 18

5. Which sign(s) and/or symptom(s) of dehydration may occur as a result of a diuretic? (Select
   all that apply.)
   a. Decreased urine specific gravity
   b. Skin remains peaked on turgor assessment
   c. Bounding peripheral pulses
   d. Neck vein engorgement
   e. Soft,sunken eyeballs

Answer 18

B,E
b. Skin remains peaked on turgor assessment
e. Soft,sunken eyeballs

Question 19

6. Which medical condition(s) may contribute to fluid volume excess? (Select all that apply.)
   a. Hypertension
   b. Liver disease
   c. Pregnancy
   d. Use of corticosteroids
   e. Skin disorders

Answer 19

A,B,C,D
a. Hypertension
b. Liver disease
c. Pregnancy
d. Use of corticosteroids

Question 20

7. Which disorder(s) contribute to the development of electrolyte disturbances during diuretic
   therapy? (Select all that apply.)
   a. History of cardiac disease
   b. History of renal disease
   c. History of hormonal disorders
   d. History of psychiatric illness
   e. Massive trauma
   f. Serious burns
   g. Overhydration

Answer 20

A,B,C,E F
a. History of cardiac disease
b. History of renal disease
c. History of hormonal disorders
e. Massive trauma
f. Serious burns

Question 21

8. The nurse transcribes a new order for ethacrynic acid (Edecrin) on a patient with edema
   resulting from cirrhosis of the liver. Which currently prescribed medication(s) should thenurse
   report to theordering healthcare provider? (Select all that apply.)
   a. Digoxin
   b. Prednisone
   c. Tobramycin
   d. Lipitor
   e. Zofran

Answer 21

a. Digoxin
b. Prednisone
c. Tobramycin