Chapter 43: Diuretics Nursing School Test Banks

Kee: Pharmacology, 7th Edition

Chapter 43: Diuretics

Test Bank

MULTIPLE CHOICE

1. Thiazide diuretics are contraindicated if the client has:

a.

emphysema.

b.

arteriosclerotic cardiovascular disease.

c.

renal failure.

d.

viral infection.

ANS: C

Renal failure decreases the excretion of the drug, leading to accumulation and electrolyte imbalance.

DIF: Cognitive Level: Comprehension REF: p. 640

TOP: Nursing Process: Analysis

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

2. Client teaching for a client taking a thiazide diuretic includes which instruction?

a.

Instruct the client to add salt liberally to his food.

b.

Instruct the client to decrease intake of potassium-rich foods.

c.

Instruct the client to check pulse rate if digoxin is taken with hydrochlorothiazide.

d.

Advise the client to rise slowly from a sitting to a standing position.

ANS: D

Diuretics can lead to orthostatic hypotension. The client should limit Na intake and ingest K-containing foods.

DIF: Cognitive Level: Application REF: p. 647

TOP: Nursing Process: Intervention/Teaching

MSC: CONTENT CATEGORY: Physiological Integrity: Pathophysiology

3. A client is taking a thiazide diuretic. The nurse assesses the clients serum glucose levelthe fasting blood glucose level is 150 mg/dl. What is an appropriate response by the nurse?

a.

Instruct the client to discontinue taking hydrochlorothiazide.

b.

Inform the healthcare provider of the glucose level and the possible need for a different diuretic.

c.

Instruct the client to take hydrochlorothiazide every other day.

d.

Instruct the client to take an antidiabetic drug instead of the diuretic.

ANS: B

Thiazide diuretics can lead to impaired insulin function and hyperglycemia, warranting changing diuretic agents.

DIF: Cognitive Level: Analysis REF: p. 642

TOP: Nursing Process: Intervention

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

4. A nurse is teaching a client about lifestyle changes when taking a potassium-sparing diuretic. Which statement indicates a need for more teaching?

a.

I need to have my blood drawn frequently.

b.

I need to call the clinic if I am urinating less than every 2 hours.

c.

I need to be careful when out in the sun.

d.

I need to eat foods like bananas frequently.

ANS: D

Eating high-potassium foods with potassium-sparing diuretics can lead to hyperkalemia.

DIF: Cognitive Level: Application REF: pp. 649-650

TOP: Nursing Process: Intervention/Teaching

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

5. A client is ordered to receive triamterene (Dyrenium) to decrease her blood pressure. The nurse is evaluating the effectiveness of the medication in returning the blood chemistries to normal. A positive response to the medication is indicated by a(n) _____ K level and a(n) _____ Na level.

a.

increased; decreased

b.

increased; increased

c.

decreased; decreased

d.

decreased; increased

ANS: A

The medication is expected to produce an increase in the potassium level and a decrease in the sodium level.

DIF: Cognitive Level: Analysis REF: p. 648

TOP: Nursing Process: Evaluation

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

6. The client is being treated with furosemide as well as an aminoglycoside. What effect should the nurse expect to see as a result of the interaction of the drugs?

a.

Blurred vision

b.

Ototoxicity

c.

Bone pain

d.

Blood-tinged urine

ANS: B

The interaction of furosemide and an aminoglycoside can produce ototoxicity in the client.

DIF: Cognitive Level: Application REF: p. 644

TOP: Nursing Process: Evaluation

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

7. The client is being treated with furosemide and a steroid drug as well. As a result of the interaction of the drugs, the nurse should expect to see an increased loss of:

a.

potassium.

b.

calcium.

c.

magnesium.

d.

sodium.

ANS: A

The interaction of furosemide and a steroid drug can result in an increased loss of potassium.

DIF: Cognitive Level: Application REF: p. 644

TOP: Nursing Process: Evaluation

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

8. The client is being treated with a thiazide diuretic. The nurse should expect to see an increased serum _____ as a result of treatment with this drug.

a.

potassium

b.

sodium

c.

magnesium

d.

calcium

ANS: D

Treatment with a thiazide diuretic will produce an increase in the levels of serum calcium, glucose, and uric acid, and a decrease in the levels of serum potassium, sodium, and magnesium.

DIF: Cognitive Level: Application REF: p. 642

TOP: Nursing Process: Evaluation

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

9. The client is being treated with chlorthalidone (Hygroton). In determining the proper time to schedule dosages, the nurse recognizes that the duration of action for the medication is up to _____ hours.

a.

12

b.

24

c.

48

d.

72

ANS: D

The medication will stay in the clients system for up to 72 hours.

DIF: Cognitive Level: Application REF: p. 641

TOP: Nursing Process: Planning

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

10. The client is being treated with a thiazide diuretic. He tells the nurse that he is interested in using herbal preparations and frequently self-medicates with ginkgo. The nurses most appropriate response to this information is:

a.

Ginkgo can be effectively used with a thiazide diuretic since it decreases blood pressure.

b.

Ginkgo can be used with a thiazide diuretic since it prolongs medications action.

c.

Ginkgo should not be used with a thiazide diuretic since it increases blood pressure.

d.

Ginkgo should not be used with a thiazide diuretic since it may cause toxicity.

ANS: C

Increased blood pressure can result when ginkgo is used in combination with a thiazide diuretic.

DIF: Cognitive Level: Application REF: p. 643

TOP: Nursing Process: Intervention

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

11. The client is being treated with a thiazide diuretic as well as digoxin. He complains to the nurse of experiencing blurred vision. The highest priority nursing intervention is to call the physician because blurred vision:

a.

is indicative of digoxin toxicity.

b.

is indicative of an anaphylactic reaction.

c.

indicates an inadequate dosage of the diuretic.

d.

indicates an overdose of the diuretic.

ANS: A

Visual changes are indicative of digoxin toxicity when the drug is combined with a thiazide diuretic.

DIF: Cognitive Level: Application REF: pp. 640-641

TOP: Nursing Process: Intervention

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

12. The client is being treated with a thiazide diuretic. The nurse anticipates that the medication will be administered at:

a.

8:00 AM.

b.

11:30 AM.

c.

4:30 PM.

d.

9:00 PM.

ANS: A

The diuretic should be administered in the morning to avoid nocturia.

DIF: Cognitive Level: Application REF: p. 640

TOP: Nursing Process: Planning

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

Copyright 2012, 2009, 2006, 2003 by Saunders, an imprint of Elsevier Inc.

Leave a Reply