Nokea
A nurse administers a thiazide diuretic to a client with renal compromise as prescribed by the primary health care provider. Which action by the nurse would be most appropriate if the client's blood urea nitrogen level increases?
- A. Give prescribed magnesium supplements
- B. Withhold the next dose of the drug
- C. Administer the drug in a diluted form
- D. Increase the fluid intake for the client
Correct Answer: B
Rationale: The nurse should withhold the drug or discontinue its use if the blood urea nitrogen (BUN) rises in the client with renal compromise.
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A client is receiving mannitol as treatment to promote diuresis in acute renal failure. The nurse would expect to administer the drug by which route?
- A. Intramuscularly
- B. Subcutaneously
- C. Intravenously
- D. Orally
Correct Answer: C
Rationale: Mannitol is administered intravenously.
The nurse is to administer bumetanide. The nurse reviews the client's medication history for possible interacting drugs. Which of the following, if found, would the nurse identify as having an increased risk for toxicity? Select all that apply.
- A. Lithium
- B. Phenytoin
- C. Gentamicin
- D. Warfarin
- E. Digoxin
Correct Answer: A,C,D,E
Rationale: Loop diuretics, like bumetanide, can increase toxicity of lithium, gentamicin, warfarin, and digoxin.
After administering metolazone to a client, the nurse monitors for signs of hypokalemia, including which of the following? Select all that apply.
- A. Diarrhea
- B. Anorexia
- C. Depression
- D. Hypoglycemia
- E. Drowsiness
Correct Answer: B,C,E
Rationale: The following are signs of hypokalemia: anorexia, nausea, vomiting, depression, confusion, cardiac arrhythmias, impaired thought process, and drowsiness.
A nurse is administering acetazolamide to a client. The nurse understands that this drug leads to excretion of which of the following? Select all that apply.
- A. Sodium
- B. Magnesium
- C. Potassium
- D. Bicarbonate
- E. Chloride
Correct Answer: A,C,D
Rationale: Carbonic anhydrase inhibitors, like acetazolamide, result in the excretion of sodium, potassium, bicarbonate, and water.
A client is prescribed a diuretic that is to be taken twice a day. When instructing the client about the schedule for administration, the nurse would suggest that the client take the drug at which times?
- A. In the early morning and at bedtime
- B. After lunch and dinner
- C. At breakfast and midafternoon
- D. Midmorning and before dinner
Correct Answer: C
Rationale: Twice-a-day dosing should be administered early in the morning (e.g., 7 a.m.) and early afternoon (e.g., 2 p.m.) to prevent the drug from interfering with the client's sleep.