Nokea
A nurse is preparing to administer spironolactone to a client. When reviewing the client's medical record, the nurse would be alert for the development of hyperkalemia if the client was also receiving which of the following?
- A. Lisinopril (Prinivil)
- B. Metoprolol (Lopressor)
- C. Terazosin (Hytrin)
- D. Diltiazem (Cardizem)
Correct Answer: A
Rationale: Spironolactone when given with ACE inhibitors (lisinopril) can lead to hyperkalemia.
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A nurse is caring for a client with edema. The physician has prescribed diuretic therapy for the client. Which of the following would be most appropriate for the nurse to do?
- A. Ask the client to decrease fluid intake
- B. Gradually increase the drug dosage
- C. Administer the drug early in the day
- D. Encourage the client to exercise
Correct Answer: C
Rationale: The nurse should administer the drug early in the day to prevent any nighttime sleep disturbance caused by increased urination.
A nurse is reviewing the medical record of several clients who are prescribed amiloride. The nurse would identify a client with which condition as being at highest risk for developing hyperkalemia? Select all that apply.
- A. Diabetes
- B. Hypertension
- C. Renal disease
- D. Epilepsy
- E. Asthma
Correct Answer: A,C
Rationale: Hyperkalemia is most likely to occur in clients with an inadequate fluid intake and urine output, those with diabetes or renal disease, the elderly, and those who are severely ill.
After teaching a group of nursing students about diuretics, the instructor determines that the teaching was successful when the students identify which of the following as causing diuresis by increasing the density of filtrate in the glomerulus? Select all that apply.
- A. Amiloride
- B. Torsemide
- C. Ethacrynic acid
- D. Mannitol
- E. Urea
Correct Answer: D,E
Rationale: Osmotic diuretics, like mannitol and urea, cause diuresis by increasing the density of the filtrate in the glomerulus.
A nurse is administering a diuretic that inhibits reabsorption of sodium and chloride ions in the distal and proximal tubules and in the loop of Henle. Which of the following might the nurse be administering? Select all that apply.
- A. Chlorothiazide
- B. Furosemide
- C. Bumetanide
- D. Mannitol
- E. Spironolactone
Correct Answer: B,C
Rationale: Loop diuretics, like furosemide (Lasix) and bumetanide (Bumex), cause diuresis by inhibiting reabsorption of sodium and chloride ions in the distal and proximal tubules and in the loop of Henle.
A primary health care provider has prescribed a loop diuretic for a client with hypertension. The client also has diabetes mellitus. The nurse would assess the client for which of the following after administering the drug?
- A. Sudden pain in the joints
- B. Increased blood glucose levels
- C. Occurrence of gout attacks
- D. Sudden increase in weight
Correct Answer: B
Rationale: The nurse should monitor for increased blood glucose levels in the diabetic client receiving a loop diuretic.