Nokea
Mannitol has been ordered for a patient with acute renal failure. The nurse will administer this drug using which procedure?
- A. Intravenously, through a filter
- B. By rapid intravenous bolus
- C. By mouth in a single morning dose
- D. Through a gravity intravenous drip with standard tubing
Correct Answer: A
Rationale: Mannitol is administered via intravenous infusion through a filter because of possible crystallization. It is not available in oral form. The other options are incorrect.
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When a patient is receiving diuretic therapy, which of these assessment measures would best reflect the patient's fluid volume status?
- A. Blood pressure and pulse
- B. Serum potassium and sodium levels
- C. Intake, output, and daily weight
- D. Measurements of abdominal girth and calf circumference
Correct Answer: C
Rationale: Urinary intake and output and daily weights are the best reflections of a patient's fluid volume status.
A patient is started on a diuretic for antihypertensive therapy. The nurse expects that a drug in which class is likely to be used initially?
- A. Loop diuretics
- B. Osmotic diuretics
- C. Thiazide diuretics
- D. Potassium-sparing diuretics
Correct Answer: C
Rationale: The Eighth Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC-8) guidelines reaffirmed the role of thiazide diuretics as among the first-line drugs in the treatment of hypertension. The other drug classes are not considered first-line treatments.
The nurse will monitor a patient for signs and symptoms of hyperkalemia if the patient is taking which of these diuretics?
- A. Hydrochlorothiazide
- B. Furosemide
- C. Acetazolamide
- D. Spironolactone
Correct Answer: D
Rationale: Spironolactone (Aldactone) is a potassium-sparing diuretic, and patients taking this drug must be monitored for signs of hyperkalemia. The other drugs do not cause hyperkalemia but instead cause hypokalemia.
When assessing a patient who is receiving a loop diuretic, the nurse looks for the manifestations of potassium deficiency, which would include what symptoms?
- A. Dyspnea
- B. Constipation
- C. Tinnitus
- D. Muscle weakness
- E. Anorexia
- F. Lethargy
Correct Answer: D,E,F
Rationale: Symptoms of hypokalemia include anorexia, nausea, lethargy, muscle weakness, mental confusion, and hypotension. The other symptoms are not associated with hypokalemia.
When reviewing the mechanisms of action of diuretics, the nurse knows that which statement is true about loop diuretics?
- A. They work by inhibiting aldosterone.
- B. They are very potent, having a diuretic effect that lasts at least 6 hours.
- C. They have a rapid onset of action and cause rapid diuresis.
- D. They are not effective when the creatinine clearance decreases below 25 mL/min.
Correct Answer: C
Rationale: The loop diuretics have a rapid onset of action; therefore, they are useful when rapid onset is desired. Their effect lasts for about 2 hours, and a distinct advantage they have over thiazide diuretics is that their diuretic action continues even when creatinine clearance decreases below 25 mL/min.