Focus on Nursing Pharmacology, 6th Edition by Amy M. Karch
Focus on Nursing Pharmacology, 6th Edition by Amy M. Karch
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Chapter 51- Diuretic Agents
Complete Chapter Questions With Answers
Sample Questions Are Posted Below
| 1. | The class of diuretics that act to block the chloride pump in the distal convoluted tubules and leads to a loss of sodium and potassium and a minor loss of water is what? | |
| A) | Carbonic anhydrase inhibitors | |
| B) | Osmotic diuretics | |
| C) | Potassium-sparing diuretics | |
| D) | Thiazide diuretics | |
| Ans: | D | |
| Feedback: | ||
| Thiazide diuretics work to block the chloride pump, which leads to a loss of sodium, potassium, and some water. They are considered mild diuretics. Carbonic anhydrase inhibitors work to block the formation of carbonic acid and bicarbonate in the renal tubules. Osmotic diuretics use hypertonic pull to remove fluid from the intravascular spaces and to deliver large amounts of water into the renal tubules. Potassium-sparing diuretics are mild and act to spare potassium in exchange for the loss of sodium and water. | ||
| 2. | The nurse is providing discharge instructions to a 72-year-old patient who has been discharged home on a diuretic. What would the patient’s instructions regarding the use of a diuretic at home include? | |
| A) | Measuring intake and output of urine | |
| B) | To weigh themselves on the same scale, at the same time of day, in the same clothing | |
| C) | Restrict fluids to 500 mL/d to limit the need to urinate | |
| D) | Decrease exercise to conserve energy | |
| Ans: | B | |
| Feedback: | ||
| Patients taking a diuretic at home need to learn to weigh themselves every day, at the same time, and in the same clothes to monitor for loss or retention of fluid. They should not be asked to measure urine output or to decrease activity. Restricting fluids can lead to a rebound fluid retention when compensatory mechanisms are activated. | ||
| 3. | The emergency department (ED) nurse is caring for a patient who is experiencing pulmonary edema. The patient is treated with furosemide (Lasix). What will the nurse monitor? | |
| A) | Sodium levels | |
| B) | Bone narrow function | |
| C) | Calcium levels | |
| D) | Potassium levels | |
| Ans: | D | |
| Feedback: | ||
| Furosemide is associated with loss of potassium, so that the patient will need to be monitored carefully for low potassium levels, which could cause cardiac arrhythmias and further aggravate pulmonary edema. The nurse would not monitor sodium or calcium levels or bone marrow function because of the effects of the drug during the acute treatment of pulmonary edema. | ||
| 4. | The nurse on the coronary unit is caring for a patient with known coronary artery disease who is being treated with cholestyramine (Questran) and hydrochlorothiazide (HydroDIURIL). What action will the nurse take? | |
| A) | Call the physician and refuse to give the drugs without further orders. | |
| B) | Make sure that the drugs are given at least 2 hours apart. | |
| C) | Give the patient an antacid with the drugs. | |
| D) | Check the patient’s blood glucose level before giving the drugs. | |
| Ans: | B | |
| Feedback: | ||
| Because of its effects in the GI tract, cholestyramine should be taken at least 2 hours earlier or later than hydrochlorothiazide to ensure the absorption of hydrochlorothiazide. This combination of drugs can be used effectively. An antacid would further aggravate drug absorption and would not be recommended. Blood glucose levels would not be affected by either of these drugs. | ||
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