NUR 2474 EXAM 2: PHARMACOLOGY FOR
PROFESSIONAL NURSING EXAM 2
RASMUSSEN LATEST UPDATE EXAM
TESTED AND APPROVED GRADED A+
A patient is taking gentamicin (Garamycin) and furosemide (Lasix). The nurse
should counsel this patient to report which symptom?
a.Frequent nocturia
b.Headaches
c.Ringing in the ears
d.Urinary retention - CORRECT ANSWER-c.Ringing in the ears
Patients taking furosemide should be advised that the risk of furosemide-
induced hearing loss can be increased when other ototoxic drugs, such as
gentamicin, are also taken. Patients should be told to report tinnitus or dizziness
or hearing loss. Nocturia may be an expected effect of furosemide. Headaches
,are not likely to occur with concomitant use of gentamicin and furosemide.
Urinary retention is not an expected side effect.
An older adult patient with congestive heart failure develops crackles in both
lungs and
pitting edema of all extremities. The physician orders hydrochlorothiazide
(HydroDIURIL). Before administering this medication, the nurse reviews the
patient's
chart. Which laboratory value causes the nurse the most concern?
a.Elevated creatinine clearance
b.Elevated serum potassium level
c.Normal blood glucose level
d.Low levels of low-density lipoprotein (LDL) cholesterol - CORRECT
ANSWER-a.Elevated creatinine clearance
Hydrochlorothiazide should not be given to patients with severe renal
impairment; therefore, an elevated creatinine clearance would cause the most
concern. Thiazide diuretics are potassium-wasting drugs and thus may actually
improve the patient's potassium level. Thiazides may elevate the serum glucose
level in diabetic patients. Thiazides increase LDL cholesterol; however, this
patient's levels are low, so this is not a risk.
,A patient with chronic congestive heart failure has repeated hospitalizations in
spite of ongoing treatment with hydrochlorothiazide (HydroDIURIL) and
digoxin. The prescriber has ordered spironolactone (Aldactone) to be added to
this patient's drug regimen, and the nurse provides education about this
medication. Which statement by the patient indicates understanding of the
teaching?
a."I can expect improvement within a few hours after taking this drug."
b."I need to stop taking potassium supplements."
c."I should use salt substitutes to prevent toxic side effects."
d."I should watch closely for dehydration." - CORRECT ANSWER-b."I need
to stop taking potassium supplements."
Spironolactone is a potassium-sparing diuretic used to counter the potassium-
wasting effects of hydrochlorothiazides. Patients taking potassium supplements
are at risk for hyperkalemia when taking this medication, so they should be
advised to stop the supplements. Spironolactone takes up to 48 hours to have
effects. Salt substitutes contain high levels of potassium and are contraindicated.
Spironolactone is a weak diuretic, so the risk of dehydration is not increased.
A patient with hypertension is prescribed an angiotensin-converting enzyme
(ACE) inhibitor. The nurse reviewing this patient's chart before administering
the medication will be most concerned about which other disease process?
a.Bronchial asthma
, b.Coronary artery disease
c.Diabetes mellitus
d.Renal artery stenosis - CORRECT ANSWER-d.Renal artery stenosis
ACE inhibitors can cause severe renal insufficiency in patients with bilateral
renal artery
stenosis or stenosis in the artery to a single remaining kidney. Bronchial asthma,
coronary artery disease, and diabetes mellitus are not comorbidities that are
contraindications to treatment with an ACE inhibitor.
A nurse administers an ACE inhibitor to a patient who is taking the drug for the
first time.
What will the nurse do?
a.Instruct the patient not to get up without assistance.
b.Make sure the patient takes a potassium supplement.
c.Report the presence of a dry cough to the prescriber.
d.Request an order for a diuretic to counter the side effects of the ACE inhibitor.
- CORRECT ANSWER-a.Instruct the patient not to get up without assistance.
PROFESSIONAL NURSING EXAM 2
RASMUSSEN LATEST UPDATE EXAM
TESTED AND APPROVED GRADED A+
A patient is taking gentamicin (Garamycin) and furosemide (Lasix). The nurse
should counsel this patient to report which symptom?
a.Frequent nocturia
b.Headaches
c.Ringing in the ears
d.Urinary retention - CORRECT ANSWER-c.Ringing in the ears
Patients taking furosemide should be advised that the risk of furosemide-
induced hearing loss can be increased when other ototoxic drugs, such as
gentamicin, are also taken. Patients should be told to report tinnitus or dizziness
or hearing loss. Nocturia may be an expected effect of furosemide. Headaches
,are not likely to occur with concomitant use of gentamicin and furosemide.
Urinary retention is not an expected side effect.
An older adult patient with congestive heart failure develops crackles in both
lungs and
pitting edema of all extremities. The physician orders hydrochlorothiazide
(HydroDIURIL). Before administering this medication, the nurse reviews the
patient's
chart. Which laboratory value causes the nurse the most concern?
a.Elevated creatinine clearance
b.Elevated serum potassium level
c.Normal blood glucose level
d.Low levels of low-density lipoprotein (LDL) cholesterol - CORRECT
ANSWER-a.Elevated creatinine clearance
Hydrochlorothiazide should not be given to patients with severe renal
impairment; therefore, an elevated creatinine clearance would cause the most
concern. Thiazide diuretics are potassium-wasting drugs and thus may actually
improve the patient's potassium level. Thiazides may elevate the serum glucose
level in diabetic patients. Thiazides increase LDL cholesterol; however, this
patient's levels are low, so this is not a risk.
,A patient with chronic congestive heart failure has repeated hospitalizations in
spite of ongoing treatment with hydrochlorothiazide (HydroDIURIL) and
digoxin. The prescriber has ordered spironolactone (Aldactone) to be added to
this patient's drug regimen, and the nurse provides education about this
medication. Which statement by the patient indicates understanding of the
teaching?
a."I can expect improvement within a few hours after taking this drug."
b."I need to stop taking potassium supplements."
c."I should use salt substitutes to prevent toxic side effects."
d."I should watch closely for dehydration." - CORRECT ANSWER-b."I need
to stop taking potassium supplements."
Spironolactone is a potassium-sparing diuretic used to counter the potassium-
wasting effects of hydrochlorothiazides. Patients taking potassium supplements
are at risk for hyperkalemia when taking this medication, so they should be
advised to stop the supplements. Spironolactone takes up to 48 hours to have
effects. Salt substitutes contain high levels of potassium and are contraindicated.
Spironolactone is a weak diuretic, so the risk of dehydration is not increased.
A patient with hypertension is prescribed an angiotensin-converting enzyme
(ACE) inhibitor. The nurse reviewing this patient's chart before administering
the medication will be most concerned about which other disease process?
a.Bronchial asthma
, b.Coronary artery disease
c.Diabetes mellitus
d.Renal artery stenosis - CORRECT ANSWER-d.Renal artery stenosis
ACE inhibitors can cause severe renal insufficiency in patients with bilateral
renal artery
stenosis or stenosis in the artery to a single remaining kidney. Bronchial asthma,
coronary artery disease, and diabetes mellitus are not comorbidities that are
contraindications to treatment with an ACE inhibitor.
A nurse administers an ACE inhibitor to a patient who is taking the drug for the
first time.
What will the nurse do?
a.Instruct the patient not to get up without assistance.
b.Make sure the patient takes a potassium supplement.
c.Report the presence of a dry cough to the prescriber.
d.Request an order for a diuretic to counter the side effects of the ACE inhibitor.
- CORRECT ANSWER-a.Instruct the patient not to get up without assistance.
