Test Bank - Focus on Nursing Pharmacology (8th Edition by Karch)
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.
5. The pharmacology instructor is discussing diuretic drugs with the nursing class.
What would the instructor cite as an adverse effect of loop diuretics?
a. Hyperkalemia
b. Alkalosis
c. Hypertension
d. Hypercalcemia
, Ans: B
Feedback:
Alkalosis is a drop in serum pH to an alkaline state due to bicarbonate loss in urine.
Hypokalemia, hypocalcemia, and hypotension are also adverse effect of these drugs.
Therefore, the other options are not correct.
6. A patient with glaucoma has been prescribed a diuretic as treatment of his or her
disease process. What drug does the nurse suspect that the patient will be
prescribed?
a. Acetazolamide (Diamox)
b. Spironolactone (Aldactone)
c. Chlorthalidone (Hygroton)
d. Bendroflumethiazide (Naturetin)
Ans: A
Feedback:
Acetazolamide is used to treat glaucoma. The inhibition of carbonic anhydrase results
in decreased secretion of aqueous humor of the eye. Spironolactone is a potassium-
sparing diuretic used to treat edema caused by congestive heart failure, liver disease,
hypertension, hyperkalemia, and hyperaldosterone. Chlorthalidone is a thiazide-like
diuretic and bendroflumethiazide, a thiazide diuretic, are used to treat edema caused
by congestive heart failure, liver disease, kidney disease, and as adjunct treatment of
hypertension.
7. A patient comes to the clinic for a 1-month follow-up appointment. The patient
tells the nurse he or she has been taking chlorothiazide (Diruil) for a month and
now has leg cramps and feels tired all the time. What will the nurse consider as the
cause of the patient’s symptoms?
a. Hypercalcemia
b. Hypocalcemia
c. Hyperkalemia
d. Hypokalemia
Ans: D
Feedback:
Hypokalemia results from the loss of potassium in the distal tubule and causes muscle
weakness, fatigue, and arrhythmias. Hyperkalemia presents with cardiac arrhythmias
and occasionally muscle weakness. Hypercalcemia is characterized by fatigue,
depression, mental confusion, nausea, vomiting, and constipation. Hypocalcemia
presents with muscle spasms, facial grimacing, possible convulsions, irritability, and
depression.
, 8. A patient has been prescribed furosemide (Lasix). Because this drug causes
potassium loss, what will the nurse instruct the patient to eat?
a. Peaches
b. Apples
c. Pears
d. Pineapple
Ans: A
Feedback:
Peaches, as well as bananas, oranges, raisins, and other fruits, spices, and vegetables
are high in potassium and consuming them should be encouraged when taking
furosemide. Apples, pears, and pineapple, however, do not replace potassium in the
body.
9. A 10-year-old child has edema caused by a heart defect. The patient is taking
furosemide (Lasix). The dosage is 6 mg/kg/d. The child weighs 76 pounds. How
many mg does the child receive in each dose?
a. 20 mg
b. 50 mg
c. 105 mg
d. 210 mg
Ans: D
Feedback:
The nurse will administer 210 mg/dose of the drug (2.2 pounds: 1 kg = 76 pounds: ×
kg, 76 divided by 2.2 = 34.5, 35 times 6 = 210 mg).
10. The nurse is caring for a patient who is taking acetazolamide (Diamox) for
treatment of glaucoma. What drug, if taken with acetazolamide (Diamox), would
cause the nurse to contact the physician?
a. Indomethacin (Indocin)
b. Colestipol (Colestid)
c. Lithium (Eskalith)
d. Ibuprofen (Motrin)
Ans: C
Feedback:
An increase in the excretion of lithium can occur when taken with acetazolamide, so
that special monitoring or a dosage adjustment may be necessary. Indomethacin,
colestipol, and ibuprofen do not produce drug-to-drug interactions when given with
acetazolamide.
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.
5. The pharmacology instructor is discussing diuretic drugs with the nursing class.
What would the instructor cite as an adverse effect of loop diuretics?
a. Hyperkalemia
b. Alkalosis
c. Hypertension
d. Hypercalcemia
, Ans: B
Feedback:
Alkalosis is a drop in serum pH to an alkaline state due to bicarbonate loss in urine.
Hypokalemia, hypocalcemia, and hypotension are also adverse effect of these drugs.
Therefore, the other options are not correct.
6. A patient with glaucoma has been prescribed a diuretic as treatment of his or her
disease process. What drug does the nurse suspect that the patient will be
prescribed?
a. Acetazolamide (Diamox)
b. Spironolactone (Aldactone)
c. Chlorthalidone (Hygroton)
d. Bendroflumethiazide (Naturetin)
Ans: A
Feedback:
Acetazolamide is used to treat glaucoma. The inhibition of carbonic anhydrase results
in decreased secretion of aqueous humor of the eye. Spironolactone is a potassium-
sparing diuretic used to treat edema caused by congestive heart failure, liver disease,
hypertension, hyperkalemia, and hyperaldosterone. Chlorthalidone is a thiazide-like
diuretic and bendroflumethiazide, a thiazide diuretic, are used to treat edema caused
by congestive heart failure, liver disease, kidney disease, and as adjunct treatment of
hypertension.
7. A patient comes to the clinic for a 1-month follow-up appointment. The patient
tells the nurse he or she has been taking chlorothiazide (Diruil) for a month and
now has leg cramps and feels tired all the time. What will the nurse consider as the
cause of the patient’s symptoms?
a. Hypercalcemia
b. Hypocalcemia
c. Hyperkalemia
d. Hypokalemia
Ans: D
Feedback:
Hypokalemia results from the loss of potassium in the distal tubule and causes muscle
weakness, fatigue, and arrhythmias. Hyperkalemia presents with cardiac arrhythmias
and occasionally muscle weakness. Hypercalcemia is characterized by fatigue,
depression, mental confusion, nausea, vomiting, and constipation. Hypocalcemia
presents with muscle spasms, facial grimacing, possible convulsions, irritability, and
depression.
, 8. A patient has been prescribed furosemide (Lasix). Because this drug causes
potassium loss, what will the nurse instruct the patient to eat?
a. Peaches
b. Apples
c. Pears
d. Pineapple
Ans: A
Feedback:
Peaches, as well as bananas, oranges, raisins, and other fruits, spices, and vegetables
are high in potassium and consuming them should be encouraged when taking
furosemide. Apples, pears, and pineapple, however, do not replace potassium in the
body.
9. A 10-year-old child has edema caused by a heart defect. The patient is taking
furosemide (Lasix). The dosage is 6 mg/kg/d. The child weighs 76 pounds. How
many mg does the child receive in each dose?
a. 20 mg
b. 50 mg
c. 105 mg
d. 210 mg
Ans: D
Feedback:
The nurse will administer 210 mg/dose of the drug (2.2 pounds: 1 kg = 76 pounds: ×
kg, 76 divided by 2.2 = 34.5, 35 times 6 = 210 mg).
10. The nurse is caring for a patient who is taking acetazolamide (Diamox) for
treatment of glaucoma. What drug, if taken with acetazolamide (Diamox), would
cause the nurse to contact the physician?
a. Indomethacin (Indocin)
b. Colestipol (Colestid)
c. Lithium (Eskalith)
d. Ibuprofen (Motrin)
Ans: C
Feedback:
An increase in the excretion of lithium can occur when taken with acetazolamide, so
that special monitoring or a dosage adjustment may be necessary. Indomethacin,
colestipol, and ibuprofen do not produce drug-to-drug interactions when given with
acetazolamide.
