NUR 2474 Pharm Exam 2 NCLEX Ques ons and answers
Newest RATED A+ 2025/2026 NEWEST
A pa ent is brought to the emergency department with shortness of breath, a respiratory rate
of 30 breaths per minute, intercostal retrac ons, and frothy, pink sputum. The nurse caring for
this pa ent will expect to administer which drug?
a.Furosemide (Lasix)
b.Hydrochlorothiazide (HydroDIURIL)
c.Mannitol (Osmitrol)
d.Spironolactone (Aldactone) - Ans a.Furosemide (Lasix)
Furosemide, a potent diure c, is used when rapid or massive mobiliza on of fluids is needed.
This pa ent shows severe signs of conges ve heart failure with respiratory distress and
pulmonary edema and needs immediate mobiliza on of fluid. Hydrochlorothiazide and
spironolactone are not indicated for pulmonary edema, because their diure c effects are less
rapid. Mannitol is indicated for pa ents with increased intracranial pressure and must be
discon nued immediately if signs of pulmonary conges on or heart failure occur.
A pa ent who is taking digoxin is admi1ed to the hospital for treatment of conges ve heart
failure. The prescriber has ordered furosemide (Lasix). The nurse notes an irregular heart rate of
86 beats per minute, a respiratory rate of 22 breaths per minute, and a blood pressure of
130/82 mm Hg. The nurse auscultates crackles in both lungs. Which laboratory value causes the
nurse the most concern?
a.Blood glucose level of 120 mg/dL
b.Oxygen satura on of 90%
c.Potassium level of 3.5 mEq/L
d.Sodium level of 140 mEq/L - Ans c.Potassium level of 3.5 mEq/L
,This pa ent has an irregular, rapid heartbeat that might be caused by a dysrhythmia. This
pa ent's serum potassium level is low, which can trigger fatal dysrhythmias, especially in
pa ents taking digoxin. Furosemide contributes to loss of potassium through its effects on the
distal nephron. Potassium-sparing diure cs oAen are used in conjunc on with furosemide to
prevent this complica on. This pa ent's serum glucose and sodium levels are normal and of no
concern at this point, although they can be affected by furosemide. The oxygen satura on is
somewhat low and needs to be monitored, although it may improve with diuresis.
A pa ent has 2+ piDng edema of the lower extremi es bilaterally. Ausculta on of the lungs
reveals crackles bilaterally, and the serum potassium level is 6 mEq/L. Which diure c agent
ordered by the prescriber should the nurse ques on?
a.Bumetanide (Bumex)
b.Furosemide (Lasix)
c.Spironolactone (Aldactone)
d.Hydrochlorothiazide (HydroDIURIL) - Ans c.Spironolactone (Aldactone)
Spironolactone is a non-potassium-was ng diure c; therefore, if the pa ent has a serum
potassium level of 6 mEq/L, indica ng hyperkalemia, an order for this drug should be
ques oned. Bumetanide, furosemide, and hydrochlorothiazide are potassium-was ng diure cs
and would be appropriate to administer in a pa ent with hyperkalemia.
A nurse preparing to administer morning medica ons notes that a pa ent with a history of
hypertension has been prescribed the angiotensin-conver ng enzyme (ACE) inhibitor captopril
(Capoten) concurrently with spironolactone (Aldactone). Morning laboratory results reveal a
serum sodium level of 144 mg/dL, a serum potassium level of 5.1 mEq/L, and a blood glucose
level of 128 mg/dL. Which interven on is appropriate?
a.Administer the medica ons as ordered.
b.Ask the pa ent about the use of salt subs tutes.
c.Contact the provider to report the laboratory values.
,d.Request an order for furosemide (Lasix). - Ans c.Contact the provider to report the laboratory
values.
Spironolactone should not be administered with ACE inhibitors, which can also elevate
potassium levels. Because the potassium level is elevated, the nurse should not administer the
medica on and should obtain clarifica on of the order. There is no need to repeat the
potassium level test that was just done this morning. Reques ng an order for furosemide is
appropriate only aAer the provider has been no fied of the laboratory values.
A pa ent with hypertension is taking furosemide (Lasix) for conges ve heart failure. The
prescriber orders digoxin to help increase cardiac output. What other medica on will the nurse
expect to be ordered for this pa ent?
a.Bumetanide (Bumex)
b.Chlorothiazide (Diuril)
c.Hydrochlorothiazide (HydroDIURIL)
d.Spironolactone (Aldactone) - Ans d.Spironolactone (Aldactone)
Spironolactone is used in conjunc on with furosemide because of its potassium-sparing effects.
Furosemide can contribute to hypokalemia, which can increase the risk of fatal dysrhythmias,
especially with digoxin administra on. The other diure cs listed are all potassium-was ng
diure cs.
A pa ent is taking gentamicin (Garamycin) and furosemide (Lasix). The nurse should counsel
this pa ent to report which symptom?
a.Frequent nocturia
b.Headaches
c.Ringing in the ears
, d.Urinary reten on - Ans c.Ringing in the ears
Pa ents 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. Pa ents should
be told to report nnitus 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 reten on is not an expected side effect.
An older adult pa ent with conges ve heart failure develops crackles in both lungs and piDng
edema of all extremi es. The physician orders hydrochlorothiazide (HydroDIURIL). Before
administering this medica on, the nurse reviews the pa ent's chart. Which laboratory value
causes the nurse the most concern?
a.Elevated crea nine clearance
b.Elevated serum potassium level
c.Normal blood glucose level
d.Low levels of low-density lipoprotein (LDL) cholesterol - Ans a.Elevated crea nine clearance
Hydrochlorothiazide should not be given to pa ents with severe renal impairment; therefore,
an elevated crea nine clearance would cause the most concern. Thiazide diure cs are
potassium-was ng drugs and thus may actually improve the pa ent's potassium level. Thiazides
may elevate the serum glucose level in diabe c pa ents. Thiazides increase LDL cholesterol;
however, this pa ent's levels are low, so this is not a risk.
A pa ent with chronic conges ve heart failure has repeated hospitaliza ons in spite of ongoing
treatment with hydrochlorothiazide (HydroDIURIL) and digoxin. The prescriber has ordered
spironolactone (Aldactone) to be added to this pa ent's drug regimen, and the nurse provides
educa on about this medica on. Which statement by the pa ent indicates understanding of
the teaching?
a."I can expect improvement within a few hours aAer taking this drug."
Newest RATED A+ 2025/2026 NEWEST
A pa ent is brought to the emergency department with shortness of breath, a respiratory rate
of 30 breaths per minute, intercostal retrac ons, and frothy, pink sputum. The nurse caring for
this pa ent will expect to administer which drug?
a.Furosemide (Lasix)
b.Hydrochlorothiazide (HydroDIURIL)
c.Mannitol (Osmitrol)
d.Spironolactone (Aldactone) - Ans a.Furosemide (Lasix)
Furosemide, a potent diure c, is used when rapid or massive mobiliza on of fluids is needed.
This pa ent shows severe signs of conges ve heart failure with respiratory distress and
pulmonary edema and needs immediate mobiliza on of fluid. Hydrochlorothiazide and
spironolactone are not indicated for pulmonary edema, because their diure c effects are less
rapid. Mannitol is indicated for pa ents with increased intracranial pressure and must be
discon nued immediately if signs of pulmonary conges on or heart failure occur.
A pa ent who is taking digoxin is admi1ed to the hospital for treatment of conges ve heart
failure. The prescriber has ordered furosemide (Lasix). The nurse notes an irregular heart rate of
86 beats per minute, a respiratory rate of 22 breaths per minute, and a blood pressure of
130/82 mm Hg. The nurse auscultates crackles in both lungs. Which laboratory value causes the
nurse the most concern?
a.Blood glucose level of 120 mg/dL
b.Oxygen satura on of 90%
c.Potassium level of 3.5 mEq/L
d.Sodium level of 140 mEq/L - Ans c.Potassium level of 3.5 mEq/L
,This pa ent has an irregular, rapid heartbeat that might be caused by a dysrhythmia. This
pa ent's serum potassium level is low, which can trigger fatal dysrhythmias, especially in
pa ents taking digoxin. Furosemide contributes to loss of potassium through its effects on the
distal nephron. Potassium-sparing diure cs oAen are used in conjunc on with furosemide to
prevent this complica on. This pa ent's serum glucose and sodium levels are normal and of no
concern at this point, although they can be affected by furosemide. The oxygen satura on is
somewhat low and needs to be monitored, although it may improve with diuresis.
A pa ent has 2+ piDng edema of the lower extremi es bilaterally. Ausculta on of the lungs
reveals crackles bilaterally, and the serum potassium level is 6 mEq/L. Which diure c agent
ordered by the prescriber should the nurse ques on?
a.Bumetanide (Bumex)
b.Furosemide (Lasix)
c.Spironolactone (Aldactone)
d.Hydrochlorothiazide (HydroDIURIL) - Ans c.Spironolactone (Aldactone)
Spironolactone is a non-potassium-was ng diure c; therefore, if the pa ent has a serum
potassium level of 6 mEq/L, indica ng hyperkalemia, an order for this drug should be
ques oned. Bumetanide, furosemide, and hydrochlorothiazide are potassium-was ng diure cs
and would be appropriate to administer in a pa ent with hyperkalemia.
A nurse preparing to administer morning medica ons notes that a pa ent with a history of
hypertension has been prescribed the angiotensin-conver ng enzyme (ACE) inhibitor captopril
(Capoten) concurrently with spironolactone (Aldactone). Morning laboratory results reveal a
serum sodium level of 144 mg/dL, a serum potassium level of 5.1 mEq/L, and a blood glucose
level of 128 mg/dL. Which interven on is appropriate?
a.Administer the medica ons as ordered.
b.Ask the pa ent about the use of salt subs tutes.
c.Contact the provider to report the laboratory values.
,d.Request an order for furosemide (Lasix). - Ans c.Contact the provider to report the laboratory
values.
Spironolactone should not be administered with ACE inhibitors, which can also elevate
potassium levels. Because the potassium level is elevated, the nurse should not administer the
medica on and should obtain clarifica on of the order. There is no need to repeat the
potassium level test that was just done this morning. Reques ng an order for furosemide is
appropriate only aAer the provider has been no fied of the laboratory values.
A pa ent with hypertension is taking furosemide (Lasix) for conges ve heart failure. The
prescriber orders digoxin to help increase cardiac output. What other medica on will the nurse
expect to be ordered for this pa ent?
a.Bumetanide (Bumex)
b.Chlorothiazide (Diuril)
c.Hydrochlorothiazide (HydroDIURIL)
d.Spironolactone (Aldactone) - Ans d.Spironolactone (Aldactone)
Spironolactone is used in conjunc on with furosemide because of its potassium-sparing effects.
Furosemide can contribute to hypokalemia, which can increase the risk of fatal dysrhythmias,
especially with digoxin administra on. The other diure cs listed are all potassium-was ng
diure cs.
A pa ent is taking gentamicin (Garamycin) and furosemide (Lasix). The nurse should counsel
this pa ent to report which symptom?
a.Frequent nocturia
b.Headaches
c.Ringing in the ears
, d.Urinary reten on - Ans c.Ringing in the ears
Pa ents 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. Pa ents should
be told to report nnitus 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 reten on is not an expected side effect.
An older adult pa ent with conges ve heart failure develops crackles in both lungs and piDng
edema of all extremi es. The physician orders hydrochlorothiazide (HydroDIURIL). Before
administering this medica on, the nurse reviews the pa ent's chart. Which laboratory value
causes the nurse the most concern?
a.Elevated crea nine clearance
b.Elevated serum potassium level
c.Normal blood glucose level
d.Low levels of low-density lipoprotein (LDL) cholesterol - Ans a.Elevated crea nine clearance
Hydrochlorothiazide should not be given to pa ents with severe renal impairment; therefore,
an elevated crea nine clearance would cause the most concern. Thiazide diure cs are
potassium-was ng drugs and thus may actually improve the pa ent's potassium level. Thiazides
may elevate the serum glucose level in diabe c pa ents. Thiazides increase LDL cholesterol;
however, this pa ent's levels are low, so this is not a risk.
A pa ent with chronic conges ve heart failure has repeated hospitaliza ons in spite of ongoing
treatment with hydrochlorothiazide (HydroDIURIL) and digoxin. The prescriber has ordered
spironolactone (Aldactone) to be added to this pa ent's drug regimen, and the nurse provides
educa on about this medica on. Which statement by the pa ent indicates understanding of
the teaching?
a."I can expect improvement within a few hours aAer taking this drug."
