NUR 2474 PHARM EXAM 2 NCLEX
COMPLETE QUESTIONS WITH 100%
CORRECT ANSWERS
\.A patient is brought to the emergency department with shortness of
breath, a respiratory rate of 30 breaths per minute, intercostal
retractions, and frothy, pink sputum. The nurse caring for this patient
will expect to administer which drug?
a.Furosemide (Lasix)
b.Hydrochlorothiazide (HydroDIURIL)
c.Mannitol (Osmitrol)
d.Spironolactone (Aldactone) - ANSWERS-a.Furosemide (Lasix)
Furosemide, a potent diuretic, is used when rapid or massive
mobilization of fluids is needed. This patient shows severe signs of
congestive heart failure with respiratory distress and pulmonary edema
and needs immediate mobilization of fluid. Hydrochlorothiazide and
spironolactone are not indicated for pulmonary edema, because their
diuretic effects are less rapid. Mannitol is indicated for patients with
,increased intracranial pressure and must be discontinued immediately if
signs of pulmonary congestion or heart failure occur.
\.A patient who is taking digoxin is admitted to the hospital for
treatment of congestive 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 saturation of 90%
c.Potassium level of 3.5 mEq/L
d.Sodium level of 140 mEq/L - ANSWERS-c.Potassium level of 3.5 mEq/L
This patient has an irregular, rapid heartbeat that might be caused by a
dysrhythmia. This patient's serum potassium level is low, which can
trigger fatal dysrhythmias, especially in patients taking digoxin.
Furosemide contributes to loss of potassium through its effects on the
distal nephron. Potassium-sparing diuretics often are used in
conjunction with furosemide to prevent this complication. This patient's
serum glucose and sodium levels are normal and of no concern at this
point, although they can be affected by furosemide. The oxygen
saturation is somewhat low and needs to be monitored, although it may
improve with diuresis.
,\.A patient has 2+ pitting edema of the lower extremities bilaterally.
Auscultation of the lungs reveals crackles bilaterally, and the serum
potassium level is 6 mEq/L. Which diuretic agent ordered by the
prescriber should the nurse question?
a.Bumetanide (Bumex)
b.Furosemide (Lasix)
c.Spironolactone (Aldactone)
d.Hydrochlorothiazide (HydroDIURIL) - ANSWERS-c.Spironolactone
(Aldactone)
Spironolactone is a non-potassium-wasting diuretic; therefore, if the
patient has a serum potassium level of 6 mEq/L, indicating
hyperkalemia, an order for this drug should be questioned.
Bumetanide, furosemide, and hydrochlorothiazide are potassium-
wasting diuretics and would be appropriate to administer in a patient
with hyperkalemia.
\.A nurse preparing to administer morning medications notes that a
patient with a history of hypertension has been prescribed the
angiotensin-converting 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
intervention is appropriate?
a.Administer the medications as ordered.
b.Ask the patient about the use of salt substitutes.
c.Contact the provider to report the laboratory values.
d.Request an order for furosemide (Lasix). - ANSWERS-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 medication and should
obtain clarification of the order. There is no need to repeat the
potassium level test that was just done this morning. Requesting an
order for furosemide is appropriate only after the provider has been
notified of the laboratory values.
\.A patient with hypertension is taking furosemide (Lasix) for congestive
heart failure. The prescriber orders digoxin to help increase cardiac
output. What other medication will the nurse expect to be ordered for
this patient?
a.Bumetanide (Bumex)
b.Chlorothiazide (Diuril)
COMPLETE QUESTIONS WITH 100%
CORRECT ANSWERS
\.A patient is brought to the emergency department with shortness of
breath, a respiratory rate of 30 breaths per minute, intercostal
retractions, and frothy, pink sputum. The nurse caring for this patient
will expect to administer which drug?
a.Furosemide (Lasix)
b.Hydrochlorothiazide (HydroDIURIL)
c.Mannitol (Osmitrol)
d.Spironolactone (Aldactone) - ANSWERS-a.Furosemide (Lasix)
Furosemide, a potent diuretic, is used when rapid or massive
mobilization of fluids is needed. This patient shows severe signs of
congestive heart failure with respiratory distress and pulmonary edema
and needs immediate mobilization of fluid. Hydrochlorothiazide and
spironolactone are not indicated for pulmonary edema, because their
diuretic effects are less rapid. Mannitol is indicated for patients with
,increased intracranial pressure and must be discontinued immediately if
signs of pulmonary congestion or heart failure occur.
\.A patient who is taking digoxin is admitted to the hospital for
treatment of congestive 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 saturation of 90%
c.Potassium level of 3.5 mEq/L
d.Sodium level of 140 mEq/L - ANSWERS-c.Potassium level of 3.5 mEq/L
This patient has an irregular, rapid heartbeat that might be caused by a
dysrhythmia. This patient's serum potassium level is low, which can
trigger fatal dysrhythmias, especially in patients taking digoxin.
Furosemide contributes to loss of potassium through its effects on the
distal nephron. Potassium-sparing diuretics often are used in
conjunction with furosemide to prevent this complication. This patient's
serum glucose and sodium levels are normal and of no concern at this
point, although they can be affected by furosemide. The oxygen
saturation is somewhat low and needs to be monitored, although it may
improve with diuresis.
,\.A patient has 2+ pitting edema of the lower extremities bilaterally.
Auscultation of the lungs reveals crackles bilaterally, and the serum
potassium level is 6 mEq/L. Which diuretic agent ordered by the
prescriber should the nurse question?
a.Bumetanide (Bumex)
b.Furosemide (Lasix)
c.Spironolactone (Aldactone)
d.Hydrochlorothiazide (HydroDIURIL) - ANSWERS-c.Spironolactone
(Aldactone)
Spironolactone is a non-potassium-wasting diuretic; therefore, if the
patient has a serum potassium level of 6 mEq/L, indicating
hyperkalemia, an order for this drug should be questioned.
Bumetanide, furosemide, and hydrochlorothiazide are potassium-
wasting diuretics and would be appropriate to administer in a patient
with hyperkalemia.
\.A nurse preparing to administer morning medications notes that a
patient with a history of hypertension has been prescribed the
angiotensin-converting 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
intervention is appropriate?
a.Administer the medications as ordered.
b.Ask the patient about the use of salt substitutes.
c.Contact the provider to report the laboratory values.
d.Request an order for furosemide (Lasix). - ANSWERS-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 medication and should
obtain clarification of the order. There is no need to repeat the
potassium level test that was just done this morning. Requesting an
order for furosemide is appropriate only after the provider has been
notified of the laboratory values.
\.A patient with hypertension is taking furosemide (Lasix) for congestive
heart failure. The prescriber orders digoxin to help increase cardiac
output. What other medication will the nurse expect to be ordered for
this patient?
a.Bumetanide (Bumex)
b.Chlorothiazide (Diuril)
