Drugs That Affect Urine Output

Understanding Pharmacology Essentials for Medication Safety

Nursing
26
Questions
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True/False
25
Choices
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Essay
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Questions

Q1
Free

For which complication does the nurse remain alert when a patient is taking any type of diuretic?

Multiple Choice
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A) Loss of appetite
B) Bladder spasms
C) Hypertension
D) Dehydration
Answer:
D) Dehydration

Explanation:
Any type of diuretic increases water loss through urination. This water loss can cause dehydration if a patients fluid intake does not keep pace with his or her urine output.
Q2
Free

A patient who has been taking a diuretic for the past 2 weeks now experiences all of the following changes. Which change indicates to the nurse that the diuretic is effective?

Multiple Choice
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A) Weight loss of 7 lb
B) Heart rate increased from 72 to 80 beats per minute
C) Respiratory rate decreased from 20 to 16 breaths per minute
D) Morning blood glucose decreased from 142 mg/dL to 110 mg/dL
Answer:
A) Weight loss of 7 lb

Explanation:
Diuretic drugs cause water loss and are often prescribed for edema. One liter of water weighs 2.2 lb. In helping the patient rid the body of excess water, the patient is expected to lose weight.
Q3
Free

A patient prescribed a once-daily diuretic calls the office to report that yesterdays drug dose was missed. What is the nurses best advice?

Multiple Choice
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A) Take todays dose now and restrict todays fluid intake to 1 L.
B) Take yesterdays dose now and take todays dose after another 6 hours.
C) Take todays dose now and maintain your normal intake of food and fluids.
D) Skip todays doses of all your medications and then begin everything fresh tomorrow.
Answer:
C) Take todays dose now and maintain your normal intake of food and fluids.

Explanation:
Too much time has passed to take both yesterdays dose and todays dose. Additional dosing would amount to doubling the dose, which could lead to more side effects and possible complications.
Q4

The nurse is teaching a patient about diuretic therapy. Which statement made by the patient indicates that more teaching is needed?

Multiple Choice
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A) I am so thankful that my high blood pressure has been cured by this drug.
B) I always try to drink just about the same amount of fluid that I urinate each day.
C) I will call my health care provider if my heart rate is less than 60 beats per minute.
D) I have been taking this drug early in the day so that I dont have to get up during the night.
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Q5

A patient taking a thiazide diuretic has the following blood laboratory values for kidney function. Which value does the nurse report to the prescriber immediately?

Multiple Choice
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A) Sodium 136 mEq/L
B) Potassium 2.6 mEq/L
C) Creatinine 0.9 mg/dL
D) Blood urea nitrogen 6 mg/dL
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Q6

Why does the nurse teach a patient who is prescribed a thiazide diuretic to change positions slowly?

Multiple Choice
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A) Moving rapidly from a standing position to a sitting position can raise blood pressure and increase the patients risk for a stroke.
B) Moving rapidly from a standing position to a sitting position can cause excess body fluids to collect in the feet and ankles increasing the patients risk for edema.
C) Moving rapidly from a sitting position to a standing position can put pressure on the bladder and increase the patients risk for incontinence.
D) Moving rapidly from a sitting position to a standing position can cause blood pressure to drop and increase the patients risk for falling.
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Q7

The nurse administers 20 mg of furosemide (Lasix) to a patient by the intravenous (IV) route. Which action is most important for the nurse to take?

Multiple Choice
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A) Give the drug slowly over at least 2 minutes.
B) Check the patient carefully for symptoms of low blood glucose levels.
C) Mix the drug with potassium chloride to prevent a rapid drop in serum potassium levels.
D) Monitor the IV site after giving the drug because furosemide causes severe tissue damage if infiltration occurs.
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Q8

Which side effect is associated only with loop diuretics?

Multiple Choice
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A) Dizziness
B) Hearing loss
C) Urinary frequency
D) Increased sun sensitivity
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Q9

Which diuretic may cause an adverse effect of a higher than normal serum potassium level?

Multiple Choice
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A) spironolactone (Aldactone)
B) bumetanide (Bumex)
C) chlorothiazide (Diuril)
D) furosemide (Lasix)
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Q10

A patient is prescribed spironolactone (Aldactone). Why does the nurse advise the patient to avoid the use of salt substitutes?

Multiple Choice
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A) They may cause the patient to be at risk for a high potassium level.
B) They can increase the patients risk for hypertension.
C) They may lead to hypokalemia.
D) They can cause water retention.
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Q11

A patient who has been taking amiloride (Midamor) for the past 3 months reports that she must shave her legs more frequently. What is the nurses best action?

Multiple Choice
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A) Hold the next dose and notify the prescriber immediately.
B) Instruct the patient to stop taking oral contraceptives while she is taking this drug.
C) Document the response and reassure the patient that this is an expected side effect.
D) Ask the patient whether she has noticed any changes in the thickness of her scalp hair.
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Q12

The nurse prepares to give a second dose of furosemide (Lasix) to a patient by intravenous (IV) push. Before the injection is started, the patient reports having chest pain ever since the last dose of the drug. What is the nurses best action?

Multiple Choice
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A) Assist the patient to lay flat and encourage him or her to take slow, deep breaths.
B) Document the report as the only action for this expected side effect.
C) Slow the IV drip rate and examine the infusion site for infiltration.
D) Hold the dose and notify the prescriber immediately.
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Q13

A patient with overactive bladder has been prescribed tolterodine (Detrol). While assessing the patient, the nurse discovers the presence of the following health problems. Which problem causes the nurse to contact the prescriber and question the drug order?

Multiple Choice
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A) Asthma
B) Glaucoma
C) Hypotension
D) Diabetes mellitus
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Q14

A patient is prescribed an extended-release drug for overactive bladder. Which precaution is most important for the nurse to teach the patient?

Multiple Choice
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A) Avoid taking this drug at bedtime.
B) Drink at least 3 L of fluid daily.
C) Swallow the tablet or capsule whole.
D) Perform a home pregnancy test monthly.
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Q15

A patient is prescribed a drug for overactive bladder. Which instruction does the nurse provide to prevent a serious complication?

Multiple Choice
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A) Be sure to let your prescriber know if your symptoms do not improve.
B) When using the patch, press it firmly to make sure it stays in place.
C) Use alcohol in moderation while taking this drug.
D) Avoid becoming overheated or dehydrated.
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Q16

Which laboratory value is always checked before giving a dose of furosemide (Lasix)?

Multiple Choice
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A) Calcium
B) Magnesium
C) Creatinine
D) Potassium
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Q17

What must the nurse teach a patient who is taking a diuretic drug?

Multiple Choice
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A) Avoid foods that are rich in potassium such as bananas and broccoli.
B) Sit on the side of the bed for 1 to 2 minutes before getting out of bed.
C) Notify the prescriber if the heart rate is less than 70 beats per minute.
D) Keep a record of dietary intake for a few weeks.
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Q18

What is the most common side effect of drugs used for benign prostate hypertrophy (BPH)?

Multiple Choice
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A) Low blood pressure
B) Decreased libido
C) Light-headedness
D) Hair loss
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Q19

An 82-year-old-man is prescribed a dihydrotestosterone (DHT) inhibitor to treat benign prostatic hypertrophy (BPH). Which health promotion activity is most important for the nurse to teach this patient?

Multiple Choice
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A) Have vision and glaucoma checks yearly.
B) Participate in yearly prostate cancer screening.
C) Avoid both alcohol and caffeine while on the drug.
D) Avoid donating blood when taking the drug and for at least 6 months after drug therapy has stopped.
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Q20

A patient has received furosemide (Lasix), 40 mg orally, 30 minutes ago. To prevent injury to the patient, what does the nurse do?

Multiple Choice
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A) Assist the patient to the bathroom
B) Keep the patient on bed rest
C) Place all four side rails in the elevated position
D) Ask the patient to get out of bed rapidly
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Q21

A patient who is prescribed hydrochlorothiazide (HCTZ) informs the nurse that she plans to become pregnant. What does the nurse include in a care plan for the patient about this drug?

Multiple Choice
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A) This drug is safe for use during pregnancy and breastfeeding.
B) The prescriber will most likely decrease your dose while you are pregnant.
C) You may take this drug during pregnancy, but should not use it if you plan to breastfeed.
D) This drug should be avoided during pregnancy and breastfeeding.
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Q22

A patient taking tolterodine (Detrol) reports decreased urination, ankle swelling, and a weight gain of 5 pounds over the past 2 days. What does the nurse do next?

Multiple Choice
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A) Holds the dose and notifies the prescriber
B) Checks the patients blood pressure and heart rate
C) Gives the dose as prescribed
D) Documents the finding as the only action
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Q23

A patient taking tamsulosin (Flomax) asks the nurse how the drug works. What is the nurses best response?

Multiple Choice
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A) This drug works on your prostate gland to decrease its size.
B) This drug signals the cells in your prostate gland not to grow.
C) This drug works by relaxing the detrusor muscle of your bladder.
D) This drug relaxes muscle around your urethra to improve urine flow.
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Q24

Which test or examination does a patient receive before taking any drug for benign prostate hypertrophy (BPH)?

Multiple Choice
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A) Digital rectal examination
B) 24-hour urinalysis
C) Kidney function test
D) Urine culture
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Q25

A patient taking finasteride (Proscar) informs the nurse that he is also taking the herbal supplement saw palmetto. What is the nurses best response?

Multiple Choice
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A) You should not take finasteride and saw palmetto at the same time.
B) Finasteride and saw palmetto taken together increase your risk of bleeding.
C) Be sure to notify your prescriber if you notice any unusual side effects.
D) Avoid people with viral infections while taking these two substances.
Answer:

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Q26

[Sequencing] The nurse is teaching a patient about the patch form of a drug to treat overactive bladder. List the correct order in which the patient should perform the steps of drug administration. (Number 1 is the first step and number 7 is the last step.)
A. Examine the skin under the old patch for redness, irritation, or open areas.
B. Press the patch firmly and hold in place for at least 15 seconds.
C. Remove the old patch after it has been on for 3 to 4 days.
D. Remove the adhesive backing on the patch.
E. Carefully clean and dry the new site.
F. Apply the patch sticky side down.
G. Select a new site.

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