Exam (elaborations)
Exam (elaborations) ADVANCED P 508 Diuretics Test Bank
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Exam (elaborations) ADVANCED P 508 Diuretics Test BankChapter 32: Diuretics
Test Bank
MULTIPLE CHOICE
1. A patient develops hypertension. The primary care nurse practitioner (NP) plans to begin
diuretic therapy for this patient. The NP notes clear breath sounds, no organomegaly, and
no peripheral edema. The patient’s serum electrolytes are normal. The NP should prescribe:
a.
furosemide (Lasix).
b.
triamterene (Dyrenium).
c.
acetazolamide (Diamox).
d.
hydrochlorothiazide (HydroDIURIL).
ANS: D
Thiazide diuretics are first-line drugs for treating hypertension. The other three drugs are not
thiazide diuretics.
DIF: Cognitive Level: Applying (Application) REF: 376
2. A patient takes hydrochlorothiazide to treat hypertension and asks the primary care NP why it
is necessary to reduce sodium intake while taking this medication. The NP should explain
that decreasing sodium is necessary to:
a.
prevent renal insufficiency.
b.
minimize the risk of hypokalemia.
c.
prevent postdiuretic sodium retention.
d.
increase the likelihood that the drug may be discontinued.
ANS: C
If dietary salt intake is high, the amount of sodium lost in response to the diuretic may be
partially or completely offset by postdiuretic sodium retention. Sodium restriction does not
prevent renal insufficiency or minimize the incidence of hypokalemia. Sodium restriction is
necessary to maintain the drug’s effectiveness but does not increase the chance of
discontinuing the medication.
DIF: Cognitive Level: Applying (Application) REF: 372
3. A patient with congestive heart failure will begin therapy with a diuretic medication. The
primary care NP orders laboratory tests, which reveal a glomerular filtration rate (GFR) of
25 mL/minute. The initial drug the NP should prescribe is:
a.
metolazone.
b.
furosemide (Lasix).
c.
spironolactone (Aldactone).
d.
hydrochlorothiazide (HydroDIURIL).
ANS: A
Thiazides are the most frequently used and the least expensive drugs administered to treat
hypertension and are considered first-line treatments. In patients with a GFR less than 30
mL/minute, thiazides are relatively ineffective, with the exception of metolazone. Furosemide
may be added as a second-line drug. Potassium-sparing diuretics, such as spironolactone,
, Exam (elaborations) ADVANCED P 508 Diuretics Test Bank
should be used with great caution or avoided altogether in patients with renal insufficiency.
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