NURS 505 Exam 2 PrepU Questions (50-52) (37)
A patient with a longstanding diagnosis of chronic renal failure has experienced a significant decline in urine output in recent days, prompting him to seek care at a local clinic. A nurse at the clinic has suggested to a colleague that the administra...
A patient with a longstanding diagnosis of chronic renal failure has experienced a
significant decline in urine output in recent days, prompting him to seek care at a
local clinic. A nurse at the clinic has suggested to a colleague that the
administration of a diuretic such as hydrochlorothiazide may improve the
patient's urine output. How should the colleague best respond to this
suggestion?
a) "That would probably help, but we'd have to do blood work first."
b) "Actually, patients with renal failure usually can't take hydrochlorothiazide."
c) "That would only work if he could come in twice a day to get it intravenously."
d) "Maybe, but hydrochlorothiazide affects the bladder more than the kidneys."
b) "Actually, patients with renal failure usually can't take hydrochlorothiazide."
Renal disease and severe renal impairment contraindicate the use of
hydrochlorothiazide. HCTZ affects the kidneys, not the bladder, and is not administered
intravenously.
The nurse is seeing a pregnant client who has a confirmed urinary tract infection
that requires treatment. Which anti-infective medication should the nurse
anticipate will be prescribed for this client?
a) methenamine
b) nitrofurantoin
c) tartrazine
d) phenazopyridine
b) nitrofurantoin
Anti-infectives are contraindicated in patients with a hypersensitivity to the drugs and
during pregnancy (pregnancy category C) and lactation. One exception is nitrofurantoin,
, which is classified as a pregnancy category B drug and is used with caution during
pregnancy. Tartrazine is not an anti-infective but a food dye that is added to the anti-
infective medication methenamine.
What best describes the structure of the kidneys?
a) The renal pelvises drain urine into the ureters.
b) The cortical nephrons concentrate urine.
c) The renal arteries arise from the renal cortex.
d) The glomerulus produces erythropoietin.
a) the renal pelvises drain urine into the ureters
The renal pelvises drain the urine into the ureters. All nephrons filter and make urine,
but only the medullary nephrons can concentrate or dilute urine. The renal arteries
come directly off the aorta. Erythropoietin is produced by a small group of cells called
the juxtaglomerular apparatus.
What would be a contraindication to the use of carbonic anhydrase inhibitors?
a) Allergy to sulfonamides
b) Adrenocortical insufficiency
c) Respiratory acidosis
d) Chronic obstructive pulmonary disease
a) allergy to sulfonamindes
Carbonic anhydrase inhibitors are sulfonamides, and as such are contraindicated in
patients with an allergy to sulfonamides. Carbonic anhydrase inhibitors are used
cautiously in patients with adrenocortical insufficiency, respiratory acidosis, and COPD
because these conditions could be exacerbated by the use of the drug.
As part of a class presentation, a nursing student is describing the actions of the
different diuretics. Which medication would the student include as exerting its
diuretic effect by inhibiting the reabsorption of sodium and chloride ions in the
ascending portion of the loop of Henle and the early distal tubule of the nephron?
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