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NURS 505 EXAM 2 PREPU QUESTIONS (50-52) (37)
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NURS 505 EXAM 2 PREPU QUESTIONS (50-52) (37)
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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 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." -
Answers-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 - Answers-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. - Answers-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 - Answers-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?
a) Hydrochlorothiazide
b) Acetazolamide
c) Furosemide
d) Spironolactone - Answers-a) Hydrochlorothiazide
Hydrochlorothiazide is a thiazide diuretic that exerts 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. Acetazolamide is a carbonic anhydrase
inhibitor and is a sulfonamide, without bacteriostatic action, that inhibits the enzyme
carbonic anhydrase. Carbonic anhydrase inhibition results in the excretion of sodium,
potassium, bicarbonate, and water. Furosemide is a loop diuretic which inhibits
reabsorption of sodium and chloride in the distal and proximal tubules of the kidney and
in the loop of Henle. Spironolactone is a potassium-sparing diuretic works to antagonize
the action of aldosterone. Aldosterone, a hormone produced by the adrenal cortex,
enhances the reabsorption of sodium in the distal convoluted tubules of the kidney.
When this is blocked by the drug, sodium (but not potassium) and water are excreted.
Which substance acts to increase blood pressure by inducing vasoconstriction?
a) angiotensin II
b) erythropoeiten
c) ADH
d) atrial natriuretic peptide - Answers-a) angiotensin II
Angiotensin II acts to reduce blood pressure by inducing vasoconstriction.
A client seeking care for the treatment of a urinary tract infection (UTI) was prescribed
nitrofurantoin. What change in the client's health status would prompt the use of an
alternative medication?
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