NUR 2474 Pharm Exam 2 NCLEX
|\ |\ |\ |\ |\ |\
Questions with 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) - CORRECT 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 - CORRECT 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) - CORRECT |\ |\ |\ |\
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). - CORRECT |\ |\ |\ |\ |\ |\ |\ |\
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?
|\ |\ |\ |\ |\ |\ |\ |\ |\
|\ |\ |\ |\ |\ |\
Questions with 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) - CORRECT 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 - CORRECT 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) - CORRECT |\ |\ |\ |\
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). - CORRECT |\ |\ |\ |\ |\ |\ |\ |\
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?
|\ |\ |\ |\ |\ |\ |\ |\ |\
