NUR 210 Exam 3 () | Pharmacology | Galen (PDF)
Question 1
A client with newly diagnosed hypertension is prescribed
hydrochlorothiazide (HCTZ). Which assessment finding is most
important for the nurse to monitor during the first weeks of
therapy?
A. Serum potassium and sodium levels
B. Serum calcium level only
C. White blood cell count
D. Serum triglyceride level
Correct Answer: A. Serum potassium and sodium levels
Rationale: Thiazide diuretics like HCTZ can cause hypokalemia and
hyponatremia along with fluid volume deficit, so monitoring K+ and Na+ on
the CMP is critical for safety and dysrhythmia prevention.
Question 2
A client with heart failure is receiving furosemide IV for pulmonary
edema. Which nursing action is priority during IV administration?
A. Administer the IV dose as fast as possible to relieve symptoms
B. Push the medication slowly while monitoring for tinnitus
C. Mix the dose with dextrose 50% for better absorption
D. Give the medication IM if IV access is difficult
,Correct Answer: B. Push the medication slowly while monitoring for
tinnitus
Rationale: Furosemide IV must be pushed slowly to avoid ototoxicity and
irreversible hearing loss; the guide stresses slow IV push to prevent
tinnitus.
Question 3
A patient on furosemide for CHF has the following lab values: K+ 3.0
mEq/L, Mg2+ low, glucose slightly elevated. Which nursing action is
most appropriate?
A. Give the furosemide and encourage fluids
B. Hold the dose and notify the provider about electrolyte abnormalities
C. Give the furosemide with orange juice to correct potassium
D. Double the furosemide dose to remove more fluid
Correct Answer: B. Hold the dose and notify the provider about
electrolyte abnormalities
Rationale: Loop diuretics cause hypokalemia and hypomagnesemia, which
increase risk for dysrhythmias and digoxin toxicity; K+ of 3.0 is low, so
the nurse should hold and notify the provider.
Question 4
A client with cirrhosis is prescribed spironolactone. Which diet
teaching is most important?
A. "Increase your intake of bananas and orange juice."
B. "Use a salt substitute like Mrs. Dash to flavor foods."
C. "Avoid foods and products high in potassium, including salt
,substitutes."
D. "Follow a high-potassium, low-sodium diet."
Correct Answer: C. "Avoid foods and products high in potassium,
including salt substitutes."
Rationale: Spironolactone is potassium-sparing and can cause
hyperkalemia, especially when combined with potassium-rich foods or
salt substitutes containing K+.
Question 5
Which patient order would cause the nurse to question the use of
spironolactone?
A. Patient taking lisinopril for heart failure
B. Patient with mild osteoarthritis
C. Patient with a history of seasonal allergies
D. Patient with controlled hypothyroidism
Correct Answer: A. Patient taking lisinopril for heart failure
Rationale: Both spironolactone and lisinopril increase potassium levels.
Concurrent use significantly increases the risk of life-threatening
hyperkalemia.
Question 6
A patient taking spironolactone should avoid which food item?
A. Bananas
B. Apples
C. Bread
D. Rice
, Correct Answer: A. Bananas
Rationale: Spironolactone is a potassium-sparing diuretic. Patients
should avoid high-potassium foods like bananas to prevent hyperkalemia.
Question 7
A patient taking furosemide should be instructed to do which of the
following?
A. Take in the morning
B. Take at bedtime
C. Take on an empty stomach
D. Take with antacids
Correct Answer: A. Take in the morning
Rationale: Furosemide should be taken in the morning to prevent nocturia
and sleep disruption.
Question 8
A patient taking hydrochlorothiazide should be monitored for which
electrolyte imbalance?
A. Hypokalemia
B. Hyperkalemia
C. Hyponatremia
D. Hypercalcemia
Correct Answer: A. Hypokalemia
Rationale: Hydrochlorothiazide is a thiazide diuretic that can cause
hypokalemia.
Question 1
A client with newly diagnosed hypertension is prescribed
hydrochlorothiazide (HCTZ). Which assessment finding is most
important for the nurse to monitor during the first weeks of
therapy?
A. Serum potassium and sodium levels
B. Serum calcium level only
C. White blood cell count
D. Serum triglyceride level
Correct Answer: A. Serum potassium and sodium levels
Rationale: Thiazide diuretics like HCTZ can cause hypokalemia and
hyponatremia along with fluid volume deficit, so monitoring K+ and Na+ on
the CMP is critical for safety and dysrhythmia prevention.
Question 2
A client with heart failure is receiving furosemide IV for pulmonary
edema. Which nursing action is priority during IV administration?
A. Administer the IV dose as fast as possible to relieve symptoms
B. Push the medication slowly while monitoring for tinnitus
C. Mix the dose with dextrose 50% for better absorption
D. Give the medication IM if IV access is difficult
,Correct Answer: B. Push the medication slowly while monitoring for
tinnitus
Rationale: Furosemide IV must be pushed slowly to avoid ototoxicity and
irreversible hearing loss; the guide stresses slow IV push to prevent
tinnitus.
Question 3
A patient on furosemide for CHF has the following lab values: K+ 3.0
mEq/L, Mg2+ low, glucose slightly elevated. Which nursing action is
most appropriate?
A. Give the furosemide and encourage fluids
B. Hold the dose and notify the provider about electrolyte abnormalities
C. Give the furosemide with orange juice to correct potassium
D. Double the furosemide dose to remove more fluid
Correct Answer: B. Hold the dose and notify the provider about
electrolyte abnormalities
Rationale: Loop diuretics cause hypokalemia and hypomagnesemia, which
increase risk for dysrhythmias and digoxin toxicity; K+ of 3.0 is low, so
the nurse should hold and notify the provider.
Question 4
A client with cirrhosis is prescribed spironolactone. Which diet
teaching is most important?
A. "Increase your intake of bananas and orange juice."
B. "Use a salt substitute like Mrs. Dash to flavor foods."
C. "Avoid foods and products high in potassium, including salt
,substitutes."
D. "Follow a high-potassium, low-sodium diet."
Correct Answer: C. "Avoid foods and products high in potassium,
including salt substitutes."
Rationale: Spironolactone is potassium-sparing and can cause
hyperkalemia, especially when combined with potassium-rich foods or
salt substitutes containing K+.
Question 5
Which patient order would cause the nurse to question the use of
spironolactone?
A. Patient taking lisinopril for heart failure
B. Patient with mild osteoarthritis
C. Patient with a history of seasonal allergies
D. Patient with controlled hypothyroidism
Correct Answer: A. Patient taking lisinopril for heart failure
Rationale: Both spironolactone and lisinopril increase potassium levels.
Concurrent use significantly increases the risk of life-threatening
hyperkalemia.
Question 6
A patient taking spironolactone should avoid which food item?
A. Bananas
B. Apples
C. Bread
D. Rice
, Correct Answer: A. Bananas
Rationale: Spironolactone is a potassium-sparing diuretic. Patients
should avoid high-potassium foods like bananas to prevent hyperkalemia.
Question 7
A patient taking furosemide should be instructed to do which of the
following?
A. Take in the morning
B. Take at bedtime
C. Take on an empty stomach
D. Take with antacids
Correct Answer: A. Take in the morning
Rationale: Furosemide should be taken in the morning to prevent nocturia
and sleep disruption.
Question 8
A patient taking hydrochlorothiazide should be monitored for which
electrolyte imbalance?
A. Hypokalemia
B. Hyperkalemia
C. Hyponatremia
D. Hypercalcemia
Correct Answer: A. Hypokalemia
Rationale: Hydrochlorothiazide is a thiazide diuretic that can cause
hypokalemia.
