TEST BANKS WITH COMPLETE
SOLUTION NEWEST
1. The nurse is preparing to administer the first dose of hydrochlorothiazide (HydroDIURIL) 50 mg to a
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patient who has a blood pressure of 160/95 mm Hg. The nurse notes that the patient had a urine output of
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200 mL in the past 12 hours. The nurse will perform which action?
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a. Administer the medication as ordered. Il` Il` Il` Il` Il`
b. Encourage the patient to drink more fluids. Il` Il` Il` Il` Il` Il` Il`
c. Hold the medication and request an order for serum BUN and creatinine.
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d. Request an order for serum electrolytes and administer the medication. - CORRECT ANSWER -ANS: C
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Thiazide diuretics are contraindicated in renal failure. This patient has oliguria and should be evaluated for
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renal failure prior to administration of the diureticespecially in the absence of known renal failure for this
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patient. Drinking more fluids will not increase urine output in patients with renal failure.
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DIF: COGNITIVE LEVEL: Applying (Application) REF: Page 623
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TOP: NURSING PROCESS: Assessment/Nursing Intervention
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MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
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2. The nurse is preparing to administer doses of hydrochlorothiazide (HydroDIURIL) and digoxin (Lanoxin)
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to a patient who has heart failure. The patient reports having blurred vision. The nurse notes a heart rate
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of 60 beats per minute and a blood pressure of 140/78 mm Hg. Which action will the nurse take?
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a. Administer the medications and request an order for serum electrolytes. Il` Il` Il` Il` Il` Il` Il` Il` Il` Il`
b. Give both medications and evaluate serum blood glucose frequently.
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c. Hold the digoxin and notify the provider. Il` Il` Il` Il` Il` Il` Il`
d. Hold the hydrochlorothiazide and notify the provider. - CORRECT ANSWER -ANS: C
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,When thiazide diuretics are taken with digoxin, patients are at risk of digoxin toxicity because thiazides can
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cause hypokalemia. The patient has bradycardia and blurred vision, which are both signs of digoxin
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toxicity. The nurse should hold the digoxin and notify the provider. Serum electrolytes may be ordered,
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but the digoxin should not be given.
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DIF: COGNITIVE LEVEL: Applying (Application) REF: Page 623
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TOP: NURSING PROCESS: Nursing Intervention/Evaluation
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MSC: NCLEX: Physiological Integrity: Pathophysiology
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3. The nurse is teaching a patient about taking hydrochlorothiazide. Which statement by the patient
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indicates a need for further teaching?
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a. I may need extra sodium and calcium while taking this drug.
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b. I should eat plenty of fruits and vegetables while taking this medication.
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c. I should take care when rising from a bed or chair when Im on this medication.
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d. I will take the medication in the morning to minimize certain side effects. - CORRECT ANSWER -ANS: A
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Il` Patients do not need extra sodium or calcium while taking thiazide diuretics.
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Thiazide diuretics can lead to hypokalemia, so patients should be counseled to eat fruits and vegetables
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that are high in potassium. Patients can develop orthostatic hypotension and should be counseled to rise
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from sitting or lying down slowly. Taking the medication in the morning helps to prevent nocturiainduced
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insomnia.
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DIF: COGNITIVE LEVEL: Applying (Application) REF: Page 624
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TOP: NURSING PROCESS: Nursing Intervention: Patient Teaching
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MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
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4. The nurse is caring for a patient who is to begin receiving a thiazide diuretic to treat heart failure. When
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performing a health history on this patient, the nurse will be concerned about a history of which
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condition?
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a. Asthma Il`
b. Glaucoma Il`
c. Gout Il`
, d. Hypertension - CORRECT ANSWER -ANS: C Il` Il` Il` Il` Il` Il`
Thiazides block uric acid secretion and elevated levels can contribute to gout. Patients with a history of
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gout should take thiazide diuretics with caution; they may need behavioral and/or pharmacologic changes
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to their gout treatment.
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DIF: COGNITIVE LEVEL: Applying (Application) REF: Page 626
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TOP: NURSING PROCESS: Assessment
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MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
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5. The nurse is caring for a patient who develops marked edema and a low urine output as a result of
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Il` heart failure. Which medication will the nurse expect the provider to order for this patient? a. Digoxin
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Il` (Lanoxin) Il`
b. Furosemide (Lasix) Il` Il`
c. Hydrochlorothiazide (HydroDIURIL) Il` Il`
d. Spironolactone (Aldactone) - CORRECT ANSWER -ANS: B Il` Il` Il` Il` Il` Il` Il`
Furosemide is a loop diuretic and is given when the patients condition warrants immediate removal of
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body fluid, as in heart failure. Digoxin improves cardiac function but does not remove fluid quickly. The
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other diuretics may be used when immediate fluid removal is not necessary.
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DIF: COGNITIVE LEVEL: Applying (Application) REF: Page 627
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TOP: NURSING PROCESS: Nursing Intervention
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MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
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6. The nurse is caring for a patient who is receiving furosemide (Lasix) and an aminoglycoside antibiotic.
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Il` The nurse will be most concerned if the patient reports which symptom? a. Dizziness
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b. Dysuria Il`
c. Nausea Il`
d. Tinnitus - CORRECT ANSWER -ANS: D Il` Il` Il` Il` Il` Il`