(41,43,44,45,46,47,48,49,50,51,52,53,55,
56) PRACTICE QUESTIONS WITH
CORRECT ANSWERS GRADED A+
GUARANTEED PASS
1.Chh41h-hhCORRECThANSWERS-Diuretics
Thehnursehknowshthathdiureticshmostlyhaffecthwhichhfunctionhofhthehkidneys?h-
hhCORRECThANSWERS-Cleansinghandhmaintenancehofhextracellularhfluidhvolumeh
h
Mosthdiureticshblockhsodiumhandhchloridehreabsorption,hthushaffectinghthehmaintenancehofhextrac
ellularhfluidhvolume.
Thehnursehplanshtohcloselyhmonitorhforhwhichhclinicalhmanifestationhafterhadministeringhfurosemid
eh[Lasix]?h-hhCORRECThANSWERS-Decreasedhbloodhpressureh
High-
ceilinghloophdiuretics,hsuchhashfurosemide,harehthehmostheffectivehdiuretichagents.hTheyhproduceh
morehlosshofhfluidhandhelectrolyteshthanhanyhothers.hAhsuddenhlosshofhfluidhcanhresulthinhdecreased
hbloodhpressure.hWhenhbloodhpressurehdrops,hthehpulsehprobablyhwillhincreasehratherhthanhdecre
ase.hLasixhshouldhnothaffecthrespirationshorhtemperature.hThehnursehshouldhalsohcloselyhmonitorht
hehpatient'shpotassiumhlevel.
Thehnursehcaringhforhahpatienthtakinghfurosemideh[Lasix]hishreviewinghthehpatient'shmosthrecenthla
boratoryhresults,hwhichhare:hsodium,h136hmEq/L;hpotassium,h3.2hmEq/L;hchloride,h100hmEq/L;hblo
,odhureahnitrogen,h15hmg/dL.hWhathishthehnurse'shbesthaction?h-hhCORRECThANSWERS-
HoldhthehLasixhandhnotifyhthehphysician.h
Thehnurse'shbesthactionhishtohholdhthehLasixhandhnotifyhthehphysician.hLoophdiuretics,hsuchhashfuros
emide,hcanhcausehsignificanthpotassiumhloss.hThehnormalhpotassiumhlevelhish3.5htoh5hmEq/L.hThehr
emaininghelectrolytehlevelsharehnormal.hAdministeringhthehLasixhcouldhresulthinhahcriticallyhlowhpot
assiumhlevel.hEffectshofhlowhpotassiumhincludehcardiachdysrhythmias.hPlacinghahpatienthonhahcardia
chmonitorhrequireshahphysician'shorderhandhwouldhwarranthfurtherhassessmenthfirst,hsuchhashtakin
ghvitalhsignshandhaskinghthehpatienthwhetherhhehorhshehishhavinghanyhcardiac-
relatedhsymptoms.hCollectinghah24-hourhurinehspecimenhishnothappropriatehinhthishcase.
Thehnursehshouldhmonitorhforhwhichhadverseheffecthafterhadministeringhhydrochlorothiazideh[Hyd
roDIURIL]handhdigoxinh[Lanoxin]htohahpatient?h-hhCORRECThANSWERS-Digoxinhtoxicity
Digoxinhlevelshhavehanhinversehrelationshiphwithhpotassiumhlevels.hBecausehhydrochlorothiazidehc
anhlowerhpotassiumhlevels,hcombinedhusehofhhydrochlorothiazidehandhdigoxinhposeshahriskhforhele
vatedhdigoxinhlevelshandhensuinghdigoxinhtoxicity.
Thehnursehishcaringhforhahpatienthwithhhearthfailurehwhohneedshahdiuretic.hWhichhagenthishlikelyhtoh
behchosen,hbecausehithhashbeenhshownhtohgreatlyhreducehmortalityhinhpatientshwithhhearthfailure?h
-hhCORRECThANSWERS-Spironolactoneh[Aldactone]h
Spironolactonehishahpotassium-
sparinghdiuretichusedhtohtreathbothhhypertensionhandhedema.hIthishahpreferredhdrughinhhearthfailur
e,hbecausehithhashbeenhshownhtohhavehahcardioprotectiveheffect,hreducinghmortalityhinhpatientshwi
thhhearthfailure.
,Thehnursehishteachinghahpatienthwhohhashahnewhprescriptionhforhspironolactoneh[Aldactone].hWhic
hhstatementhbyhthehpatienthindicateshthaththehteachinghwasheffective?h-hhCORRECThANSWERS-
"IhwillhcallhmyhdoctorhifhIhbeginhhavinghmenstrualhirregularities."h
h
Spironolactonehishahpotassium-sparing,haldosterone-
blockinghdiuretic.hAshsuch,hithcanhcausehendocrineheffects,hsuchhashgynecomastia,hmenstrualhirreg
ularities,himpotence,hhirsutism,handhdeepeninghofhthehvoice.hPatientshtakinghspironolactonehshoul
dhavoidhsalthsubstituteshbecausehtheyhcontainhpotassium,handhhigh-
potassiumhfoodshshouldhbehavoidedhwithhthishdrug.hIdeally,hallhdiureticshshouldhbehtakenhinhthehm
orninghtohpreventhnocturia.
Thehhealthcarehproviderhordershfurosemideh[Lasix]h20hmghIVhtwicehdaily.hThehmedicationhavailable
hishfurosemideh[Lasix]h10hmg/mL.hHowhmanyhmLhwillhthehnursehadministerhwithheachhdose?h-
hhCORRECThANSWERS-2hmLh
h
Thehhealthcarehproviderhhashorderedh20hmghofhfurosemideh[Lasix],hwhichhishavailablehinh10hmg/m
L.hMultiplyh10hmg/mLhbyh2htohequalh20hmg/2hmL.hThehnursehwillhadministerh2hmLhofhfurosemidehto
hequalh20hmghwithheachhdose.
Thehnursehishreviewinghthehhomehmedicationhlisthwithhthehpatient.hThehnursehrecognizeshthathhydr
ochlorothiazidehishusedhprimarilyhforhwhichhcondition?h-hhCORRECThANSWERS-Hypertensionh
Thehprimaryhindicationhforhhydrochlorothiazidehishhypertension,hahconditionhforhwhichhthiazidesha
rehoftenhthehdrugshofhfirsthchoice.hHydrochlorothiazidesharehusedhforhthehotherhconditions,hbuthth
ehprimaryhindicationhishhypertension.
Thehhealthcarehproviderhordershmannitolh72hgmhinfusionhoverh24hhours.hThehnursehplanshtohsethth
ehinfusionhpumphforhhowhmanyhgramshperhhour?h-hhCORRECThANSWERS-3hgmh
, Tohinfuseh72hgramshoverh24hhours,hdivideh72hbyh24hforhthehtotalhperhhour.h72hdividedhbyh24hequalsh
3hgramshperhhour.
Whichhofhthehfollowinghstatementshabouthmannitolh[Osmitrol]harehcorrect?h(Selecthallhthathapply.)h
-hhCORRECThANSWERS--Mannitolhcannothbehgivenhorally.
-Mannitolhcanhcausehedema.h
-Diuresishbeginshinh30htoh60hminuteshafterhadministration.
h
MannitolhdoeshnothdiffusehacrosshthehGIhepitheliumhandhcannothbehtransportedhbyhthehuptakehsys
temshthathabsorbhdietaryhsugars.hAccordingly,htohreachhthehcirculation,hthehdrughmusthbehgivenhpa
renterally.hDiuresishbeginshinh30htoh60hminuteshandhpersistsh6htoh8hhours.hMannitolhcanhleavehthehv
ascularhsystemhathallhcapillaryhbedshexcepththosehofhthehbrain.hWhenhthehdrughexitshcapillaries,hithd
rawshwaterhalong,hcausinghedema.hMannitolhishusehinhprophylaxishofhrenalhfailure.hMannitolhishanh
osmotichdiuretic,hnothahloophdiuretic.
Chh43h-hhCORRECThANSWERS-ReviewhofhHemodynamics
Whichhhemodynamichsystemhserveshashahreservoirhforhcirculatinghblood?h-hhCORRECThANSWERS-
Veinsh
Mosthofhthehcirculatinghbloodhishinhthehveins,hvenules,handhvenoushsinuses.hThehvenoushsystemhser
veshashahreservoirhforhcirculatinghblood.
Completehthehequation:hCardiachoutputh=hVolumehofhbloodhejectedhatheachhheartbeath×h____.h-
hhCORRECThANSWERS-Hearthrateh