NURA 307 EXAM 2 UPDATED ACTUAL QUESTIONS AND CORRECT ANSWERS

NURA 307 EXAM 2 UPDATED ACTUAL QUESTIONS AND
CORRECT ANSWERS

Question:
1. Global Diuretic Principles
Answer:
■ Dose in the morning to prevent nocturia. ■ Daily weights (same time/clothes); report e 2-3 lb change in
24 hr. ■ Low■sodium diet (water follows sodium). ■ Orthostatic hypotension education (slow position
changes). ■ Monitor I&O and electrolytes closely. D's: Diuretics Decrease BP by Draining fluid; watch
Dizzy orthostatics & Deranged electrolytes. "IDEs make the body dry": many potassium■wasting agents
end in ■ide. Don't confuse isosorbide (vasodilator; "two o's" ■ ’ vasO dilatOr) with diuretics.

Question:
2. Thiazide Diuretics
Answer:
Hydrochlorothiazide Action: Blocks Cl■ pump in distal tubule ’ Na■/water loss; K■ follows. Indications:
HTN, mild edema. Mnemonic: "Thiazide = Hypertension Aid." / "We give I■D■E■S to make the body
dry." Contains sulfa ■ screen for sulfa allergy. (itchy rash that blisters, swells face, lips, or ’ tongue)
Adverse: GI upset, dizziness, muscle cramps; “ K■, “ Na■, ‘ Ca²■ ( Ca excretion). May “ uric ‘
acid/glucose. HTZ blocks Cl pump & causes sulfa allergies and lost fluid and k. Be on the lookout for red
itchy, blistery rashes, muscle cramps. Give in the morning and with food.

Question:
3. Loop Diuretics
Answer:
Furosemide (Lasix) Action: Blocks Na■ reabsorption in ascending loop of Henle ’ potent diuresis.
Indications: Pulmonary edema, acute HF, severe edema/HTN. Assess: Lung sounds (crackles), peripheral
edema, rapid weight gain watch I's and O's Mnemonic: "Loopy furosemide makes you Lose all your water
and k so give in the am and monitor those i's and o's and daily weights and give with food to prevent upset
tummies." Adverse: Major fluid/electrolyte shifts ( “ K■ especially); dehydration; ototoxicity (high
doses/rapid IV). ■ Give AM; may give with food for GI upset. Labs: K■, Na■, Mg²■/Ca²■, BUN/Cr;
check K■ before dosing. indicated for rapid and extreme diuresis Give with food to avoid GI upset Daily
weights, I's and O's, give in AM, causes massive UOP

Question:
4. Potassium Sparing Diuretics
Answer:
Spironolactone Action: Aldosterone antagonist ’ Na■/water out, K■ stays. Use: When hypokalemia risk is
high; adjunct diuresis; HF benefit. Mnemonic: "Spironolactone Saves K■." Adverse: ‘ K■, endocrine
effects (gynecomastia, irregular menses, hirsutism), dizziness, GI upset. Avoid severe renal disease. Hold
for low BP; check BP. ■ ■ Teach: Avoid high■potassium foods; report palpitations/weakness. Labs: K■,
renal function. Spiro is an aldosterone agonist and saves K but is not for those with renal disease or low
Bp.

Question:
5. Osmotic Diuretics

, Answer:
Mannitol Uses: “ ICP (cerebral edema, TBI without hemorrhage to bring swelling down), “ IOP
(glaucoma/eye surgery), toxin excretion. Action: Osmotic pull water into tubule without Na■ loss; shifts
fluid from brain/eye ’ ’ blood ’ urine. Mnemonic: "Man, it pulls fluid! But listen to that man's heart and
lungs because fluid shifts." Adverse/Monitor: Fluid shifts ’ HF, pulmonary edema, hypotension, electrolyte
issues; CNS changes. Do NOT use in hemorrhagic stroke. ■ Monitor: Neuro status (ICP), IOP,
lungs/edema, renal function.

Question:
6. Urinary Tract Anti■infectives
Answer:
Typical agents: Fosfomycin, nitrofurantoin, trimethoprim-sulfamethoxazole. Indication: Cystitis/UTI. Key
Risks: Stevens-Johnson syndrome (watch rash), GI upset (fosfomycin often worst), hepatotoxicity. ■
Culture & sensitivity before/early in therapy; teach that antibiotic may change once results return. ■ Food
can reduce GI upset; fluids encouraged. Mnemonic: "Fat Ninjas Twerk." "Fat Ninjas Twerk and give red
itchy rashes and upset tummies and toxic livers" Fat ’ Fosfomycin Ninjas ’ Nitrofurantoin (can cause
peripheral neuropathy) Twerk ’ Trimethoprim

Question:
7. Urinary Antispasmodics (Anticholinergics)
Answer:
Oxybutynin, Tolterodine Use: Overactive bladder, bladder spasms. Effect: “ frequency, urgency, nocturia.
Mnemonic: "Can't see, can't pee, can't spit, can't Shit" / "DRY■O" (Oxybutynin). Adverse: Dry
eyes/blurred vision, urinary retention, dry mouth, constipation; dizziness, overheating ( “ sweat). Avoid
with glaucoma, BPH, urinary retention, GI obstruction. ■ ■ Check if it worked by tracking voiding
frequency. ■ Teach: Sugarless gum/candy, fluids/fiber; safety with drowsiness. Mnemonic: "Oxy dries
you up only if you do not have BPH, retention, or glaucoma."

Question:
8. Urinary Analgesic
Answer:
Phenazopyridine (Pyridium/Azo) Role: Symptom relief only (burning, urgency, frequency) d 2-3 days
while antibiotic treats infection. Adverse: GI upset; orange urine, tears; stains contacts/underwear. ■
Teach: Use glasses; consider pads; stop & call Dr if yellow skin/sclera (hepatic toxicity). Mnemonic: "Pee
Orange for 2-3 days with Phenazopyridine."

Question:
9. BPH Meds — Alpha■1 Blockers
Answer:
Alpha■1 Blockers — Doxazosin, Terazosin, Tamsulosin Action: Relax prostate/bladder neck ’ ‘ flow;
some also for HTN. (relax the vascular system) Use: HTN, help BPH pts urinate Adverse:
First■dose/orthostatic hypotension, headache, dizziness; sexual dysfunction. Avoid PDE■5s (e.g.,
sildenafil) ■ ’ dangerous hypotension ("Sildenafil can kill"). ■ Teach: Rise slowly; consider bedtime first
dose; monitor BP; hold before cataract surgery (floppy iris). Mnemonic: "Dads Take Tinkles at while using
Alpha-1 Blockers to relax the vascular system" Dads ’ Doxazosin Take ’ Terazosin Tinkles ’ Tamsulosin

Question:
10. 5■α Reductase Inhibitor