NURS 2110 Exam 3 UPDATED ACTUAL
Exam Questions and CORRECT Answers
The nurse knows that diuretics mostly affect which function of the kidneys?
a. Cleansing and maintenance of extracellular fluid volume
b. Maintenance of acid-base balance
c. Excretion of metabolic waste
d. Elimination of foreign substances - CORRECT ANSWER -a
Most diuretics block sodium and chloride reabsorption, thus affecting the maintenance of
extracellular fluid volume.
The nurse plans to closely monitor for which clinical manifestation after administering
furosemide [Lasix]?
a. Decreased pulse
b. Decreased temperature
c. Decreased blood pressure
d. Decreased respiratory rate - CORRECT ANSWER -c
High-ceiling loop diuretics, such as furosemide, are the most effective diuretic agents. They
produce more loss of fluid and electrolytes than any others. A sudden loss of fluid can result in
decreased blood pressure. When blood pressure drops, the pulse probably will increase rather
than decrease. Lasix should not affect respiration or temperature. The nurse should also closely
monitor the patient's potassium level.
The nurse caring for a patient taking furosemide [Lasix] is reviewing the patient's most recent
laboratory results, which are: sodium, 136 mEq/L; potassium, 3.2 mEq/L; chloride, 100 mEq/L;
blood urea nitrogen, 15 mg/dL. What is the nurse's best action?
a. Administer Lasix as ordered.
b. Place the patient on a cardiac monitor.
c. Begin a 24-hour urine collection.
d. Hold the Lasix and notify the physician. - CORRECT ANSWER -d
,The nurse's best action is to hold the Lasix and notify the physician. Loop diuretics, such as
furosemide, can cause significant potassium loss. The normal potassium level is 3.5 to 5 mEq/L.
The remaining electrolyte levels are normal. Administering the Lasix could result in a critically
low potassium level. Effects of low potassium include cardiac dysrhythmias. Placing a patient on
a cardiac monitor requires a physician's order and would warrant further assessment first, such as
taking vital signs and asking the patient whether he or she is having any cardiac-related
symptoms. Collecting a 24-hour urine specimen is not appropriate in this case.
The nurse should monitor for which adverse effect after administering hydrochlorothiazide
[HydroDIURIL] and digoxin [Lanoxin] to a patient?
a. Digoxin toxicity
b. Decreased diuretic effect
c. Dehydration
d. Heart failure - CORRECT ANSWER -a
Digoxin levels have an inverse relationship with potassium levels. Because hydrochlorothiazide
can lower potassium levels, combined use of hydrochlorothiazide and digoxin poses a risk for
elevated digoxin levels and ensuing digoxin toxicity.
The nurse is caring for a patient with heart failure who needs a diuretic. Which agent is likely to
be chosen, because it has been shown to greatly reduce mortality in patients with heart failure?
a. Furosemide [Lasix]
b. Hydrochlorothiazide [HydroDIURIL]
b. Spironolactone [Aldactone]
d. Mannitol [Osmitrol] - CORRECT ANSWER -c
Spironolactone is a potassium-sparing diuretic used to treat both hypertension and edema. It is a
preferred drug in heart failure, because it has been shown to have a cardioprotective effect,
reducing mortality in patients with heart failure.
The nurse is teaching a patient who has a new prescription for spironolactone [Aldactone].
Which statement by the patient indicates that the teaching was effective?
a. "I will use salt substitutes to lower my sodium intake."
b. "I will increase my intake of foods that are high in potassium."
c. "I will call my doctor if I begin having menstrual irregularities."
,d. "I will take this medication at bedtime each evening." - CORRECT ANSWER -c
Spironolactone is a potassium-sparing, aldosterone-blocking diuretic. As such, it can cause
endocrine effects, such as gynecomastia, menstrual irregularities, impotence, hirsutism, and
deepening of the voice. Patients taking spironolactone should avoid salt substitutes because they
contain potassium, and high-potassium foods should be avoided with this drug. Ideally, all
diuretics should be taken in the morning to prevent nocturia.
The healthcare provider orders furosemide [Lasix] 20 mg IV twice daily. The medication
available is furosemide [Lasix] 10 mg/mL. How many mL will the nurse administer with each
dose?
a. 0.5 mL
b. 1 mL
c. 2 mL
d. 4 mL - CORRECT ANSWER -c
The nurse is reviewing the home medication list with the patient. The nurse recognizes that
hydrochlorothiazide is used primarily for which condition?
a. Hypertension
b. Edema
c. Diabetes insipidus
d. Protection against postmenopausal osteoporosis - CORRECT ANSWER -a
The primary indication for hydrochlorothiazide is hypertension, a condition for which thiazides
are often the drugs of first choice. Hydrochlorothiazides are used for other conditions, but the
primary indication is hypertension.
The healthcare provider orders mannitol 72 gm infusion over 24 hours. The nurse plans to set the
infusion pump for how many grams per hour?
a. 1 gm
b. 2 gm
c. 3 gm
d. 4 gm - CORRECT ANSWER -c
, The nurse is caring for a patient with renal artery stenosis who has been prescribed benazepril
[Lotensin]. Which laboratory result indicates an adverse effect of this drug?
a. Potassium level of 3.2 mEq/L Incorrect
b. Blood glucose level of 180 mg/dL
c. Serum creatinine level of 2.3 mg/dL Correct
d. Uric acid level of 10 mg/dL - CORRECT ANSWER -c
Patients with bilateral renal artery stenosis are at increased risk for renal insufficiency and failure
with angiotensin-converting enzyme (ACE) inhibitors, such as benazepril. ACE inhibitors do not
typically cause hypokalemia, hyperglycemia, or hyperuricemia.
The renin-angiotensin-aldosterone system plays an important role in maintaining blood pressure.
Which compound in this system is most powerful at raising the blood pressure?
a. Angiotensin I
b. Angiotensin II
c. Angiotensin III
d. Renin - CORRECT ANSWER -b
Angiotensin II is a potent vasoconstrictor. It participates in all the pathways regulated by the
renin-angiotensin-aldosterone system. Angiotensin I is a precursor to angiotensin II; angiotensin
III is formed by degradation of angiotensin II and is less potent. Renin catalyzes the conversion
of angiotensinogen to angiotensin I.
The nurse is caring for a patient with bipolar disorder treated with lithium [Eskalith]. The patient
has a new prescription for captopril [Capoten] for hypertension. The combination of these two
drugs makes which assessment particularly important?
a. Potassium level
b. Lithium level
c. Creatinine level
d. Blood pressure - CORRECT ANSWER -b
ACE inhibitors, such as captopril, can cause lithium accumulation. Lithium levels should be
monitored on a regular basis. ACE inhibitors can cause hyperkalemia, renal insufficiency in
Exam Questions and CORRECT Answers
The nurse knows that diuretics mostly affect which function of the kidneys?
a. Cleansing and maintenance of extracellular fluid volume
b. Maintenance of acid-base balance
c. Excretion of metabolic waste
d. Elimination of foreign substances - CORRECT ANSWER -a
Most diuretics block sodium and chloride reabsorption, thus affecting the maintenance of
extracellular fluid volume.
The nurse plans to closely monitor for which clinical manifestation after administering
furosemide [Lasix]?
a. Decreased pulse
b. Decreased temperature
c. Decreased blood pressure
d. Decreased respiratory rate - CORRECT ANSWER -c
High-ceiling loop diuretics, such as furosemide, are the most effective diuretic agents. They
produce more loss of fluid and electrolytes than any others. A sudden loss of fluid can result in
decreased blood pressure. When blood pressure drops, the pulse probably will increase rather
than decrease. Lasix should not affect respiration or temperature. The nurse should also closely
monitor the patient's potassium level.
The nurse caring for a patient taking furosemide [Lasix] is reviewing the patient's most recent
laboratory results, which are: sodium, 136 mEq/L; potassium, 3.2 mEq/L; chloride, 100 mEq/L;
blood urea nitrogen, 15 mg/dL. What is the nurse's best action?
a. Administer Lasix as ordered.
b. Place the patient on a cardiac monitor.
c. Begin a 24-hour urine collection.
d. Hold the Lasix and notify the physician. - CORRECT ANSWER -d
,The nurse's best action is to hold the Lasix and notify the physician. Loop diuretics, such as
furosemide, can cause significant potassium loss. The normal potassium level is 3.5 to 5 mEq/L.
The remaining electrolyte levels are normal. Administering the Lasix could result in a critically
low potassium level. Effects of low potassium include cardiac dysrhythmias. Placing a patient on
a cardiac monitor requires a physician's order and would warrant further assessment first, such as
taking vital signs and asking the patient whether he or she is having any cardiac-related
symptoms. Collecting a 24-hour urine specimen is not appropriate in this case.
The nurse should monitor for which adverse effect after administering hydrochlorothiazide
[HydroDIURIL] and digoxin [Lanoxin] to a patient?
a. Digoxin toxicity
b. Decreased diuretic effect
c. Dehydration
d. Heart failure - CORRECT ANSWER -a
Digoxin levels have an inverse relationship with potassium levels. Because hydrochlorothiazide
can lower potassium levels, combined use of hydrochlorothiazide and digoxin poses a risk for
elevated digoxin levels and ensuing digoxin toxicity.
The nurse is caring for a patient with heart failure who needs a diuretic. Which agent is likely to
be chosen, because it has been shown to greatly reduce mortality in patients with heart failure?
a. Furosemide [Lasix]
b. Hydrochlorothiazide [HydroDIURIL]
b. Spironolactone [Aldactone]
d. Mannitol [Osmitrol] - CORRECT ANSWER -c
Spironolactone is a potassium-sparing diuretic used to treat both hypertension and edema. It is a
preferred drug in heart failure, because it has been shown to have a cardioprotective effect,
reducing mortality in patients with heart failure.
The nurse is teaching a patient who has a new prescription for spironolactone [Aldactone].
Which statement by the patient indicates that the teaching was effective?
a. "I will use salt substitutes to lower my sodium intake."
b. "I will increase my intake of foods that are high in potassium."
c. "I will call my doctor if I begin having menstrual irregularities."
,d. "I will take this medication at bedtime each evening." - CORRECT ANSWER -c
Spironolactone is a potassium-sparing, aldosterone-blocking diuretic. As such, it can cause
endocrine effects, such as gynecomastia, menstrual irregularities, impotence, hirsutism, and
deepening of the voice. Patients taking spironolactone should avoid salt substitutes because they
contain potassium, and high-potassium foods should be avoided with this drug. Ideally, all
diuretics should be taken in the morning to prevent nocturia.
The healthcare provider orders furosemide [Lasix] 20 mg IV twice daily. The medication
available is furosemide [Lasix] 10 mg/mL. How many mL will the nurse administer with each
dose?
a. 0.5 mL
b. 1 mL
c. 2 mL
d. 4 mL - CORRECT ANSWER -c
The nurse is reviewing the home medication list with the patient. The nurse recognizes that
hydrochlorothiazide is used primarily for which condition?
a. Hypertension
b. Edema
c. Diabetes insipidus
d. Protection against postmenopausal osteoporosis - CORRECT ANSWER -a
The primary indication for hydrochlorothiazide is hypertension, a condition for which thiazides
are often the drugs of first choice. Hydrochlorothiazides are used for other conditions, but the
primary indication is hypertension.
The healthcare provider orders mannitol 72 gm infusion over 24 hours. The nurse plans to set the
infusion pump for how many grams per hour?
a. 1 gm
b. 2 gm
c. 3 gm
d. 4 gm - CORRECT ANSWER -c
, The nurse is caring for a patient with renal artery stenosis who has been prescribed benazepril
[Lotensin]. Which laboratory result indicates an adverse effect of this drug?
a. Potassium level of 3.2 mEq/L Incorrect
b. Blood glucose level of 180 mg/dL
c. Serum creatinine level of 2.3 mg/dL Correct
d. Uric acid level of 10 mg/dL - CORRECT ANSWER -c
Patients with bilateral renal artery stenosis are at increased risk for renal insufficiency and failure
with angiotensin-converting enzyme (ACE) inhibitors, such as benazepril. ACE inhibitors do not
typically cause hypokalemia, hyperglycemia, or hyperuricemia.
The renin-angiotensin-aldosterone system plays an important role in maintaining blood pressure.
Which compound in this system is most powerful at raising the blood pressure?
a. Angiotensin I
b. Angiotensin II
c. Angiotensin III
d. Renin - CORRECT ANSWER -b
Angiotensin II is a potent vasoconstrictor. It participates in all the pathways regulated by the
renin-angiotensin-aldosterone system. Angiotensin I is a precursor to angiotensin II; angiotensin
III is formed by degradation of angiotensin II and is less potent. Renin catalyzes the conversion
of angiotensinogen to angiotensin I.
The nurse is caring for a patient with bipolar disorder treated with lithium [Eskalith]. The patient
has a new prescription for captopril [Capoten] for hypertension. The combination of these two
drugs makes which assessment particularly important?
a. Potassium level
b. Lithium level
c. Creatinine level
d. Blood pressure - CORRECT ANSWER -b
ACE inhibitors, such as captopril, can cause lithium accumulation. Lithium levels should be
monitored on a regular basis. ACE inhibitors can cause hyperkalemia, renal insufficiency in
