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