RESEARCHED
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 qof q140/78 qmm qHg. qWhich
qaction qwill qthe qnurse qtake?
a. Administer qthe qmedications qand qrequest qan qorder qfor qserum qelectrolytes.
b. Give qboth qmedications qand qevaluate qserum qblood qglucose qfrequently.
c. Hold qthe qdigoxin qand qnotify qthe qprovider.
d. Hold qthe qhydrochlorothiazide qand qnotify qthe qprovider. q- qCORRECT q ANSWER q-ANS: qC
,When qthiazide qdiuretics qare qtaken qwith qdigoxin, qpatients qare qat qrisk qof qdigoxin qtoxicity
qbecause qthiazides qcan qcause qhypokalemia. qThe qpatient qhas qbradycardia qand qblurred
qvision, qwhich qare qboth qsigns qof qdigoxin qtoxicity. qThe qnurse qshould qhold qthe qdigoxin
qand qnotify qthe qprovider. qSerum qelectrolytes qmay qbe qordered, qbut qthe qdigoxin qshould
qnot qbe qgiven.
DIF: qCOGNITIVE qLEVEL: qApplying q(Application) qREF:
qPage q623 qTOP: qNURSING qPROCESS: qNursing
qIntervention/Evaluation qMSC: qNCLEX: qPhysiological
qIntegrity: qPathophysiology
3. The qnurse qis qteaching qa qpatient qabout qtaking qhydrochlorothiazide. qWhich qstatement
qby qthe qpatient qindicates qa qneed qfor qfurther qteaching?
a. I qmay qneed qextra qsodium qand qcalcium qwhile qtaking qthis qdrug.
b. I qshould qeat qplenty qof qfruits qand qvegetables qwhile qtaking qthis qmedication.
c. I qshould qtake qcare qwhen qrising qfrom qa qbed qor qchair qwhen qIm qon qthis qmedication.
d. I qwill qtake qthe qmedication qin qthe qmorning qto qminimize qcertain qside qeffects. q-
qCORRECT q ANSWER q-ANS: qA
Patients qdo qnot qneed qextra qsodium qor qcalcium qwhile qtaking qthiazide qdiuretics.
Thiazide qdiuretics qcan qlead qto qhypokalemia, qso qpatients qshould qbe qcounseled qto qeat
qfruits qand qvegetables qthat qare qhigh qin qpotassium. qPatients qcan qdevelop qorthostatic
qhypotension qand qshould qbe qcounseled qto qrise qfrom qsitting qor qlying qdown qslowly.
qTaking qthe qmedication qin qthe qmorning qhelps qto qprevent qnocturia- qinduced qinsomnia.
DIF: qCOGNITIVE qLEVEL: qApplying q(Application) qREF:
qPage q624 qTOP: qNURSING qPROCESS: qNursing
qIntervention: qPatient qTeaching
MSC: qNCLEX: qPhysiological qIntegrity: qPharmacological qand qParenteral qTherapies
4. The qnurse qis qcaring qfor qa qpatient qwho qis qto qbegin qreceiving qa qthiazide qdiuretic qto
qtreat qheart qfailure. qWhen qperforming qa qhealth qhistory qon qthis qpatient, qthe qnurse qwill
qbe qconcerned qabout qa qhistory qof qwhich qcondition?
, a. Asthma
b. Glaucoma
c. Gout
d. Hypertension q- qCORRECT q ANSWER q-ANS: qC
Thiazides qblock quric qacid qsecretion qand qelevated qlevels qcan qcontribute qto qgout. qPatients
qwith qa qhistory qof qgout qshould qtake qthiazide qdiuretics qwith qcaution; qthey qmay qneed
qbehavioral qand/or qpharmacologic qchanges qto qtheir qgout qtreatment.
DIF: qCOGNITIVE qLEVEL: qApplying q(Application) qREF:
qPage q626 qTOP: qNURSING qPROCESS: qAssessment
MSC: qNCLEX: qPhysiological qIntegrity: qPharmacological qand qParenteral qTherapies
5. The qnurse qis qcaring qfor qa qpatient qwho qdevelops qmarked qedema qand qa qlow qurine
qoutput qas qa qresult qof qheart qfailure. qWhich qmedication qwill qthe qnurse qexpect qthe
qprovider qto qorder qfor qthis qpatient?
a. Digoxin q(Lanoxin)
b. Furosemide q(Lasix)
c. Hydrochlorothiazide q(HydroDIURIL)
d. Spironolactone q(Aldactone) q- qCORRECT q ANSWER q-ANS: qB
Furosemide qis qa qloop qdiuretic qand qis qgiven qwhen qthe qpatients qcondition qwarrants
qimmediate qremoval qof qbody qfluid, qas qin qheart qfailure. qDigoxin qimproves qcardiac
qfunction qbut qdoes qnot qremove qfluid qquickly. qThe qother qdiuretics qmay qbe qused qwhen
qimmediate qfluid qremoval qis qnot qnecessary.
DIF: qCOGNITIVE qLEVEL: qApplying q(Application) qREF:
qPage q627 qTOP: qNURSING qPROCESS: qNursing
qIntervention
MSC: qNCLEX: qPhysiological qIntegrity: qPharmacological qand qParenteral qTherapies
6. The qnurse qis qcaring qfor qa qpatient qwho qis qreceiving qfurosemide q(Lasix) qand qan
qaminoglycoside qantibiotic. qThe qnurse qwill qbe qmost qconcerned qif qthe qpatient qreports
qwhich qsymptom?
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 qof q140/78 qmm qHg. qWhich
qaction qwill qthe qnurse qtake?
a. Administer qthe qmedications qand qrequest qan qorder qfor qserum qelectrolytes.
b. Give qboth qmedications qand qevaluate qserum qblood qglucose qfrequently.
c. Hold qthe qdigoxin qand qnotify qthe qprovider.
d. Hold qthe qhydrochlorothiazide qand qnotify qthe qprovider. q- qCORRECT q ANSWER q-ANS: qC
,When qthiazide qdiuretics qare qtaken qwith qdigoxin, qpatients qare qat qrisk qof qdigoxin qtoxicity
qbecause qthiazides qcan qcause qhypokalemia. qThe qpatient qhas qbradycardia qand qblurred
qvision, qwhich qare qboth qsigns qof qdigoxin qtoxicity. qThe qnurse qshould qhold qthe qdigoxin
qand qnotify qthe qprovider. qSerum qelectrolytes qmay qbe qordered, qbut qthe qdigoxin qshould
qnot qbe qgiven.
DIF: qCOGNITIVE qLEVEL: qApplying q(Application) qREF:
qPage q623 qTOP: qNURSING qPROCESS: qNursing
qIntervention/Evaluation qMSC: qNCLEX: qPhysiological
qIntegrity: qPathophysiology
3. The qnurse qis qteaching qa qpatient qabout qtaking qhydrochlorothiazide. qWhich qstatement
qby qthe qpatient qindicates qa qneed qfor qfurther qteaching?
a. I qmay qneed qextra qsodium qand qcalcium qwhile qtaking qthis qdrug.
b. I qshould qeat qplenty qof qfruits qand qvegetables qwhile qtaking qthis qmedication.
c. I qshould qtake qcare qwhen qrising qfrom qa qbed qor qchair qwhen qIm qon qthis qmedication.
d. I qwill qtake qthe qmedication qin qthe qmorning qto qminimize qcertain qside qeffects. q-
qCORRECT q ANSWER q-ANS: qA
Patients qdo qnot qneed qextra qsodium qor qcalcium qwhile qtaking qthiazide qdiuretics.
Thiazide qdiuretics qcan qlead qto qhypokalemia, qso qpatients qshould qbe qcounseled qto qeat
qfruits qand qvegetables qthat qare qhigh qin qpotassium. qPatients qcan qdevelop qorthostatic
qhypotension qand qshould qbe qcounseled qto qrise qfrom qsitting qor qlying qdown qslowly.
qTaking qthe qmedication qin qthe qmorning qhelps qto qprevent qnocturia- qinduced qinsomnia.
DIF: qCOGNITIVE qLEVEL: qApplying q(Application) qREF:
qPage q624 qTOP: qNURSING qPROCESS: qNursing
qIntervention: qPatient qTeaching
MSC: qNCLEX: qPhysiological qIntegrity: qPharmacological qand qParenteral qTherapies
4. The qnurse qis qcaring qfor qa qpatient qwho qis qto qbegin qreceiving qa qthiazide qdiuretic qto
qtreat qheart qfailure. qWhen qperforming qa qhealth qhistory qon qthis qpatient, qthe qnurse qwill
qbe qconcerned qabout qa qhistory qof qwhich qcondition?
, a. Asthma
b. Glaucoma
c. Gout
d. Hypertension q- qCORRECT q ANSWER q-ANS: qC
Thiazides qblock quric qacid qsecretion qand qelevated qlevels qcan qcontribute qto qgout. qPatients
qwith qa qhistory qof qgout qshould qtake qthiazide qdiuretics qwith qcaution; qthey qmay qneed
qbehavioral qand/or qpharmacologic qchanges qto qtheir qgout qtreatment.
DIF: qCOGNITIVE qLEVEL: qApplying q(Application) qREF:
qPage q626 qTOP: qNURSING qPROCESS: qAssessment
MSC: qNCLEX: qPhysiological qIntegrity: qPharmacological qand qParenteral qTherapies
5. The qnurse qis qcaring qfor qa qpatient qwho qdevelops qmarked qedema qand qa qlow qurine
qoutput qas qa qresult qof qheart qfailure. qWhich qmedication qwill qthe qnurse qexpect qthe
qprovider qto qorder qfor qthis qpatient?
a. Digoxin q(Lanoxin)
b. Furosemide q(Lasix)
c. Hydrochlorothiazide q(HydroDIURIL)
d. Spironolactone q(Aldactone) q- qCORRECT q ANSWER q-ANS: qB
Furosemide qis qa qloop qdiuretic qand qis qgiven qwhen qthe qpatients qcondition qwarrants
qimmediate qremoval qof qbody qfluid, qas qin qheart qfailure. qDigoxin qimproves qcardiac
qfunction qbut qdoes qnot qremove qfluid qquickly. qThe qother qdiuretics qmay qbe qused qwhen
qimmediate qfluid qremoval qis qnot qnecessary.
DIF: qCOGNITIVE qLEVEL: qApplying q(Application) qREF:
qPage q627 qTOP: qNURSING qPROCESS: qNursing
qIntervention
MSC: qNCLEX: qPhysiological qIntegrity: qPharmacological qand qParenteral qTherapies
6. The qnurse qis qcaring qfor qa qpatient qwho qis qreceiving qfurosemide q(Lasix) qand qan
qaminoglycoside qantibiotic. qThe qnurse qwill qbe qmost qconcerned qif qthe qpatient qreports
qwhich qsymptom?
