A patient is brought to the emergency department with shortness of breath, a respiratory
rate of 30 breaths per minute, intercostal retractions, and frothy, pink sputum. The nurse
caring for this patient
will expect to administer which drug?
A) Furosemide (Lasix)
B) Hydrochlorothiazide (HydroD...
A patient is brought to the emergency department with shortness of breath, a respiratory
rate of 30 breaths per minute, intercostal retractions, and frothy, pink sputum. The nurse
caring for this patient
will expect to administer which drug?
A) Furosemide (Lasix)
B) Hydrochlorothiazide (HydroDIURIL)
C) Mannitol (Osmitrol)
D) Spironolactone (Aidactone)
A) Furosemide (Lasix)
A patient who is taking digoxin is admitted to the hospital for treatment of congestive
heart failure. The prescriber has ordered furosemide (Lasix). The nurse notes an
irregular heart rate of 86 beats per minute, a respiratory rate of 22 breaths per minute,
and a blood pressure of 130/82 mm Hg. The nurse auscultates crackles in both lungs.
Which laboratory value causes the nurse the most concern?
A) Blood glucose level of 120 mg/dL
B) Oxygen saturation of 90%
C) Potassium level of 3.5 mEq/L
D) Sodium level of 140 mEq/L
C) Potassium level of 3.5 mEq/L
A patient has 2+ pitting edema of the tower extremities bilaterally. Auscultation of the
lungs reveals crackles bilaterally, and the serum potassium level is 6 mEqjL. Which
diuretic agent ordered by the prescriber should the nurse question?
A) Bumetanide (Bumex)
B) Furosemide (Lasix)
C) Spironolactone (Aidactone)
D) Hydrochlorothiazide (HydroDIURIL)
C) Spironolactone (Aidactone)
A nurse preparing to administer morning medications notes that a patient with a history
of hypertension has been prescribed the angiotensin-converting enzyme (ACE) inhibitor
captopril (Capoten) concurrently with spironolactone (Aidactone). Morning laboratory
results reveal a serum sodium level of 144 mg/dL, a serum potassium level of 5.1
mEq/L, and a blood glucose level of 128 mgjdL. Which intervention is appropriate?
A) Administer the medications as ordered.
B) Ask the patient about the use of salt substitutes.
C) Contact the provider to report the laboratory values.
D) Request an order for furosemide (Lasix).
C) Contact the provider to report the laboratory values.
,A patient with hypertension is taking furosemide {Lasix) for congestive heart failure. The
prescriber orders digoxin to help increase cardiac output. What other medication will the
nurse expect to be ordered for this patient?
A) Bumetanide (Bumex)
B) Chlorothiazide (Diuril)
C) Hydrochlorothiazide (HydroDIURjL)
D) Spironolactone (Aidactone)
D) Spironolactone (Aidactone)
A patient who was in a motor vehicle accident sustained a severe head injury and is
brought into the emergency department. The provider orders intravenous mannitol
(Osmitrol). The nurse knows that this is given to:
A) reduce intracranial pressure.
B) reduce renal perfusion.
C) reduce peripheral edema.
D) restore extracellular fluid.
A) reduce intracranial pressure.
A patient is taking gentamicin (Garamycin) and furosemide (Lasix). The nurse should
counsel this patient to report which symptom?
A) Frequent nocturia
B) Headaches
C) Ringing in the ears
D) Urinary retention
C) Ringing in the ears
An older adult patient with congestive heart failure develops crackles in both lungs and
pitting edema of all extremities. The physician orders hydrochlorothiazide
(HydroDIURIL). Before administering this medication, the nurse reviews the patient's
chart. Which laboratory value causes the nurse the most concern?
A) Elevated creatinine clearance
B) Elevated serum potassium level
C) Normal blood glucose level
D) Low levels of low-density lipoprotein (LDL) cholesterol
A) Elevated creatinine clearance
A patient with chronic congestive heart failure has repeated hospitalizations in spite of
ongoing treatment with hydrochlorothiazide (HydroDIURIL) and digoxin. The prescriber
has ordered spironolactone (Aidactone) to be added to this patient's drug regimen, and
the nurse provides education about this medication. Which statement by the patient
indicates understanding of the teaching?
A) "I can expect improvement within a few hours after taking this drug."
B) "I need to stop taking potassium supplements."
,C) "I should use salt substitutes to prevent toxic side effects."
D) "I should watch closely for dehydration."
B) "I need to stop taking potassium supplements."
A patient with hypertension is prescribed an angiotensin-converting enzyme (ACE)
inhibitor. The nurse reviewing this patient's chart before administering the medication
will be most concerned about which other disease process?
A) Bronchial asthma
B) Coronary artery disease
C) Diabetes mellitus
D) Renal artery stenosis
D) Renal artery stenosis
A nurse administers an ACE inhibitor to a patient who is taking the drug for the first time.
What will the nurse do?
A) Instruct the patient not to get up without assistance.
B) Make sure the patient takes a potassium supplement.
C) Report the presence of a dry cough to the prescriber.
D) Request an order for a diuretic to counter the side effects of the ACE inhibitor.
A) Instruct the patient not to get up without assistance.
A patient who has been taking an antihypertensive medication for several years is
recovering from a myocardial infarction. The prescriber changes the patient's
medication to an ACE inhibitor. The patient asks the nurse why a new drug is necessary.
What is the nurse's response?
A) "ACE inhibitors can prevent or reverse pathologic changes in the heart's structure."
B) "ACE inhibitors help lower LDL cholesterol and raise HDL cholesterol."
C) "ACE inhibitors increase venous return to the heart, improving cardiac output."
D) "ACE inhibitors regulate electrolytes that affect the cardiac rhythm."
A) "ACE inhibitors can prevent or reverse pathologic changes in the heart's structure."
A prescriber orders ramipril (Altace) for an obese patient with type 2 diabetes mellitus
who has developed hypertension. The nurse provides teaching before dismissing the
patient home. Which statement by the patient indicates understanding of the teaching?
A) "I am less likely to develop diabetic nephropathy when taking this medication."
B) "I should check my blood sugar more often, because hyperglycemia is a side effect
of this drug."
C) "Taking this medication helps reduce my risk of stroke and heart attack."
D) "This medication will probably prevent the development of diabetic retinopathy."
C) "Taking this medication helps reduce my risk of stroke and heart attack."
, A patient begins taking an ACE inhibitor and complains of a dry cough. What does the
nurse correctly tell the patient about this symptom?
A) It indicates that a serious side effect has occurred.
B) It is a common side effect that occurs in almost all patients taking the drug.
C) It may be uncomfortable enough that the drug will need to be discontinued.
D) It occurs frequently in patients taking the drug but will subside over time.
C) It may be uncomfortable enough that the drug will need to be discontinued.
A patient with hypertension who has been taking captopril (Capoten) for several months
is admitted to the hospital. The patient reports that food "tastes funny." What will the
nurse do?
A) Compare the patient's admission weight to a previous weight.
B) Notify the provider to request a different antihypertensive medication.
C) Reassure the patient that this is a temporary side effect of the drug.
D) Request an order for a white blood cell count (WBC) with differential.
A) Compare the patient's admission weight to a previous weight.
A nurse is reviewing a patient's medications before administration. Which drug-to-drug
interactions should most concern the nurse in a patient with a history of heart failure and
a potassium level of 5.5 mEq/L?
A) Furosemide (Lasix) and enalapril (Vasotec)
B) Amlodipine (Norvasc) and spironolactone (Aidactone)
C) Eplerenone (Inspra) and spironolactone (Aidactone)
D) Metoprolol (Lopressor) and furosemide (Lasix)
C) Eplerenone (Inspra) and spironolactone (Aidactone)
A patient who is taking furosemide (Lasix) and digoxin will begin taking captopril
(Capoten). The nurse is providing information about the drug. Which statement by the
patient indicates a need for further teaching?
A) "I can use acetaminophen for analgesia if needed."
B) "I should stop taking the Lasix about a week before starting the Capoten."
C) "I should take this medication on a full stomach."
D) "I will need to have blood tests done every 2 weeks for a few months."
C) "I should take this medication on a full stomach."
A patient who stops taking an ACE inhibitor because of its side effects will begin taking
an angiotensin II receptor blocker (ARB) medication. Which side effect of ACE inhibitors
will not occur with an ARB medication?
A) Angioedema
B) Cancer
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