NUR 2474 Exam 2: Pharmacology for Professional Nursing Exam 2 (Latest 2024 / 2025) Rasmussen
Chapter-41 Questions 1.ID: 7 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 n...
Question:
1. 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 (Aldactone)
Answer:
a.Furosemide (Lasix)
Furosemide, a potent diuretic, is used when rapid or massive mobilization of
fluids is needed. This patient shows severe signs of congestive heart failure
with respiratory distress and pulmonary edema and needs immediate
mobilization of fluid. Hydrochlorothiazide and spironolactone are not
indicated for pulmonary edema, because their diuretic effects are less rapid.
Mannitol is indicated for patients with increased intracranial pressure and
must be discontinued immediately if signs of pulmonary congestion or heart
failure occur.
,Question:
2. 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
Answer:
c.Potassium level of 3.5 mEq/L
This patient has an irregular, rapid heartbeat that might be caused by a
dysrhythmia. This patient's serum potassium level is low, which can trigger
fatal dysrhythmias, especially in patients taking digoxin. Furosemide
contributes to loss of potassium through its effects on the distal nephron.
Potassium-sparing diuretics often are used in conjunction with furosemide
to prevent this complication. This patient's serum glucose and sodium levels
are normal and of no concern at this point, although they can be affected by
furosemide. The oxygen saturation is somewhat low and needs to be
monitored, although it may improve with diuresis.
,Question:
3. A patient has 2+ pitting edema of the lower extremities bilaterally.
Auscultation of the lungs reveals crackles bilaterally, and the serum
potassium level is 6 mEq/L. Which diuretic agent ordered by the
prescriber should the nurse question?
a.Bumetanide (Bumex)
b.Furosemide (Lasix)
c.Spironolactone (Aldactone)
d.Hydrochlorothiazide (HydroDIURIL)
Answer:
c.Spironolactone (Aldactone)
Spironolactone is a non-potassium-wasting diuretic; therefore, if the patient
has a serum potassium level of 6 mEq/L, indicating hyperkalemia, an order
for this drug should be questioned. Bumetanide, furosemide, and
hydrochlorothiazide are potassium-wasting diuretics and would be
appropriate to administer in a patient with hyperkalemia.
Question:
4. 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 (Aldactone). 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 mg/dL. 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).
Answer:
c.Contact the provider to report the laboratory values.
Spironolactone should not be administered with ACE inhibitors, which can
also elevate potassium levels. Because the potassium level is elevated, the
nurse should not administer the medication and should obtain clarification
of the order. There is no need to repeat the potassium level test that was just
done this morning. Requesting an order for furosemide is appropriate only
after the provider has been notified of the laboratory values.
Question:
5. 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 (HydroDIURIL)
d.Spironolactone (Aldactone)
Answer:
d.Spironolactone (Aldactone)
Spironolactone is used in conjunction with furosemide because of its
potassium-sparing effects. Furosemide can contribute to hypokalemia, which
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