NURS 505 Exam 2 Prep Questions With 100% Correct Answers 2024, Exams of Advanced Education

Download NURS 505 Exam 2 Prep Questions With 100% Correct Answers 2024 and more Exams Advanced Education in PDF only on Docsity! NURS 505 Exam 2 Prep Questions With 100% Correct Answers 2024 A patient with a longstanding diagnosis of chronic renal failure has experienced a significant decline in urine output in recent days, prompting him to seek care at a local clinic. A nurse at the clinic has suggested to a colleague that the administration of a diuretic such as hydrochlorothiazide may improve the patient's urine output. How should the colleague best respond to this suggestion? a) "That would probably help, but we'd have to do blood work first." b) "Actually, patients with renal failure usually can't take hydrochlorothiazide." c) "That would only work if he could come in twice a day to get it intravenously." d) "Maybe, but hydrochlorothiazide affects the bladder more than the kidneys." - Correct Answer-b) "Actually, patients with renal failure usually can't take hydrochlorothiazide." Renal disease and severe renal impairment contraindicate the use of hydrochlorothiazide. HCTZ affects the kidneys, not the bladder, and is not administered intravenously. The nurse is seeing a pregnant client who has a confirmed urinary tract infection that requires treatment. Which anti- infective medication should the nurse anticipate will be prescribed for this client? a) methenamine b) nitrofurantoin c) tartrazine d) phenazopyridine - Correct Answer-b) nitrofurantoin Anti-infectives are contraindicated in patients with a hypersensitivity to the drugs and during pregnancy (pregnancy category C) and lactation. One exception is nitrofurantoin, which is classified as a pregnancy category B drug and is used with caution during pregnancy. Tartrazine is not an anti- infective but a food dye that is added to the anti-infective medication methenamine. What best describes the structure of the kidneys? a) The renal pelvises drain urine into the ureters. d) "I have reddish-orange urine." - Correct Answer-a) "I slept uninterrupted through the night." Patients with symptoms of overactive bladder commonly report their sleep is interrupted by a need to urinate. The effective antispasmodic would reduce nightly interruptions. The other options all list possible adverse effects of urinary tract medications. Which would the nurse expect to find in a client receiving acetazolamide? a) Metabolic alkalosis b) Metabolic acidosis c) Respiratory acidosis d) Respiratory alkalosis - Correct Answer-b) Metabolic acidosis Metabolic acidosis is a relatively common and potentially dangerous effect that occurs when bicarbonate is lost due to the action of carbonic anhydrase inhibitors. Metabolic alkalosis would occur if bicarbonate were retained. No respiratory acid-base imbalances are associated with this drug. A nurse is caring for an elderly patient with a UTI. Which assessment should the nurse perform while caring for this patient? a) Document symptoms of the patient's condition. b) Monitor the patient's vital signs every four hours. c) Document the patient's urine output every hour. d) Assess the patient for bladder distension. - Correct Answer- b) monitor the patient's vital signs every four hours When caring for a patient with UTI undergoing urinary tract anti-infective drug therapy, the nurse should monitor vital signs of the patient every four hours after administration of the drug or as ordered by the primary health care provider. Any significant rise in body temperature is reported to the primary health care provider because the methods of reducing the fever or culture and sensitivity tests may need to be repeated. The nurse should document the symptoms experienced by the patient and assess the patient for bladder distension as part of the pre-administration assessment before administering the drug to the patient. The nurse need not document the patient's urine output every hour or monitor the patient's respiratory rate in this case. A client with a urinary tract infection (UTI) has a new prescription for nitrofurantoin. The nurse would question this order if the client has a history of: a) chronic UTI. b) hypertension. c) glaucoma d) renal dysfunction. - Correct Answer-d) renal dysfunction The urinary tract antiseptic nitrofurantoin is commonly prescribed for chronic UTI, because it is concentrated in the urine with minimal systemic effect. It does not affect blood pressure or glaucoma. Because it is concentrated in the urine, it should be used cautiously with clients experiencing renal dysfunction. The nursing instructor is teaching a session explaining the various drugs used to treat urinary tract infections. The instructor determines the session is successful when the students correctly choose which organ as most often affected by infections? d) Increased blood pressure - Correct Answer-c) decreased cardiac output Decreased cardiac output is an effect of hypothyroidism. Low- grade fever, nervousness and restlessness, and increased systolic blood pressure are among the effects of hyperthyroidism. The nurse assesses a client receiving furosemide for: a) Acidosis b) Hypercalcemia c) Hypotension d) Hypoglycemia - Correct Answer-c) Hypotension Use of furosemide can lead to hypotension due to fluid loss, alkalosis due to loss of bicarbonate, hypocalcemia due to loss of calcium, and hyperglycemia (with long-term use) due to diuretic effect on glucose levels. Which medication exerts its effects by depressing the reabsorption of sodium in the kidney tubules, thereby increasing sodium and water excretion? a) Triamterene b) Furosemide c) Hydrochlorothiazide d) Acetazolamide - Correct Answer-a) Triamterene Triamterene is a potassium-sparing diuretic that exerts its effect by depressing the reabsorption of sodium in the kidney tubules, thereby increasing sodium and water excretion. Furosemide is a loop diuretic which inhibits reabsorption of sodium and chloride in the distal and proximal tubules of the kidney and in the loop of Henle. Hydrochlorothiazide inhibits the reabsorption of sodium and chloride ions in the ascending portion of the loop of Henle and the early distal tubule of the nephron. This action results in the excretion of sodium, chloride, and water. Acetazolamide is a carbonic anhydrase inhibitor and is a sulfonamide, without bacteriostatic action, that inhibits the enzyme carbonic anhydrase. Carbonic anhydrase inhibition results in the excretion of sodium, potassium, bicarbonate, and water.