renal/diuretics
A patient prescribed furosemide is at risk for which electrolyte imbalance?
A. Hyperkalemia
B. Hypokalemia
C. Hypernatremia
D. Hypocalcemia
Answer: B. Hypokalemia
Rationale: Loop diuretics increase potassium excretion, raising the risk of hypokalemia.
Which lab value requires immediate intervention in a patient on furosemide?
A. Sodium 142 mEq/L
B. Potassium 2.9 mEq/L
C. Glucose 120 mg/dL
D. BUN 18 mg/dL
Answer: B. Potassium 2.9 mEq/L
Rationale: Severe hypokalemia increases risk of arrhythmias.
Which diuretic is the drug of choice for acute pulmonary edema?
A. Mannitol
B. Furosemide
C. Hydrochlorothiazide
D. Spironolactone
Answer: B. Furosemide
Rationale: Loop diuretics rapidly reduce fluid overload in pulmonary edema.
Which vitamin deficiency causes scurvy?
A. Vitamin A
B. Vitamin B12
C. Vitamin C
D. Vitamin D
Answer: C. Vitamin C
Rationale: Vitamin C deficiency causes scurvy (bleeding gums, poor wound healing).
Which IV fluid is isotonic?
B. 0.9% Normal Saline
D. 0.45% Normal Saline
A. 3% Normal Saline
C. D5W
Answer: B. 0.9% Normal Saline
Rationale: Normal saline has equal osmolarity to plasma, making it isotonic.
Which finding indicates hydrochlorothiazide is effective?
A. Blood pressure decreased from 160/90 to 130/80 mmHg
B. Urine output decreased from 1500 mL to 800 mL in 24 hr
C. Serum potassium decreased from 4.2 to 3.0 mEq/L
D. Patient reports dizziness when standing
Answer: A. Blood pressure decreased from 160/90 to 130/80 mmHg
Rationale: Thiazide diuretics are primarily used for hypertension management.
Which assessment finding indicates mannitol is effective in a patient with increased intracranial pressure (ICP)?
A. Decreased urine output
B. Decreased ICP
C. Decreased potassium levels
D. Decreased blood glucose
Answer: B. Decreased ICP
Rationale: Mannitol is an osmotic diuretic that reduces intracranial pressure.
Which symptom suggests hypokalemia from diuretic therapy?
A. Muscle weakness
B. Increased reflexes
C. Bradycardia
D. Confusion
Answer: A. Muscle weakness
Rationale: Hypokalemia causes muscle weakness and cramps.
Which patient is most at risk for vitamin B12 deficiency?
A. A patient with liver disease
B. A patient with chronic alcohol use
C. A patient with hypothyroidism
D. A patient with pernicious anemia
Answer: d. A patient with pernicious anemia
Rationale: Pernicious anemia prevents absorption of B12 due to lack of intrinsic factor.
Which vitamin deficiency causes rickets in children?
A. Vitamin A
B. Vitamin C
C. Vitamin D
D. Vitamin K
Answer: C. Vitamin D
Rationale: Lack of vitamin D leads to poor bone mineralization and rickets.
Which diuretic is contraindicated in a patient with hyperkalemia?
A. Furosemide
B. Hydrochlorothiazide
C. Mannitol
D. Spironolactone
Answer: D. Spironolactone
Rationale: Spironolactone is potassium-sparing and can worsen hyperkalemia.
Which condition is a contraindication for mannitol use?
A. Glaucoma
B. Intracranial hemorrhage
C. Cerebral edema
D. Hypertension
Answer: B. Intracranial hemorrhage
Rationale: Osmotic diuretics can worsen bleeding by increasing blood flow.
Which condition is BEST treated with thiazide diuretics?
A. Hypertension
B. Acute pulmonary edema
C. Increased ICP
D. Severe renal failure
Answer: A. Hypertension
Rationale: Thiazides are first-line therapy for mild hypertension.
Folic acid supplementation is essential for which patient group?
B. Elderly men
C. Women of childbearing age
D. Patients with hypertension
A. Athletes
Answer: C. Women of childbearing age
Rationale: Folic acid prevents neural tube defects during pregnancy.
Which mineral is essential for nerve and muscle function?
B. Sodium
A. Magnesium
D. Chloride
C. Phosphorus
Answer: A. Magnesium
Rationale: Magnesium stabilizes neuromuscular excitability and cardiac function.
Which patient teaching is MOST important for a patient taking loop diuretics?
A. Avoid foods high in potassium
B. Report ringing in the ears
C. Expect increased blood glucose levels
D. Limit fluid intake to 500 mL/day
Answer: B. Report ringing in the ears
Rationale: Loop diuretics can cause ototoxicity, so tinnitus should be reported.
A patient on spironolactone should avoid which food?
A. Apples
B. Bananas
C. Grapes
D. Strawberries
Answer: B. Bananas
Rationale: Bananas are high in potassium; spironolactone increases K retention, risking hyperkalemia.
A nurse is reviewing labs for a patient on diuretics. Which finding is concerning?
A. Sodium 135 mEq/L
B. Potassium 5.8 mEq/L
C. Calcium 9.0 mg/dL
D. BUN 20 mg/dL
Answer: B. Potassium 5.8 mEq/L
Rationale: Hyperkalemia is dangerous and can cause cardiac dysrhythmias.
Which vitamin is necessary for calcium absorption?
B. Vitamin A
A. Vitamin D
D. Vitamin E
C. Vitamin K
Answer: A. Vitamin D
Rationale: Vitamin D promotes calcium absorption in the gut.
A patient receiving IV calcium should be monitored for:
A. Respiratory depression
B. hypertension
C. Tachycardia
D. Hypotension
Answer: B. Hypotension
Rationale: Rapid calcium infusion can cause bradycardia and hypotension.
A patient on acetazolamide should be monitored for:
A. Respiratory acidosis
B. Metabolic acidosis
C. Hypoglycemia
D. Hypercalcemia
Answer: B. Metabolic acidosis
Rationale: Carbonic anhydrase inhibitors increase bicarbonate excretion, leading to metabolic acidosis.
Which nursing action is priority before giving furosemide IV?
A. Check bowel sounds
B. Assess blood pressure
C. Assess skin turgor
D. Check pedal pulses
Answer: B. Assess blood pressure
Rationale: Loop diuretics can cause significant hypotension.
Which teaching is MOST appropriate for a patient starting hydrochlorothiazide?
A. Take medication at bedtime
B. Limit fluid intake to 1000 mL/day
C.Rise slowly from sitting or lying positions
D. Avoid all dairy products
Answer: C. Rise slowly from sitting or lying positions
Rationale: Thiazides can cause orthostatic hypotension; safety is key.
Which electrolyte should NEVER be given IV push?
A. Sodium
B. Potassium
C. Magnesium
D. Calcium
Answer: B. Potassium
Rationale: IV push potassium can cause cardiac arrest.
Which vitamin enhances clotting factors?
A. Vitamin A
B. Vitamin D
C. Vitamin E
D. Vitamin K
Answer: D. Vitamin K
Rationale: Vitamin K is necessary for synthesis of clotting factors II, VII, IX, and X.