Renal Meds Review Questions
A client who has a cold is seen in the emergency department with an inability to void.
Because the client has a history of
... [Show More] benign prostatic hyperplasia, the nurse determines that
the client should be questioned about the use of which medication?
1. Diuretics
2. Antibiotics
3. Antitussives
4. Decongestants
Rationale:
In the client with benign prostatic hyperplasia, episodes of urinary retention can be
triggered by certain medications, such as decongestants, anticholinergics, and
antidepressants. The client should be questioned about the use of these medications if the
client has urinary retention. Retention also can be precipitated by other factors, such as
alcoholic beverages, infection, bed rest, and becoming chilled.
1. Nitrofurantoin (Macrodantin) is prescribed for a client with a urinary tract
infection. The client contacts the nurse and reports a cough, chills, fever, and
difficulty breathing. The nurse should make which interpretation about the
client's complaints?
1. The client may have contracted the flu.
2. The client is experiencing anaphylaxis.
3. The client is experiencing expected effects of the medication.
4. The client is experiencing a pulmonary reaction requiring
cessation of the medication.
Rationale:
Nitrofurantoin can induce two kinds of pulmonary reactions: acute and subacute. Acute
reactions, which are most common, manifest with dyspnea, chest pain, chills, fever, cough,
and alveolar infiltrates. These symptoms resolve 2 to 4 days after discontinuing the
medication. Acute pulmonary responses are thought to be hypersensitivity reactions.
Subacute reactions are rare and occur during prolonged treatment. Symptoms (e.g.,
dyspnea, cough, malaise) usually regress over weeks to months following nitrofurantoin
withdrawal. However, in some clients, permanent lung damage may occur. The remaining
options are incorrect interpretations.
2. The nurse is providing discharge instructions to a client receiving
sulfamethoxazole. Which instruction should be included in the list?
1. Restrict fluid intake.
2. Maintain a high fluid intake.
3. If the urine turns dark brown, call the health care provider (HCP)
immediately.
4. Decrease the dosage when symptoms are improving to prevent an
allergic response.
Rationale:
Each dose of sulfamethoxazole should be administered with a full glass of water, and the
client should maintain a high fluid intake. The medication is more soluble in alkaline urine.
The client should not be instructed to taper or discontinue the dose. Some forms of
sulfamethoxazole cause urine to turn dark brown or red. This does not indicate the need to
notify the HCP.
3. Trimethoprim-sulfamethoxazole (TMP-SMZ; Bactrim) is prescribed for a
client. The nurse should instruct the client to report which symptom if it
develops during the course of this medication therapy?
1. Nausea
2. Diarrhea
3. Headache
4. Sore throat
Rationale:
Clients taking trimethoprim (TMP)-sulfamethoxazole (SMZ) should be informed about early
signs/symptoms of blood disorders that can occur from this medication. These include sore
throat, fever, and pallor, and the client should be instructed to notify the health care
provider (HCP) if these occur. The other options do not require HCP notification.
4. Phenazopyridine (Pyridium) is prescribed for a client for symptomatic relief of
pain resulting from a lower urinary tract infection. The nurse should provide
the client with which information regarding this medication?
1. Take the medication at bedtime.
2. Take the medication before meals.
3. Discontinue the medication if a headache occurs.
4. A reddish orange discoloration of the urine may occur.
Rationale:
The nurse should instruct the c [Show Less]