A nurse is administering bumetanide to a client who has ascites. The nurse should recognize that which of the following findings is an expected therapeutic effect of this medication?
Decreased excretion of urine sodium.
Increased urinary output.
Decreased serum glucose.
Increased blood pressure.
The Correct Answer is B
Choice A rationale
Decreased excretion of urine sodium is not an expected therapeutic effect of bumetanide. Bumetanide is a loop diuretic that works by inhibiting the reabsorption of sodium and chloride in the ascending loop of Henle, leading to increased excretion of sodium and water.
Choice B rationale
Increased urinary output is the expected therapeutic effect of bumetanide. As a potent loop diuretic, bumetanide increases the excretion of water and electrolytes, which helps reduce fluid accumulation in conditions like ascites.
Choice C rationale
Decreased serum glucose is not associated with bumetanide. Bumetanide primarily affects fluid and electrolyte balance and does not have a significant impact on blood glucose levels.
Choice D rationale
Increased blood pressure is not an expected effect of bumetanide. On the contrary, bumetanide can help lower blood pressure by reducing fluid volume and decreasing the workload on the heart.
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Correct Answer is B
Explanation
Choice A rationale
Crushing tadalafil is not recommended as it can alter the medication’s effectiveness and absorption. Tadalafil should be taken whole to ensure proper dosage and efficacy.
Choice B rationale
Tadalafil can decrease blood pressure by relaxing blood vessels, which allows for increased blood flow. This is a known effect of phosphodiesterase type 5 (PDE5) inhibitors like tadalafil.
Choice C rationale
Tadalafil should not be taken more than once a day. Taking it twice a day can increase the risk of side effects and is not recommended.
Choice D rationale
The effects of tadalafil can last up to 36 hours, not just 4 hours. This prolonged duration is one of the reasons it is preferred by some patients.
Correct Answer is A
Explanation
Choice A rationale
A neutrophil count of 650/mm³ is significantly lower than the normal range (2,500 to 8,000/mm³) and indicates neutropenia, which is a known adverse effect of zidovudine. Neutropenia increases the risk of infections and requires close monitoring and potential dose adjustment or discontinuation of the medication.
Choice B rationale
A platelet count of 450,000/mm³ is slightly above the normal range (150,000 to 400,000/mm³) but is not typically associated with zidovudine toxicity. Zidovudine is more commonly associated with bone marrow suppression leading to anemia and neutropenia rather than thrombocytosis.
Choice C rationale
An Hgb level of 17 g/dL is above the normal range for females (12 to 16 g/dL) but is not a common adverse effect of zidovudine. Zidovudine is more likely to cause anemia, leading to lower hemoglobin levels rather than elevated levels.
Choice D rationale
A creatinine level of 1.5 mg/dL is within the upper limit of the normal range (0.5 to 1 mg/dL) and is not a typical adverse effect of zidovudine. Zidovudine primarily affects the bone marrow and does not have a significant impact on renal function.