Thiazide Diuretics Study Guide

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Sample questions from Thiazide Diuretics Study Guide

This material has 12 questions with answers and rationales. Here are the first 5.

1. 1.A client asks how hydrochlorothiazide lowers blood pressure. Which explanation by the nurse is most accurate?

   • A.B. It blocks aldosterone receptors in the collecting duct.
   • B.C. It inhibits sodium-potassium-chloride transport in the ascending loop of Henle.
   • C.A. It blocks sodium-chloride reabsorption in the distal convoluted tubule.
   • D.D. It increases water reabsorption by stimulating antidiuretic hormone.

   Rationale: A is correct because thiazides inhibit the sodium-chloride cotransporter in the early distal convoluted tubule. B describes aldosterone antagonists such as spironolactone. C describes loop diuretics. D would promote water retention and does not describe the thiazide mechanism.

2. 2.An older adult recently started chlorthalidone. Which new finding requires the nurse's most urgent assessment?

   • A.D. Mild ankle edema that is improving
   • B.C. New confusion and difficulty walking steadily
   • C.B. Blood pressure decreasing from 154/90 to 132/78 mm Hg without symptoms
   • D.A. Increased urination during the morning

   Rationale: C is correct because confusion and gait instability may indicate hyponatremia or another acute complication and create immediate injury risk. A can be an expected effect. B suggests a therapeutic response when the client is asymptomatic. D suggests improving fluid retention rather than an urgent adverse effect.

3. 3.A client taking hydrochlorothiazide and digoxin has a potassium level of 2.8 mEq/L and reports palpitations. What should the nurse do first?

   • A.A. Administer both scheduled medications and recheck potassium next week.
   • B.D. Administer potassium by intravenous push.
   • C.C. Encourage a banana and discharge the client.
   • D.B. Assess the cardiac rhythm, withhold the scheduled medications pending urgent review, and notify the clinician.

   Rationale: B is correct because symptomatic hypokalemia increases dysrhythmia risk, especially with digoxin. Rhythm assessment and urgent medication review are necessary. A continues potentially harmful exposure and delays care. C is inadequate for symptomatic depletion. D is unsafe because intravenous-push potassium can cause fatal cardiac arrest.

4. 4.Which statement by a client prescribed a thiazide indicates a need for further teaching?

   • A.D. 'I will start potassium salt substitute without checking with anyone.'
   • B.C. 'I will keep my laboratory follow-up appointment.'
   • C.A. 'I will ask before taking ibuprofen regularly.'
   • D.B. 'I will stand up slowly if I feel lightheaded.'

   Answer and rationale are in the full material.

5. 5.A client taking a thiazide has a sodium level of 118 mEq/L and develops a seizure. Which action is the priority?

   • A.A. Encourage oral water to dilute the medication.
   • B.B. Protect the airway, initiate seizure safety measures, and activate emergency assistance.
   • C.D. Administer the next thiazide dose to remove excess sodium.
   • D.C. Ask assistive personnel to repeat the sodium test before notifying anyone.

   Answer and rationale are in the full material.