Which drug increases the excretion of water and sodium by the kidneys, reducing blood volume and blood pressure?

Angiotensin-converting enzyme (ACE) inhibitors

Diuretics

Adrenergic drugs

Direct acting vasodilators.

Answer and Explanation

The Correct Answer is B

Diuretics are drugs that increase the excretion of water and sodium by the kidneys, reducing blood volume and blood pressure. Diuretics lower blood pressure by dilating peripheral arterioles and decreasing blood volume by increasing the excretion of sodium and water.

Choice A is wrong because angiotensin-converting enzyme (ACE) inhibitors do not increase the excretion of water and sodium by the kidneys. ACE inhibitors block the conversion of angiotensin I to angiotensin II, a potent vasoconstrictor and stimulator of aldosterone secretion. By reducing angiotensin II levels, ACE inhibitors lower blood pressure by dilating blood vessels and decreasing sodium and water retention.

Choice C is wrong because adrenergic drugs do not increase the excretion of water and sodium by the kidneys. Adrenergic drugs act on the sympathetic nervous system, which regulates heart rate, blood pressure, and other functions. Depending on the type and location of adrenergic receptors, adrenergic drugs can have different effects on blood pressure. Some adrenergic drugs can increase blood pressure by stimulating alpha receptors, which cause vasoconstriction. Other adrenergic drugs can decrease blood pressure by stimulating beta receptors, which cause vasodilation and decreased cardiac output.

Choice D is wrong because direct acting vasodilators do not increase the excretion of water and sodium by the kidneys. Direct acting vasodilators are drugs that relax the smooth muscle of blood vessels, causing them to widen and lower blood pressure. Direct acting vasodilators do not affect the renin-angiotensin-aldosterone system or the sympathetic nervous system, which regulate sodium and water balance.

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Free Nursing Study Resources

Correct Answer is A

Explanation

Mannitol is an osmotic diuretic that increases urine output and decreases intracranial pressure and intraocular pressure. The nurse should check the urine output before giving the medication to ensure adequate renal function and prevent fluid overload and electrolyte imbalance. The normal urine output is 0.5 to 1 mL/kg/hr.

Choice B is wrong because checking the blood pressure is not specific to mannitol administration. Mannitol can cause hypotension or hypertension depending on the fluid status of the client, but this is not the priority action before giving the medication.

Choice C is wrong because checking the blood glucose is not relevant to mannitol administration. Mannitol does not affect blood glucose levels.

Choice D is wrong because checking the oxygen saturation is not related to mannitol administration. Mannitol does not affect oxygen saturation levels.

A. The client has no edema in the lower extremities. B. The client has a urine output of 30 mL/hr. C. The client has a blood pressure of 120/78 mm Hg. D. The client has a serum creatinine level of 1.2 mg/dL.

Correct Answer is C

Explanation

The client has a blood pressure of 120/78 mm Hg. This indicates that the medication is effective because it lowers the blood pressure below the hypertensive levels.In adults 60 years of age or older, this is typically defined as a systolic pressure below 150 mm Hg and a diastolic pressure below 90 mm Hg.

Choice A is wrong because the client has no edema in the lower extremities. This is not a specific outcome of lisinopril, an angiotensin II receptor blocker (ARB). Edema can be caused by many factors, such as heart failure, kidney disease, or venous insufficiency. Lisinopril does not directly affect fluid retention or edema.

Choice B is wrong because the client has a urine output of 30 mL/hr. This is a low urine output that may indicate dehydration, kidney impairment, or urinary obstruction. Lisinopril is expected to increase urine output by reducing the blood pressure and improving the renal blood flow.

Choice D is wrong because the client has a serum creatinine level of 1.2 mg/dL. This is a high serum creatinine level that may indicate kidney damage or reduced kidney function. Lisinopril is expected to lower the serum creatinine level by preventing the progression of kidney disease and protecting the kidney from further injury.

Normal ranges of urine output, blood pressure, and serum creatinine are:

• Urine output: 800 to 2000 mL/day or 40 to 80 mL/hr

• Blood pressure: less than 120/80 mm Hg for adults

• Serum creatinine: 0.6 to 1.2 mg/dL for males and 0.5 to 1.1 mg/dL for females

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Which drug increases the excretion of water and sodium by the kidneys, reducing blood volume and blood pressure?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is planning to administer mannitol to a client who has heart failure and pulmonary edema. Which of the following actions should the nurse take before giving the medication?

Correct Answer is A

Explanation

A nurse is evaluating a client who has hypertension and is taking lisinopril, an angiotensin II receptor blocker (ARB). Which of the following outcomes indicates that the medication is effective?

Correct Answer is C

Explanation

A nurse is teaching a client who has heart failure and is prescribed captopril. Which of the following instructions should the nurse include? (Select all that apply.).

A nurse is caring for a client who has heart failure and is receiving carvedilol (Coreg). The nurse should monitor which of the following laboratory values to determine therapeutic effectiveness of this medication?

The nurse is caring for a patient with atrial fibrillation who has been prescribed warfarin (Coumadin). The patient’s INR level is 3.5, which is above therapeutic range. What action should the nurse take?

A nurse is caring for a client who has heart failure and is prescribed furosemide. Which of the following laboratory values should the nurse monitor closely?

A patient with atrial fibrillation has been prescribed digoxin (Lanoxin). The nurse should monitor which laboratory value to evaluate therapeutic effectiveness?

A nurse is teaching a client who has hypertension and is prescribed nifedipine, a calcium channel blocker, about self-care measures. Which of the following instructions should the nurse include? (Select all that apply.)

The nurse is teaching a patient with heart failure about dietary modifications to reduce fluid retention and improve cardiac function. Which of the following foods should the nurse advise the patient to limit or avoid?

Which drug blocks the binding of angiotensin II to its receptors on blood vessels and adrenal glands, preventing its vasoconstrictive and aldosterone-stimulating effects?