A nurse is preparing to administer mannitol via continuous IV infusion to a client.
Which of the following findings should the nurse identify as an expected outcome of this medication therapy?
Improved urinary output.
Resolution of diabetic ketoacidosis.
Decreased brain natriuretic peptide levels.
Increased intraocular pressure.
The Correct Answer is A
Choice A rationale
Mannitol is an osmotic diuretic that increases the osmolality of the glomerular filtrate, thereby inhibiting water reabsorption in the renal tubules. This osmotic effect leads to increased water excretion and subsequently an improved urinary output. This enhanced diuresis is a primary therapeutic goal, particularly in conditions like cerebral edema or acute renal failure.
Choice B rationale
Mannitol is not indicated for the resolution of diabetic ketoacidosis. Diabetic ketoacidosis is a metabolic emergency characterized by hyperglycemia, ketonemia, and acidosis, requiring insulin therapy, fluid resuscitation, and electrolyte management. Mannitol does not address the underlying pathophysiology of insulin deficiency.
Choice C rationale
Mannitol's mechanism of action does not directly decrease brain natriuretic peptide (BNP) levels. BNP is a hormone released by cardiomyocytes in response to ventricular stretch and is a marker of heart failure. While mannitol can reduce fluid overload, which might indirectly impact cardiac preload, its direct effect is not on BNP secretion.
Choice D rationale
Mannitol is used to decrease, not increase, intraocular pressure. Its osmotic properties draw fluid from the extravascular space, including the vitreous humor of the eye, into the vascular compartment. This reduction in fluid volume within the eye lowers intraocular pressure, making it useful in treating acute angle-closure glaucoma.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale
Bronchospasm is a constriction of the airways, commonly seen in respiratory conditions like asthma. It is mediated by inflammatory responses and smooth muscle contraction in the bronchi. Acetazolamide, a carbonic anhydrase inhibitor, does not typically cause bronchospasm; its primary effects are on fluid and electrolyte balance and intraocular pressure.
Choice B rationale
Constipation is a common gastrointestinal symptom characterized by infrequent or difficult bowel movements. It can be caused by various factors, including dietary habits, medications, and underlying medical conditions. Acetazolamide's mechanism of action, involving inhibition of carbonic anhydrase, does not directly lead to constipation as a significant adverse effect.
Choice C rationale
Diplopia, or double vision, is a visual disturbance where a single object appears as two. It can result from ocular muscle weakness, nerve damage, or other neurological conditions. Acetazolamide's therapeutic effects are on aqueous humor production in the eye to reduce intraocular pressure, but diplopia is not a recognized adverse effect of this medication.
Choice D rationale
Acetazolamide is a carbonic anhydrase inhibitor that promotes the excretion of bicarbonate, sodium, potassium, and water. This diuretic action can lead to metabolic acidosis, hypokalemia (normal range: 3.5-5.0 mEq/L), and hyponatremia (normal range: 135-145 mEq/L) due to increased renal excretion, hence requiring close monitoring of electrolyte balance.
Correct Answer is B
Explanation
Choice A rationale
Tuberculosis is a bacterial infection primarily affecting the lungs, caused by *Mycobacterium tuberculosis*. Didanosine is an antiretroviral medication, specifically a nucleoside reverse transcriptase inhibitor (NRTI), and as such, it does not possess antimicrobial activity against bacterial pathogens like *Mycobacterium tuberculosis*. Therefore, it is not indicated for treating tuberculosis.
Choice B rationale
Human immunodeficiency virus (HIV) is a retrovirus that attacks the body's immune system. Didanosine is an antiretroviral drug that inhibits the replication of HIV by interfering with the reverse transcriptase enzyme, which is crucial for the virus to convert its RNA into DNA. This mechanism of action effectively reduces the viral load and improves immune function in individuals with HIV infection.
Choice C rationale
Bacterial meningitis is an inflammation of the meninges, the membranes surrounding the brain and spinal cord, caused by various bacterial species. Didanosine is an antiviral agent specifically targeting retroviruses like HIV. It does not have any direct antibacterial properties or efficacy against the common bacterial pathogens responsible for meningitis, thus making it an inappropriate treatment.
Choice D rationale
Syphilis is a sexually transmitted infection caused by the bacterium *Treponema pallidum*. The primary treatment for syphilis is antibiotics, particularly penicillin. Didanosine, being an antiretroviral medication, does not exhibit any treponemicidal activity and is ineffective against *Treponema pallidum*. Therefore, it is not used in the treatment of syphilis.
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