The nurse provides medication teaching for a client prescribed spironolactone

Potassium-sparing diuretics pharmacology NCLEX questions for nursing students!

Potassium-sparing diuretics are medications used to help remove extra fluid volume from the body. The nurse should be aware of how the drug works, why it is ordered, nursing implications, adverse reactions, and how to teach the patient how to take the medication.

This quiz is part of a pharmacology NCLEX question review series and will include various medications. This series will test your knowledge on nursing implications, side effects, patient teaching, therapeutic effects, and more.

Don’t forget to watch the lecture on potassium-sparing diuretics before taking the quiz.

Potassium-Sparing Diuretics NCLEX Questions

This quiz has NCLEX practice questions that will test your knowledge on potassium-sparing diuretics.

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1. The physician prescribes the patient a potassium-sparing diuretic. Which statement below best describes how this medication works to cause diuresis?

A. These medications work to inhibit the sodium-chloride cotransporter in the early part of the distal convoluted tubule.

B. These medications work to inhibit the sodium-potassium-chloride cotransporter in the thick ascending limb of the loop of Henle.

C. These medications work to inhibit the sodium and potassium exchange within the sodium channels in the distal tubule and collecting duct.

D. These medications work to inhibit the sodium channels within the proximal convoluted tubule by decreasing sodium reabsorption.

The answer is C. Potassium-sparing diuretics work to inhibit the sodium and potassium exchange within the sodium channels in the distal tubule and collecting duct.

2. Which potassium-sparing diuretics are known to antagonize aldosterone in order to cause diuresis? Select all that apply:

A. Triamterene

B. Spironolactone

C. Amiloride

D. Eplerenone

The answers are B and D. Spironolactone and Eplerenone are types of potassium-sparing diuretics that are known as the aldosterone antagnoists or aldosterone receptor blockers. These medications work against aldosterone (hence the name aldosterone “antagnoists”). Aldosterone normally works to influence epithelial sodium channels and the sodium-potassium pumps in the distal tubule and collecting duct by increasing this number. This leads to the reabsorption of sodium into the bloodstream from the filtrate and secretion of potassium into the filtrate from the blood. However, when this is inhibited (due to these medications) sodium is NOT reabsorbed back into the blood and potassium is NOT secreted into the filtrate but stays in the blood (hence this can lead to HYPERkalemia). Triamterene and Amiloride are potassium-sparing diuretics, BUT they work to inhibit the epithelial sodium channels, which causes the same affects as the aldosterone antagonists but in a different way.

3. Potassium-sparing diuretics alter how sodium is reabsorbed in what part of the nephron? Select all that apply:

A. Loop of Henle

B. Proximal Convoluted Tubule

C. Distal Convoluted Tubule

D. Collecting Duct

E. Thick ascending limb of the loop of Henle

The answers are C and D. Potassium-sparing diuretics work in the distal parts of the nephron (the late part of the distal tubule and collecting duct) to alter the sodium and potassium exchange within the nephron.

4. TRUE or FALSE: Potassium-sparing diuretics are the most effective type of diuretic and are often combined with loop or thiazide diuretics.

The answer is FALSE. Potassium-sparing diuretics are the WEAKEST (not most effective) type of diuretic. However, yes, they are often combined with loop or thiazide diuretics to help prevent HYPOkalemia, which is a common side effect of loop and thiazide diuretics.

5. What conditions below are potassium-sparing diuretics ordered to treat? Select all that apply:

A. Edema due to renal failure

B. Hyperaldosteronism

C. Hypertension

D. Hypokalemia secondary to loop or thiazide diuretic usage

The answers are B, C, and D. Potassium-sparing diuretics are NOT for patients who have renal failure (therefore, option A is wrong). Yes, they treat edema/swelling due to heart failure, liver impairment, or nephrotic syndrome, but are contraindicated in patients with renal failure. However, potassium-sparing diuretics help treat hyperaldosteronism (specifically Spironolactone). Hyperaldosteronism is where the body produces too much aldosterone, which leads to low potassium levels, high sodium levels, and hypertension. Spironolactone will antagonize the aldosterone and decrease it. Many times potassium-sparing diuretics are ordered with loop or thiazide diuretics to treat hypertension. In addition, since potassium-sparing diuretics increase the blood level of potassium, they may be ordered for patients who are experiencing hypokalemia while taking diuretics that waste potassium (loop or thiazide diuretics).

6. A patient is currently taking a potassium-sparing diuretic. The patient is experiencing EKG changes with tall-peaked T-waves, nausea, diarrhea, and paresthesia. The patient’s morning lab results are back and the nurse makes it priority to check what lab result?

A. Calcium

B. Potassium

C. Magnesium

D. Sodium

The answer is B. Potassium-sparing diuretics can increase a patient’s potassium level and based on the patient’s signs and symptoms in the scenario above this correlates with hyperkalemia. The nurse should check the morning lab result for potassium.

7. A patient has a dose of Spironolactone due at 1000. Which finding below would require the nurse to hold the dose and notify the physician for further orders?

A. Magnesium 1.5 mg/dL

B. BUN 18

C. Sodium 140 mEq/L

D. Potassium 7 mEq/L

The answer is D. A normal potassium level is 3.5-5 mEq/L. Spironolactone can increase potassium levels because it’s a potassium-sparing diuretic. Therefore, the nurse should hold the scheduled dose and notify the MD for further orders.

8. Your patient is prescribed to take Lisinopril and Triamterene. As the nurse you know that these medications increase a patient’s risk for developing?

A. Hyperkalemia

B. Hypertension

C. Hypernatremia

D. Renal failure

The answer is A. Lisinopril is an ACE inhibitor (ACEI) and this medication can increase potassium levels due to how it affects the RAAS. Triamterene is a potassium-sparing diuretic, which can increase potassium levels. Therefore, the nurse should monitor for HYPERkalemia.

9. You’re providing discharge teaching to a patient who will be taking Amiloride. Which items below should the patient limit in their diet? Select all that apply:

A. Salt-substitutes

B. Spinach

C. Bananas

D. Rice

E. Cheese

The answers are A, B, and C. All of these items are high in potassium. Amiloride is a potassium-sparing diuretic that can increase the blood levels of potassium. Therefore, the patient should limit these items.

10. Which potassium-sparing diuretic can cause antiandrogenic effects in a patient, such as menstrual irregularities, gynecomastia, and decreased sex drive?

A. Triamterene

B. Spironolactone

C. Amiloride

D. Eplerenone

The answer is B. Spironolactone can have antiandrogen effects on some patients (gynecomastia, increase hair growth in women, menstrual irregulars, sexual dysfunction). This is because Spironolactone affects the androgen and progesterone receptors.

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