A patient with a creatinine clearance of 20 mL/min is admitted to the medical-surgical unit. The patient is in need of rapid diuresis. Which class of diuretic does the nurse anticipate administering?

Correct Answer: D

Rationale: A patient with a creatinine clearance of 20 mL/min indicates impaired kidney function or renal insufficiency. Loop diuretics are the preferred choice for patients with reduced kidney function because they act on the loop of Henle in the nephron, which is independent of creatinine clearance. They are effective for rapid diuresis even in patients with significantly reduced renal function. Loop diuretics, such as furosemide, are commonly used in patients with acute or chronic kidney disease to promote diuresis and manage fluid overload. Thiazides are not as effective in patients with low glomerular filtration rates, and osmotic diuretics may not be appropriate for rapid diuresis in this scenario. Potassium-sparing diuretics are not typically used for rapid diuresis but rather for maintaining potassium balance in cases where patients are at risk for hypokalemia.

Correct Answer: D

Rationale: Failed to generate a rationale of 500+ characters after 5 retries.

Correct Answer: B

Rationale: Before administering a whole blood transfusion to a patient, it is crucial for the transfusion services to determine the patient's blood type and perform a crossmatch with the donor blood to ensure compatibility. The blood type (e.g., ABO and Rh) of the patient must be identified to select compatible donor blood. A crossmatch is performed to further confirm compatibility and prevent adverse reactions, such as hemolytic transfusion reactions, which can occur when incompatible blood components are transfused. This process helps ensure the safety and efficacy of the transfusion for the patient. A complete blood count and differential, blood culture and sensitivity, and antibody screening are important tests in other clinical contexts but are not essential for preparing a whole blood transfusion.

Correct Answer: D

Rationale: Lithium is commonly used in the treatment of bipolar disorder. One of the expected outcomes of lithium treatment is a decreased incidence of acute manic episodes. Lithium helps stabilize mood and reduce the frequency and severity of manic episodes in patients with bipolar disorder. It is considered one of the first-line treatments for managing symptoms of mania in bipolar disorder. While lithium has various physiological effects in the body, its primary use in mental health is to manage mood symptoms associated with bipolar disorder, particularly the manic phase. Therefore, the expected outcome of lithium treatment is a decrease in the incidence of acute manic episodes.

Correct Answer: C

Rationale: Metformin belongs to the pharmacological class known as biguanides. Biguanides are a group of oral medications commonly used to treat type 2 diabetes by lowering blood sugar levels. Metformin works primarily by decreasing the production of glucose in the liver while also increasing the sensitivity of muscle cells to insulin. This class of drugs does not stimulate insulin release from the pancreas like sulfonylureas and meglitinides but rather works by targeting the liver and improving insulin sensitivity in peripheral tissues. The main pharmacological effect of metformin is to reduce hepatic glucose output, which helps to control blood glucose levels in individuals with type 2 diabetes.