Chapter 43: Drugs Acting on the Renin-Angiotensin-Aldosterone System

Chapter 43: Drugs Acting on the Renin-Angiotensin-Aldosterone System

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

1. A nurse is assessing the appropriateness of her patient’s medications. The nurse understands that it would be most dangerous for the patient taking an angiotensin-converting enzyme (ACE) inhibitor if the patient had which of the following co-morbidities?

a.	Coronary artery disease
b.	Heart failure
c.	Renal artery stenosis
d.	Diabetes mellitus

 

 

ANS:   C

ACE inhibitors can cause severe renal insufficiency in patients with bilateral renal artery stenosis or stenosis in the artery to a single remaining kidney.

Coronary artery disease, heart failure, and diabetes mellitus are not co-morbidities that pose a contraindication in a patient taking an ACE inhibitor.

 

DIF:    Cognitive Level: Application             REF:    pp. 471-472

TOP:    Nursing Process: Diagnosis

MSC:   NCLEX Client Needs Category: Physiological Integrity: Reduction of Risk Potential

 

2. A nurse just administered the first dose of an ACE inhibitor to her patient 1 hour ago. The patient, who is resting supine, urgently asks to go to the bathroom. The nurse’s best action would be which of the following interventions?

a.	Provide a bedside commode.
b.	Provide a bed pan.
c.	Assist the patient to the bathroom immediately.
d.	Allow the patient to dangle the legs on the side of the bed for a few minutes.

 

 

ANS:   B

Severe hypotension can result with the first dose of an ACE inhibitor. The patient should be discouraged from getting up, and a bed pan should be provided.

Providing a bedside commode or assisting the patient to the bathroom, even after dangling the legs on the side of the bed, is contraindicated at this time.

 

DIF:    Cognitive Level: Application             REF:    p. 471

TOP:    Nursing Process: Implementation

MSC:   NCLEX Client Needs Category: Physiological Integrity: Reduction of Risk Potential

 

3. A patient who has been taking lisinopril (Zestril) for 2 weeks complains of a dry cough. What patient education should the nurse provide regarding this complaint?

a.	The cough will subside within 5 to 7 days.
b.	The cough is an adverse effect of the medication and may lead to angioedema.
c.	Lisinopril also can have a hypotensive effect with the first dose.
d.	The cough is a common side effect of the medication.

 

 

ANS:   D

A cough occurs in 5% to 10% of patients taking ACE inhibitors and is due to the accumulation of bradykinin.

The cough will subside within 3 days of discontinuing the medication and should be totally absent within 10 days of discontinuation.

The cough will not lead to angioedema.

The patient has been taking the medication for 2 weeks already, therefore it is too late to discuss the first-dose effect; that should have been done before the first dose of the medication was administered.

 

DIF:    Cognitive Level: Application             REF:    p. 471

TOP:    Nursing Process: Implementation

MSC:   NCLEX Client Needs Category: Physiological Integrity: Pharmacological and Parenteral Therapies

 

4. A nurse is providing education on losartan (Cozaar) to a group of nurses. The nurse asks the participants, “Which of the following patients would most specifically benefit from the administration of losartan (Cozaar)?” A participant would be correct to choose which of the following patients?

a.	The patient at risk for stroke
b.	The patient who wants to reduce cardiovascular mortality
c.	The patient with right-sided heart failure
d.	The patient who is pregnant

 

 

ANS:   A

Losartan is indicated for and reduces the risk of stroke in hypertensive crisis.

Losartan is not indicated to reduce cardiovascular mortality.

Losartan is not indicated for patients with heart failure.

Losartan is contraindicated in pregnant women.

 

DIF:    Cognitive Level: Application             REF:    p. 474

TOP:    Nursing Process: Diagnosis

MSC:   NCLEX Client Needs Category: Physiological Integrity: Pharmacological and Parenteral Therapies