Nokea
A nurse is educating a client with hypertension who is prescribed losartan about the drug's action. Which of the following would the nurse incorporate into the teaching about this drug?
- A. Blocking aldosterone receptors
- B. Preventing conversion of angiotensin I
- C. Blocking angiotensin II receptors
- D. Preventing renin secretion
Correct Answer: C
Rationale: Losartan is an angiotensin II receptor antagonist, acting to block the angiotensin II receptors. By blocking the angiotensin II receptor, the renin-angiotensin system is stopped and consequently blood pressure is reduced. Drugs such as captopril prevent the conversion of angiotensin I. Losartan does not prevent renin secretion. Losartan does not block aldosterone receptors.
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While reviewing a client's lab work, the nurse notices the client's potassium is elevated. The nurse checks the client's medication record. Which of the following, if found, would the nurse identify as contributing to the client's elevated potassium level? Select all that apply.
- A. Atenolol
- B. Aliskiren
- C. Clonidine
- D. Metoprolol
- E. Eplerenone
Correct Answer: B,E
Rationale: Direct renin inhibitors such as aliskiren and the drug eplerenone can cause hyperkalemia. Atenolol and metoprolol are beta blockers. Clonidine is a centrally acting adrenergic drug.
An older adult client is prescribed a diuretic and an antihypertensive drug as treatment for his hypertension. The client tells the nurse that he has been perspiring a lot lately and has had some diarrhea. Which nursing diagnosis would the nurse most likely identify as a priority?
- A. Risk for Deficient Fluid Volume
- B. Ineffective Sexuality Patterns
- C. Activity Intolerance
- D. Acute Pain
Correct Answer: A
Rationale: Risk for Deficient Fluid Volume would be the most likely priority because the client is receiving a diuretic and an antihypertensive drug. The risk increases if the client is older or confused. Ineffective Sexuality Patterns would be appropriate if the client were to experience sexual dysfunction related to drug therapy. Activity Intolerance would be appropriate if the client complained of feeling tired and weak. Acute Pain would be related to the development of a headache that may occur with angiotensin II receptor blockers or antiadrenergics.
A client with hypertension is to receive a calcium channel blocker. The nurse understands that this class of drug leads to which of the following? Select all that apply.
- A. Relaxation of blood vessels
- B. Increased oxygen supply to the heart
- C. Reduced workload on the heart
- D. Decreased blood pressure
- E. Increased workload on the kidneys
Correct Answer: A,B,C,D
Rationale: The use of calcium channel blockers results in relaxation of blood vessels, increased oxygen supply to the heart, reduced workload on the heart, and decreased blood pressure.
A client is receiving a diuretic for the treatment of hypertension. Which of the following conditions should the nurse monitor for in clients taking diuretics?
- A. Hyperkalemia
- B. Hyponatremia
- C. Hypomagnesemia
- D. Hypocalcemia
Correct Answer: B
Rationale: The nurse should assess for hyponatremia in clients receiving diuretics. Diuretic usage causes electrolyte disturbances such as hyponatremia and hypokalemia. The nurse should inform the primary health care provider if signs and symptoms of electrolyte imbalance occur. Hyperkalemia, hypomagnesemia, and hypocalcemia do not occur in clients taking diuretics.
A client is prescribed clonidine as a transdermal patch. After instructing the client about this drug, the nurse determines that the teaching was successful when the client states that the patch should remain in place for how long?
- A. 24 hours
- B. 3 days
- C. 7 days
- D. 2 weeks
Correct Answer: C
Rationale: The nurse should ensure that the transdermal patch is intact for a period of 1 week. A clonidine transdermal patch should be applied to a hairless area over the torso for 1 week. If the patch loosens before 7 days, it has to be reinforced. The nurse has to mark the date of placement and the date of removal of the patch on the surface of the patch.