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A patient with severe liver disease is receiving the angiotensin-converting enzyme (ACE) inhibitor, captopril. The nurse is aware that the advantage of this drug for this patient is which characteristic?
- A. Captopril rarely causes first-dose hypotensive effects.
- B. Captopril has little effect on electrolyte levels.
- C. Captopril is a prodrug and is metabolized by the liver before becoming active.
- D. Captopril does not need to be metabolized by the liver before becoming active because it is not a prodrug.
Correct Answer: D
Rationale: A prodrug relies on a functioning liver to be converted to its active form. Captopril is not a prodrug, and therefore it would be safer for the patient with liver dysfunction.
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When counseling a male patient about the possible adverse effects of antihypertensive drugs, the nurse will discuss which potential problem?
- A. Impotence
- B. Bradycardia
- C. Increased libido
- D. Weight gain
Correct Answer: A
Rationale: Sexual dysfunction is a common complication of antihypertensive medications and may be manifested in men as decreased libido or impotence. The other options are incorrect.
A patient who is now in heart failure after a recent myocardial infarction will be receiving a new prescription for eplerenone. The nurse is reviewing the patient's laboratory results and will report which of these as a potential contraindication?
- A. Serum sodium level 136 mEq/L
- B. Serum potassium 5.6 mEq/L
- C. Elevated white blood cell count
- D. Elevated cardiac troponin levels
Correct Answer: B
Rationale: Eplerenone is contraindicated in patients with elevated serum potassium levels (higher than 5.5 mEq/L). The other answers are incorrect.
A patient is to receive enalapril 5 mg IV every 6 hours. Each dose is given over 5 minutes. The medication is available in an injectable form, 1.25 mg/mL. Identify how many milliliters of medication will the nurse draw up for each dose.
Correct Answer: 4 mL
Rationale: 1.25 mg : 1 mL :: 5 mg : x mL; (1.25 * x) = (1 * 5); 1.25x = 5; x = 4 mL.
The nurse is reviewing drug therapy for hypertension. According to the JNC-8 guidelines, antihypertensive drug therapy for a newly diagnosed hypertensive black patient would most likely include which drug or drug classes?
- A. Vasodilators alone
- B. ACE inhibitors alone
- C. Calcium channel blockers with thiazide diuretics
- D. Beta blockers with thiazide diuretics
Correct Answer: C
Rationale: According to the JNC-8 guidelines, calcium channel blockers and thiazide diuretics are recommended as first-line therapy for management of hypertension in black patients. The other drugs are not recommended as first-line drugs for this group.
A patient with primary hypertension is prescribed drug therapy for the first time. The patient asks how long drug therapy will be needed. Which answer by the nurse is the correct response?
- A. This therapy will take about 3 months.
- B. This therapy will take about a year.
- C. This therapy will go on until your symptoms disappear.
- D. Therapy for high blood pressure is usually lifelong.
Correct Answer: D
Rationale: There is no cure for hypertension, and treatment will be lifelong. The other answers are not appropriate.