Nokea
A patient with type 2 diabetes mellitus has been found to have trace proteinuria. The prescriber writes an order for an angiotensin-converting enzyme (ACE) inhibitor. What is the main reason for prescribing this class of drug for this patient?
- A. Cardioprotective effects
- B. Renal protective effects
- C. Reduces blood pressure
- D. Promotes fluid output
Correct Answer: B
Rationale: ACE inhibitors have been shown to have a protective effect on the kidneys because they reduce glomerular filtration pressure. This is one reason that they are among the cardiovascular drugs of choice for diabetic patients. The other drugs do not have this effect.
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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.
The nurse is creating a plan of care for a patient with a new diagnosis of hypertension. Which is a potential human needs statement for the patient taking antihypertensive medications?
- A. Altered GI elimination (diarrhea)
- B. Altered sexual function
- C. Altered urinary elimination (urge incontinence)
- D. Need for effective perception
Correct Answer: B
Rationale: Altered sexual function is a potential human needs statement related to possible adverse effects of antihypertensive drug therapy. The other human needs statements are not appropriate.
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.
When teaching a patient about antihypertensive drug therapy, which statements by the nurse are correct?
- A. You need to have your blood pressure checked once a week and keep track of the readings.
- B. If you notice that the symptoms have gone away, you should be able to stop taking the drug.
- C. An exercise program may be helpful in treating hypertension, but let's check with your doctor first.
- D. If you experience severe side effects, stop the medicine and let us know at your next office visit.
- E. Most over-the-counter decongestants are compatible with antihypertensive drugs.
- F. Please continue taking the medication, even if you are feeling better.
Correct Answer: A,C,F
Rationale: Keeping a record of weekly blood pressure checks helps to monitor the effectiveness of the therapy. An exercise program may be beneficial but should be confirmed with the prescriber. Therapy is often lifelong, and patients should continue taking the medication even if feeling better to prevent rebound hypertension. Abruptly stopping medication or assuming over-the-counter decongestants are safe can lead to serious complications.
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.