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After teaching a group of nursing students about antihypertensive drugs, the instructor determines a need for additional teaching when the students identify which of the following as an angiotensin-converting enzyme inhibitor?
- A. Pindolol
- B. Benazepril
- C. Quinapril
- D. Enalapril
Correct Answer: A
Rationale: Pindolol is a beta-adrenergic blocker. Benazepril, quinapril, and enalapril are ACEIs.
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A client has a nursing diagnosis of Activity Intolerance related to fatigue and weakness. Which of the following would be appropriate for the nurse to include in the client's plan of care?
- A. Encouraging ambulation as tolerated
- B. Maintaining bed rest as much as possible
- C. Mandating the use of assistive devices
- D. Encouraging activities early in the morning when fatigue is less
- E. Promoting rest periods throughout the day as necessary
Correct Answer: A,E
Rationale: The client is encouraged to walk and ambulate as he or she can tolerate. Assistive devices may be used if needed, but these should not be mandated for use. The client can gradually increase tolerance by increasing the daily amount of activity. Planning rest periods according to the individual's tolerance is appropriate. Rest can take many forms, such as sitting in a chair, napping, watching television, or sitting with legs elevated.
A client with hypertension comes to the clinic for a follow-up visit. Which of the following would be appropriate for the nurse to do when assisting the client in managing his hypertension? Select all that apply.
- A. Find local resources in the community for taking blood pressure.
- B. Teach client how to properly record weight and blood pressure.
- C. Schedule regular monitoring of weight and blood pressure.
- D. Schedule an appointment to see a cardiologist.
- E. Schedule an appointment to see a nephrologist.
Correct Answer: A,B,C
Rationale: In the ambulatory care setting, the nurse helps plan a schedule of regular monitoring of weight and blood pressure, finds local resources for taking blood pressure in the community, and teaches the client how to record weight and blood pressure readings.
A client is prescribed atenolol. After administering the drug, the nurse would be alert for which of the following? Select all that apply.
- A. Cough
- B. Hyperkalemia
- C. Bradycardia
- D. Dizziness
- E. Constipation
Correct Answer: C,D
Rationale: Common adverse reactions seen with atenolol, a beta-adrenergic blocker, include bradycardia, dizziness, fatigue, weakness, hypotension, nausea, vomiting, diarrhea, and nervousness. Cough is associated with ACE inhibitors. Hyperkalemia is associated with eplerenone and aliskiren. Constipation is not a common adverse reaction with atenolol.
When educating a group of nursing students on the mechanism of action of angiotensin-converting enzyme inhibitor (ACEI) drugs, the instructor identifies which of the following as the action brought about by aldosterone?
- A. Inhibits renin secretion
- B. Causes sodium and water retention
- C. Causes excess potassium retention
- D. Promotes angiotensin I conversion
Correct Answer: B
Rationale: Aldosterone causes retention of sodium and water. This in turn causes a rise in blood pressure. ACEIs act by inhibiting the conversion of angiotensin I to angiotensin II. Aldosterone does not inhibit the release of renin and is not involved in the retention of potassium. Angiotensin-converting enzymes, and not aldosterone, are involved in the conversion of angiotensin I to angiotensin II.
The nurse should advise the client to do which of the following to reduce the risk of falls due to orthostatic hypotension from antihypertensive drugs? Select all that apply.
- A. Sit on the bed for 1 or 2 minutes when rising from a lying position.
- B. Rise quickly from a chair when moving to a standing position.
- C. Take the antihypertensive less frequently if hypotension occurs.
- D. Have someone assist the client if dizziness or weakness occurs.
- E. Increase salt intake to counteract the hypotension.
Correct Answer: A,D
Rationale: The nurse explains that when rising from a lying position, the client should sit on the edge of the bed for 1 or 2 minutes; the client should rise slowly from a chair and then stand for 1 to 2 minutes; and when symptoms of orthostatic hypotension occur, someone assisting the client in getting out of bed or a chair can decrease the risk of falls due to orthostatic hypotension.