NSG 6005 WEEK 5 QUIZ MIDTERM SOUTH

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NSG 6005 WEEK 5 QUIZ MIDTERM SOUTH

UNIVERSITY ACTUAL EXAM NOVEMBER QUARTER

AGRADE

RATED

Ray has been diagnosed with hypertension and an angiotensin-converting enzyme inhibitor is determined to be needed. Prior to prescribing this drug, the NP should

assess for:

• Hypokalemia
• Impotence
• Decreased renal function
• Inability to concentrate - ANSWER-3. Decreased renal function

Angiotensin-converting enzyme inhibitors are the drug of choice in treating hypertension

in diabetic patients because they:

• Improve insulin sensitivity
• Improve renal hemodynamics
• Reduce the production of angiotensin II 1 / 4

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• All of the above - ANSWER-4. All of the above

A potentially life-threatening adverse response to angiotensin-converting enzyme inhibitors is angioedema. Which of the following statements is true about this adverse response?

• Swelling of the tongue or hoarseness are the most common symptoms.
• It appears to be related to the decrease in aldosterone production.
• Presence of a dry, hacky cough indicates a high risk for this adverse response.
• Because it takes time to build up a blood level, it occurs after being on the drug for

about 1 week. - ANSWER-1. Swelling of the tongue or hoarseness are the most common symptoms.

Despite good blood pressure control, an NP might change a patient's drug from an angiotensin-converting enzyme (ACE) inhibitor to an angiotensin II receptor blocker

(ARB) because the ARB:

• Is stronger than the ACE inhibitor
• Does not produce a dry, hacky cough
• Has no effect on the renal system
• Reduces sodium and water retention - ANSWER-2. Does not produce a dry, hacky

cough

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3 While taking an angiotensin II receptor blocker (ARB), patients need to avoid certain

over-the-counter drugs without first consulting the provider because:

• Cimetidine is metabolized by the CYP 3A4 isoenzymes
• Nonsteroidal anti-inflammatory drugs reduce prostaglandin levels
• Both 1 and 2
• Neither 1 nor 2 - ANSWER-3. Both 1 and 2

Laboratory monitoring for patients on angiotensin-converting enzyme inhibitors or

angiotensin II receptor blockers should include:

• White blood cell counts with the drug dosage increased for elevations above 10,000

feet

• Liver function tests with the drug dosage stopped for alanine aminotransferase values

twice that of normal

• Serum creatinine levels with the drug dosage reduced for values greater than 2.5

mg/dL

• Serum glucose levels with the drug dosage increased for levels greater than 120

mg/dL - ANSWER-3. Serum creatinine levels with the drug dosage reduced for values greater than 2.5 mg/dL

Jacob has hypertension, for which a calcium channel blocker has been prescribed. This

drug helps control blood pressure because it:

• Decreases the amount of calcium inside the cell 3 / 4

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• Reduces stroke volume
• Increases the activity of the Na+/K+/ATPase pump indirectly
• Decreases heart rate - ANSWER-1. Decreases the amount of calcium inside the cell

Which of the following adverse effects may occur due to a dihydropyridine-type calcium channel blocker?

• Bradycardia
• Hepatic impairment
• Increased contractility
• Edema of the hands and feet - ANSWER-4. Edema of the hands and feet

Patient teaching related to amlodipine includes:

• Increase calcium intake to prevent osteoporosis from a calcium blockade.
• Do not crush the tablet; it must be given in liquid form if the patient has trouble

swallowing it.

• Avoid grapefruit juice as it affects the metabolism of this drug.
• Rise slowly from a supine position to reduce orthostatic hypotension. - ANSWER-3.

Avoid grapefruit juice as it affects the metabolism of this drug.

Larry has heart failure, which is being treated with digoxin because it exhibits:

• Negative inotropism
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