Question 1

A female patient taking an ACE inhibitor learns that she is pregnant. What will the nurse tell this patient?

Accepted Answer

A)  The fetus most likely will have serious congenital defects. 
B)  The fetus must be monitored closely while the patient is taking this drug. 
C)  The patient's prescriber probably will change her medication to an ARB. 
D)  The patient should stop taking the medication and contact her provider immediately. 
A)  The fetus most likely will have serious congenital defects. 
B)  The fetus must be monitored closely while the patient is taking this drug. 
C)  The patient's prescriber probably will change her medication to an ARB. 
D)  The patient should stop taking the medication and contact her provider immediately. D

Question 2

A provider has ordered captopril [Capoten] for a patient who has hypertension. The patient reports a history of swelling of the tongue and lips after taking enalapril [Vasotec] in the past. Which action by the nurse is correct?

Accepted Answer

A)  Administer the captopril and monitor for adverse effects. 
B)  Hold the dose and notify the provider. 
C)  Request an order to administer fosinopril instead of captopril. 
D)  Reassure the patient that this is not a serious side effect. 
A)  Administer the captopril and monitor for adverse effects. 
B)  Hold the dose and notify the provider. 
C)  Request an order to administer fosinopril instead of captopril. 
D)  Reassure the patient that this is not a serious side effect. B

Question 3

A nurse is reviewing a patient's medications before administration. Which drug-to-drug interactions will most concern the nurse in a patient with a history of heart failure and a potassium level of 5.5 mEq/L?

Accepted Answer

A)  Furosemide [Lasix] and enalapril [Vasotec] 
B)  Amlodipine [Norvasc] and spironolactone [Aldactone] 
C)  Captopril [Capoten] and spironolactone [Aldactone] 
D)  Metoprolol [Lopressor] and furosemide [Lasix] 
A)  Furosemide [Lasix] and enalapril [Vasotec] 
B)  Amlodipine [Norvasc] and spironolactone [Aldactone] 
C)  Captopril [Capoten] and spironolactone [Aldactone] 
D)  Metoprolol [Lopressor] and furosemide [Lasix] C

Question 4

A patient who stops taking an ACE inhibitor because of its side effects will begin taking an angiotensin II receptor blocker (ARB) medication. Which side effect of ACE inhibitors will not occur with an ARB medication?

Accepted Answer

A)  Angioedema 
B)  Cough 
C)  Hyperkalemia 
D)  Renal failure 
A)  Angioedema 
B)  Cough 
C)  Hyperkalemia 
D)  Renal failure

Question 5

A patient who is taking furosemide [Lasix] and digoxin will begin taking captopril [Capoten]. The nurse is providing information about the drug. Which statement by the patient indicates a need for further teaching?

Accepted Answer

A)  "I can use acetaminophen for analgesia if needed." 
B)  "I should stop taking the Lasix about a week before starting the Capoten." 
C)  "I should take this medication on a full stomach." 
D)  "I will need to have blood tests done every 2 weeks for a few months." 
A)  "I can use acetaminophen for analgesia if needed." 
B)  "I should stop taking the Lasix about a week before starting the Capoten." 
C)  "I should take this medication on a full stomach." 
D)  "I will need to have blood tests done every 2 weeks for a few months."

Question 6

A female patient who is not taking any other medications is prescribed aliskiren [Tekturna], a direct renin inhibitor (DRI). The nurse reviews medication information with the patient. Which statement by the patient indicates understanding of the teaching?

Accepted Answer

A)  "If I get pregnant, I should stop taking this drug by the second trimester." 
B)  "If I take this drug with a high-fat meal, it will be more effective." 
C)  "I should restrict my potassium intake while taking this drug." 
D)  "I should take this medication 1 hour before sitting down to a meal." 
A)  "If I get pregnant, I should stop taking this drug by the second trimester." 
B)  "If I take this drug with a high-fat meal, it will be more effective." 
C)  "I should restrict my potassium intake while taking this drug." 
D)  "I should take this medication 1 hour before sitting down to a meal."

Question 7

A patient with hypertension is prescribed an angiotensin-converting enzyme (ACE) inhibitor. The nurse reviewing this patient's chart before administering the medication will be most concerned about which other disease process?

Accepted Answer

A)  Bronchial asthma 
B)  Coronary artery disease 
C)  Diabetes mellitus 
D)  Renal artery stenosis 
A)  Bronchial asthma 
B)  Coronary artery disease 
C)  Diabetes mellitus 
D)  Renal artery stenosis

Question 8

A patient begins taking an ACE inhibitor and complains of a dry cough. What does the nurse correctly tell the patient about this symptom?

Accepted Answer

A)  It indicates that a serious side effect has occurred. 
B)  It is a common side effect that occurs in almost all patients taking the drug. 
C)  It may be uncomfortable enough that the drug will need to be discontinued. 
D)  It occurs frequently in patients taking the drug but will subside over time. 
A)  It indicates that a serious side effect has occurred. 
B)  It is a common side effect that occurs in almost all patients taking the drug. 
C)  It may be uncomfortable enough that the drug will need to be discontinued. 
D)  It occurs frequently in patients taking the drug but will subside over time.

Question 9

A female patient who begins taking spironolactone [Aldactone] as an adjunct to furosemide [Lasix] complains that her voice is deepening. What will the nurse do?

Accepted Answer

A)  Contact the provider to obtain an order for a complete blood count (CB
C)  and liver function tests. 
B)  Explain that this drug binds with receptors for steroid hormones, causing this effect. 
C)  Report this side effect to the provider and request another medication for this patient. 
D)  Teach the patient to report any associated cough, which may indicate a more severe side effect. 
A)  Contact the provider to obtain an order for a complete blood count (CB
C)  and liver function tests. 
B)  Explain that this drug binds with receptors for steroid hormones, causing this effect. 
C)  Report this side effect to the provider and request another medication for this patient. 
D)  Teach the patient to report any associated cough, which may indicate a more severe side effect.

Question 10

A patient who has been taking an antihypertensive medication for several years is recovering from a myocardial infarction. The prescriber changes the patient's medication to an ACE inhibitor. The patient asks the nurse why a new drug is necessary. What is the nurse's response?

Accepted Answer

A)  "ACE inhibitors can prevent or reverse pathologic changes in the heart's structure." 
B)  "ACE inhibitors help lower LDL cholesterol and raise HDL cholesterol." 
C)  "ACE inhibitors increase venous return to the heart, improving cardiac output." 
D)  "ACE inhibitors regulate electrolytes that affect the cardiac rhythm." 
A)  "ACE inhibitors can prevent or reverse pathologic changes in the heart's structure." 
B)  "ACE inhibitors help lower LDL cholesterol and raise HDL cholesterol." 
C)  "ACE inhibitors increase venous return to the heart, improving cardiac output." 
D)  "ACE inhibitors regulate electrolytes that affect the cardiac rhythm."

Question 11

A prescriber orders ramipril [Altace] for an obese patient with type 2 diabetes mellitus who has developed hypertension. The nurse provides teaching before dismissing the patient home. Which statement by the patient indicates understanding of the teaching?

Accepted Answer

A)  "I am less likely to develop diabetic nephropathy when taking this medication." 
B)  "I should check my blood sugar more often, because hyperglycemia is a side effect of this drug." 
C)  "Taking this medication helps reduce my risk of stroke and heart attack." 
D)  "This medication will probably prevent the development of diabetic retinopathy." 
A)  "I am less likely to develop diabetic nephropathy when taking this medication." 
B)  "I should check my blood sugar more often, because hyperglycemia is a side effect of this drug." 
C)  "Taking this medication helps reduce my risk of stroke and heart attack." 
D)  "This medication will probably prevent the development of diabetic retinopathy."

Question 12

A nurse administers an ACE inhibitor to a patient who is taking the drug for the first time. What will the nurse do?

Accepted Answer

A)  Instruct the patient not to get up without assistance. 
B)  Make sure the patient takes a potassium supplement. 
C)  Report the presence of a dry cough to the prescriber. 
D)  Request an order for a diuretic to counter the side effects of the ACE inhibitor. 
A)  Instruct the patient not to get up without assistance. 
B)  Make sure the patient takes a potassium supplement. 
C)  Report the presence of a dry cough to the prescriber. 
D)  Request an order for a diuretic to counter the side effects of the ACE inhibitor.

Exam 44: Drugs Acting on the Renin-Angiotensin-Aldosterone System

A female patient taking an ACE inhibitor learns that she is pregnant. What will the nurse tell this patient?

A provider has ordered captopril [Capoten] for a patient who has hypertension. The patient reports a history of swelling of the tongue and lips after taking enalapril [Vasotec] in the past. Which action by the nurse is correct?

A nurse is reviewing a patient's medications before administration. Which drug-to-drug interactions will most concern the nurse in a patient with a history of heart failure and a potassium level of 5.5 mEq/L?

A patient who stops taking an ACE inhibitor because of its side effects will begin taking an angiotensin II receptor blocker (ARB) medication. Which side effect of ACE inhibitors will not occur with an ARB medication?

A patient who is taking furosemide [Lasix] and digoxin will begin taking captopril [Capoten]. The nurse is providing information about the drug. Which statement by the patient indicates a need for further teaching?

A female patient who is not taking any other medications is prescribed aliskiren [Tekturna], a direct renin inhibitor (DRI). The nurse reviews medication information with the patient. Which statement by the patient indicates understanding of the teaching?

A patient with hypertension is prescribed an angiotensin-converting enzyme (ACE) inhibitor. The nurse reviewing this patient's chart before administering the medication will be most concerned about which other disease process?

A patient begins taking an ACE inhibitor and complains of a dry cough. What does the nurse correctly tell the patient about this symptom?

A female patient who begins taking spironolactone [Aldactone] as an adjunct to furosemide [Lasix] complains that her voice is deepening. What will the nurse do?

A patient who has been taking an antihypertensive medication for several years is recovering from a myocardial infarction. The prescriber changes the patient's medication to an ACE inhibitor. The patient asks the nurse why a new drug is necessary. What is the nurse's response?

A prescriber orders ramipril [Altace] for an obese patient with type 2 diabetes mellitus who has developed hypertension. The nurse provides teaching before dismissing the patient home. Which statement by the patient indicates understanding of the teaching?

A nurse administers an ACE inhibitor to a patient who is taking the drug for the first time. What will the nurse do?

Orientation to Pharmacology

Application of Pharmacology in Nursing Practice

Drug Regulation, Development, Names, and Information

Pharmacokinetics

Pharmacodynamics

Drug Interactions

Adverse Drug Reactions and Medication Errors

Individual Variation in Drug Responses

Drug Therapy During Pregnancy and Breast-Feeding

Drug Therapy in Pediatric Patients

Drug Therapy in Geriatric Patients

Basic Principles of Neuropharmacology

Physiology of the Peripheral Nervous System

Muscarinic Agonists and Antagonists

Cholinesterase Inhibitors and Their Use in Myasthenia Gravis

Drugs That Block Nicotinic Cholinergic Transmission: Neuromuscular Blocking Agents

Adrenergic Agonists

Adrenergic Antagonists

Indirect-Acting Antiadrenergic Agents

Introduction to Central Nervous System Pharmacology

Drugs for Parkinson Disease

Drugs for Alzheimers Disease

Drugs for Multiple Sclerosis

Drugs for Seizure Disorders

Drugs for Muscle Spasm and Spasticity

Local Anesthetics

General Anesthetics

Opioid Analgesics, Opioid Antagonists, and Nonopioid Centrally Acting Analgesics

Pain Management in Patients With Cancer

Drugs for Headache

Antipsychotic Agents and Their Use in Schizophrenia

Antidepressants

Drugs for Bipolar Disorder

Sedative-Hypnotic Drugs

Management of Anxiety Disorders

Central Nervous System Stimulants and Attention-Deficithyperactivity Disorder

Drug Abuse I: Basic Considerations

Drug Abuse II: Alcohol

Drug Abuse III: Nicotine and Smoking

Drug Abuse IV: Major Drugs of Abuse Other Than Alcohol and Nicotine

Diuretics

Agents Affecting the Volume and Ion Content of Body Fluids

Review of Hemodynamics

Calcium Channel Blockers

Vasodilators

Drugs for Hypertension

Drugs for Heart Failure

Antidysrhythmic Drugs

Prophylaxis of Atherosclerotic Cardiovascular Disease: Drugs That Help Normalize Cholesterol and Triglyceride Levels

Drugs for Angina Pectoris

Anticoagulant, Antiplatelet, and Thrombolytic Drugs

Management of St-Elevation Myocardial Infarction

Drugs for Hemophilia

Drugs for Deficiency Anemias

Hematopoietic Agents

Drugs for Diabetes Mellitus

Drugs for Thyroid Disorders

Drugs Related to Hypothalamic and Pituitary Function

Drugs for Disorders of the Adrenal Cortex

Estrogens and Progestins: Basic Pharmacology and Noncontraceptive Applications

Birth Control

Drug Therapy of Infertility

Drugs That Affect Uterine Function

Androgens

Drugs for Erectile Dysfunction and Benign Prostatic Hyperplasia

Review of the Immune System

Childhood Immunization