Ray has been recognized with hypertension and it's miles decided that an
angiotensin-converting enzyme inhibitor is wanted. Prior to prescribing this drug, the nurse
practitioner (NP) have to investigate for:
Decreased renal characteristic
Angiotensin-changing enzyme (ACE) inhibitors are the drug of desire in treating high blood
pressure in diabetic patients because they:
All of the above:
Improve insulin sensitivity
Improve renal hemodynamics
Reduce the manufacturing of angiotensin II
A doubtlessly lifestyles-threatening unfavorable response to an ACE inhibitor is angioedema.
Which of the following statements is proper approximately this destructive reaction?
Swelling of the tongue and hoarseness are the most common symptoms.
ACE inhibitors are beneficial in a selection of problems. Which of the subsequent statements
is authentic about each their usefulness in a particular ailment and the purpose for their use?
Both 1 and a couple of are true:
1. They are useful to prevent strong angina due to the fact they decrease the thickening of
vascular partitions because of decreased changed launch.
2. They are useful to save you coronary heart failure due to the fact they lessen reworking of
injured myocardial tissues.
Despite correct blood pressure manage, an NP would possibly alternate a patient's drug
from an ACE inhibitor to an angiotensin II receptor blocker (ARB) due to the fact the ARB:
Does not produce a dry, hacking cough
While taking an ARB, patients need to avoid sure over-the-counter capsules with out irst
consulting the company because:
Both 1 and a couple of:
1. Cimetidine is metabolized by using the CYP3A4 isoenzymes
2. Nonsteroidal anti inflammatory pills reduce prostaglandin levels
Laboratory tracking for patients on ACE inhibitors or ARBs ought to include:
Serum creatinine stages with the drug dosage decreased for values greater than 2.5 mg/dL
,Jacob has hypertension, for which a calcium channel blocker has been prescribed. This drug
allows control blood strain because it:
Decreases the amount of calcium within the mobile
Which of the following adverse outcomes might also arise due to a dihydropyridine-kind
calcium channel blocker?
Edema of the arms and toes
Patient coaching associated with amlodipine includes:
Avoid grapefruit juice as it influences the metabolism of this drug.
Vera, age 70, has isolated systolic high blood pressure. Calcium channel blocker dosages
for her should be:
Started at about 1/2 the standard dosage
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Larry has coronary heart failure, that is being dealt with with digoxin because it famous:
Negative inotropism
Furosemide is delivered to a treatment routine for coronary heart failure that includes
digoxin. Monitoring for this mixture includes:
Serum potassium
Which of the subsequent create a higher danger for digoxin toxicity? Both the reason and
the motive for it should be accurate.
Administration to older adults due to reduced renal function
Serum digoxin stages are monitored for capability toxicity. Monitoring must arise:
Because a reference factor is wanted to adjust dosage
Which of the subsequent is authentic approximately procainamide and its dosing time table?
Rodrigo has been prescribed procainamide after a myocardial infarction. He is monitored for
dyspnea, jugular venous distention, and peripheral edema due to the fact they'll imply:
Onset of congestive heart failure
,Amiodarone has been prescribed in a patient with a supraventricular dysrhythmia. Patient
teaching must include all the following EXCEPT:
Take a hot shower or bathtub in case you feel dizzy.
The NP orders a thyroid panel for a patient on amiodarone. The affected person tells the NP
that he does no longer have thyroid ailment and desires to understand why the test has been
ordered. Which is a correct response?
Amiodarone inhibits an enzyme that is important in making thyroid hormone and may cause
hypothyroidism.
Isosorbide dinitrate is prescribed for a patient with persistent strong angina. This drug is
administered two times day by day, but the time table is 7 a.M. And 2 p.M. Due to the fact:
Nitrate tolerance can broaden.
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Art is a 55-12 months-old smoker who has been identified with angina and positioned on
nitrates. He complains of headaches after using his nitrate. An suitable respond is probably:
In teaching about the usage of sublingual nitroglycerine, the affected person ought to be
informed:
To place one pill underneath the tongue if chest ache happens and allow it to dissolve
Donald has been identified with hyperlipidemia. Based on his lipid profile, atorvastatin is
prescribed. Rhabdomyolysis is an extraordinary but severe destructive response to this drug.
Donald have to be instructed to:
Report muscle weakness or tenderness and dark urine to his provider at once.
Which of the subsequent diagnostic outcomes might NOT suggest a trouble related to a
reductase inhibitor?
Increased white blood cellular count number
Because of the sample of ldl cholesterol synthesis, reductase inhibitors are given
In the evening in a unmarried each day dose
Niaspan, an prolonged-launch form of niacin, was formerly prescribed to deal with a patient's
hypertriglycerides. However, the FDA withdrew its approval of the drug. Which of the
following drugs with studies efficacy ought to be substituted?
1 or 2:
1. Statins
2. Fibrates
, Niaspan is less probable to motive which side impact this is commonplace to niacin?
Cutaneous flushing
Dulcea has kind 2 diabetes and a high triglyceride level. She has been prescribed
gemfibrozil to deal with her hypertriglyceridemia. A history of which of the following would
possibly contraindicate the use of this drug?
Gallbladder sickness
Many sufferers with hyperlipidemia are dealt with with multiple drug. Combining a fibric acid
derivative along with gemfibrozil with which of the subsequent isn't always encouraged? The
drug and the reason ought to both be correct for the solution to be correct.
Reductase inhibitors, because of an expanded danger for rhabdomyolysis
Felicity has been prescribed colestipol to treat her hyperlipidemia. Unlike different
antilipidemics, this drug:
Exchanges chloride ions for negatively charged acids within the bowel
Because of their website of motion, bile acid sequestering resins:
Should be administered one by one from other pills with the aid of at the least 4 hours
Colestipol is available in a powdered shape. The patient is taught to:
Mix the powder with 4 to 6 oz. Of milk or fruit juice
The preference of diuretic to use in treating hypertension is based on:
Level of kidney function with a thiazide diuretic getting used for an envisioned glomerular
filtration fee higher than the mid-40 mL/min variety
Direct renin inhibitors have the subsequent houses. They:
"Shut down" the entire RAAS cycle
When comparing ACE and ARB medicines, which of the subsequent holds proper?
Both contribute to some retention of potassium
How is diabetic renal safety affected by ACE medicinal drugs? Diabetes mellitus sufferers:
Have a discounted charge of renal progression, however ACE medications nonetheless
need to be discontinued whilst superior renal troubles are gift