Lehne Ch 44 Drugs Acting on RAAS Questions and Answers With Verified
Solutions 2025
1. 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.
Bronchial asthma
b.
Coronary artery disease
c.
Diabetes mellitus
d.
Renal artery stenosis - ANS: D
ACE inhibitors can cause severe renal insufficiency in patients with bilateral renal artery stenosis or
stenosis in the artery to a single remaining kidney. Bronchial asthma, coronary artery disease, and
diabetes mellitus are not comorbidities that are contraindications to treatment with an ACE inhibitor.
PTS: 1 DIF: Cognitive Level: Application REF: p. 474 | p. 476
2. A nurse administers an ACE inhibitor to a patient who is taking the drug for the first time. What will
the nurse do?
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. - ANS: A
, Severe hypotension can result with the first dose of an ACE inhibitor. The patient should be discouraged
from getting up without assistance. Potassium supplements are contraindicated. A dry cough is an
expected side effect that eventually may cause a patient to discontinue the drug; however, it is not a
contraindication to treatment. Diuretics can exacerbate hypotension and should be discontinued
temporarily when a patient starts an ACE inhibitor.
PTS: 1 DIF: Cognitive Level: Application REF: p. 476
3. 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.
"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." - ANS: A
ACE inhibitors have many advantages over other antihypertensive medications, the most important of
which is their ability to prevent or reverse pathologic changes in the heart and reduce the risk of cardiac
mortality caused by hypertension. They are useful in patients with high low-density lipoprotein (LDL) or
low high-density lipoprotein (HDL) cholesterol, but they do not directly affect this comorbidity. They
reduce venous return to the heart, thereby reducing right heart size. They do not alter serum electrolyte
levels.
PTS: 1 DIF: Cognitive Level: Application REF: p. 474
4. 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.
"I am less likely to develop diabetic nephropathy when taking this medication."
b.
Solutions 2025
1. 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.
Bronchial asthma
b.
Coronary artery disease
c.
Diabetes mellitus
d.
Renal artery stenosis - ANS: D
ACE inhibitors can cause severe renal insufficiency in patients with bilateral renal artery stenosis or
stenosis in the artery to a single remaining kidney. Bronchial asthma, coronary artery disease, and
diabetes mellitus are not comorbidities that are contraindications to treatment with an ACE inhibitor.
PTS: 1 DIF: Cognitive Level: Application REF: p. 474 | p. 476
2. A nurse administers an ACE inhibitor to a patient who is taking the drug for the first time. What will
the nurse do?
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. - ANS: A
, Severe hypotension can result with the first dose of an ACE inhibitor. The patient should be discouraged
from getting up without assistance. Potassium supplements are contraindicated. A dry cough is an
expected side effect that eventually may cause a patient to discontinue the drug; however, it is not a
contraindication to treatment. Diuretics can exacerbate hypotension and should be discontinued
temporarily when a patient starts an ACE inhibitor.
PTS: 1 DIF: Cognitive Level: Application REF: p. 476
3. 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.
"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." - ANS: A
ACE inhibitors have many advantages over other antihypertensive medications, the most important of
which is their ability to prevent or reverse pathologic changes in the heart and reduce the risk of cardiac
mortality caused by hypertension. They are useful in patients with high low-density lipoprotein (LDL) or
low high-density lipoprotein (HDL) cholesterol, but they do not directly affect this comorbidity. They
reduce venous return to the heart, thereby reducing right heart size. They do not alter serum electrolyte
levels.
PTS: 1 DIF: Cognitive Level: Application REF: p. 474
4. 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.
"I am less likely to develop diabetic nephropathy when taking this medication."
b.
