NURSING 6005 CHAPTER 76: DRUGS FOR ASTHMA Test Bank

NURSING 6005 CHAPTER 44: DRUGS ACTING ON THE RENIN-ANGIOTENSIN-ALDOSTERONE SYSTEM Test Bank MULTIPLE CHOICE 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. DIF: Cognitive Level: Application REF: Angiotensin-Converting Enzyme Inhibitors | Therapeutic Uses | Adverse Effects TOP: Nursing Process: Assessment MSC: NCLEX Client Needs Category: Physiologic Integrity: Reduction of Risk Potential 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. DIF: Cognitive Level: Application REF: Angiotensin-Converting Enzyme Inhibitors | Adverse Effects TOP: Nursing Process: Implementation MSC: NCLEX Client Needs Category: Physiologic Integrity: Reduction of Risk Potential 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.”