NSG 6005 QUIZLET_W6

1.Ray has been diagnosed with hypertension and an ACE inhibitor is determined to be needed. Prior to prescribing this drug, the NP should assess for: A.Hypokalemia B.Impotence C.Decreased renal function D.Inability to concentrate C.Decreased renal function 2.ACE inhibitors are the drug of choice in treating hypertension in diabetic patients because they 1.Improve insulin sensitivity 2.Improve renal hemodynamics 3.Reduce the production of angiotensin II 4.All of the above 4.All of the above 3.A potentially life-threatening adverse response to ACE inhibitors is angioedema. Which of the following statements is true about this adverse response? 1.Swelling of the tongue or hoarseness are the most common symptoms. 2.It appears to be related to the decrease in aldosterone production. 3.Presence of a dry, hacky cough indicates a high risk for this adverse response. 4.Because it takestime to build up a blood level, it occurs after being on the drug for about 1week. 1.Swelling of the tongue or hoarseness are the most common symptoms. 4.ACE inhibitors are useful in a variety of disorders. Which of the following statements are true about both its usefulness in the disorder and the reason for its use? 1.Stable angina because it decreases the thickening of vascular walls due to decreased modified release. 2.Heart failure because it reduces remodeling of injured myocardial tissues. 3.Both 1 and 2 aretrue and the reasons are correct. 4.Both 1 and 2 aretrue but the reasons are wrong. 5 Neither 1 nor 2 are true 3.Both 1 and 2 aretrue and the reasons are correct. Stable angina because it decreases the thickening of vascular walls to decreased MOD. Heart failure because it reduces remodeling of injured myocardial tissues. 5.Despite good blood pressure control, a NP might change a patient's drug from an ACEI to an angiotensin II receptor blocker (ARB) because the ARB: A.Is stronger than the ACEI B.Does not produce a dry, hacky cough C.Has no effect on the renal system D.Reduces sodium and water retention b. Does not produce a dry, hacky cough ACE INHIBITORS: • Dry, hacking cough in some patients • Can switch to an angiotension blocker which won't cause cough • Reduce dose with either of these if Cr. > 2.5 • Most are associated with hypotension: dizziness, headache, fatigue, orthostatic hypotension, tachyphylaxis (Medical term describing an acute (sudden) decrease in the response to a drug after its administration.) 6.While taken an ARB, patients need to avoid certain over-the-counter drugs without first consulting the provider because 1.Cimetidine is metabolized by the CYP 3A4 isoenzymes (antacid/antihistamine) 2.Nonsteroidal anti-inflammatory drugs reduce prostaglandin levels 3.Both 1 and 2 4.Neither 1 nor 2 3.Both 1 and 2 Cimetidine is metabolized by the CYP3A4 isoenzymes NSAIDS reduce prostaglandin levels 7.Laboratory monitoring for patients on ACEIs or ARBs should include: A.White blood cells counts with the drug dose increased for elevations above 10,000 B.Liver function tests with the drug dose stopped for ALT values 2normal C.Serum creatinine levels with the drug dose reduced for values above 2.5 mg/dL D.Serum glucose levels with the drug dose increased for levels above 120 mg/dL C.Serum creatinine levels with the drug dose reduced for values above 2.5 mg/dL 8.Jacob has hypertension, for which a calcium channel blocker has been prescribed. This drug helps control blood pressure because it: 1.Decreases the amount of calcium inside the cell 2. Reduces stroke volume 3. increases the activity of the na+/K+/ATPase pump indirectly 4.Decreases HR 1. Decreases the amount of calcium inside the cell 9. Which of the following adverse effects may occur due to a dihydropyridine-type calcium channel blocker? 1. bradycardia 2. hepatic impairment 3. increased contractility 4. edema of the hands and feet 4. edema of the hands and feet 10. patient teaching related to amlodipine includes: 1. increase calcium intake to prevent osteoporosis 2. do not crush the tablet; it must be given in liquid form if the patient has trouble swallowing it 3. avoid grapefruit juice as it affects the metabolism of this drug. 4. rise slowly from a supine position to reduce orthostatic hypotension 3. Avoid grapefruit juice as it affects the metabolism of this drug --> increase Amlodipine level.