A client with hypertension has had their ACE inhibitor discontinued and an angiotensin II receptor blocker prescribed. What factor may have contributed to this change in medication?

Rebound hypertension

Persistent cough

Transient ischemic attack

Non-adherence to ACE inhibitor treatment

Answer and Explanation

The Correct Answer is B

A. Rebound hypertension can occur if antihypertensive medications are abruptly stopped, but it is not a direct reason for switching from an ACE inhibitor to an angiotensin II receptor blocker.

B. A persistent cough is a well-known side effect of ACE inhibitors due to the accumulation of bradykinin. If the client experienced this side effect, it would likely prompt the healthcare provider to switch to an angiotensin II receptor blocker, which does not typically cause this issue.

C. A transient ischemic attack (TIA) would require urgent intervention but is not a reason for changing from an ACE inhibitor to an angiotensin II receptor blocker.

D. Non-adherence to ACE inhibitor treatment may lead to ineffective blood pressure control but would not directly justify a switch to a different class of medication.

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Correct Answer is A

Explanation

A. An INR of 5.0 indicates a significantly increased risk of bleeding, and administering vitamin K is the appropriate antidote for reversing the effects of warfarin. This is a critical intervention to restore coagulation.

B. Increasing the dose of warfarin is inappropriate in this scenario because the INR is already elevated; it would further increase bleeding risk.

C. While heparin can be used for anticoagulation, it is not appropriate to administer it while the INR is dangerously high without reversing the warfarin first.

D. Continuing warfarin is unsafe at this INR level due to the high risk of bleeding; monitoring for symptoms without intervention is not adequate care.

A. Increase fluid intake B. Continue the medication; these are expected side effects C. Discontinue the medication and consult a healthcare provider D. Switch to a different type of laxative

Correct Answer is B

Explanation

A. Increasing fluid intake may not alleviate the cramping and diarrhea, which are common side effects of magnesium citrate.

B. Abdominal cramping and diarrhea are expected side effects of magnesium citrate, and the patient can continue the medication unless symptoms become severe.

C. Discontinuing the medication should not be recommended unless the side effects are intolerable or the patient experiences severe reactions.

D. Switching to a different type of laxative is unnecessary unless the patient has contraindications to magnesium citrate or develops severe side effects.

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A client with hypertension has had their ACE inhibitor discontinued and an angiotensin II receptor blocker prescribed. What factor may have contributed to this change in medication?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A patient on warfarin is found to have an INR of 5.0. What is the most appropriate action by the nurse?

Correct Answer is A

Explanation

A patient taking magnesium citrate as an osmotic laxative reports abdominal cramping and diarrhea. What should the nurse recommend?

Correct Answer is B

Explanation

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