A nurse is assessing a client who is taking losartan.
Which of the following findings should the nurse identify as an adverse effect of this medication?
Hypertension.
Double vision.
Dizziness.
Hyperactivity.
The Correct Answer is C
Choice A rationale
Losartan is an angiotensin II receptor blocker (ARB) which works by preventing angiotensin II from binding to its receptors in vascular smooth muscle, thereby causing vasodilation and lowering blood pressure. Hypertension is the condition losartan is prescribed to treat, not an adverse effect, because its mechanism directly counteracts the vasoconstrictive effects of angiotensin II. The intended therapeutic effect is a reduction in systemic vascular resistance and blood pressure.
Choice B rationale
Double vision, also known as diplopia, is not a recognized common or significant adverse effect of losartan. The mechanism of action of losartan primarily targets the renin-angiotensin-aldosterone system (RAAS), influencing blood pressure regulation and fluid balance, not directly affecting the central nervous system or ocular motor function. This symptom would be more indicative of neurological or ophthalmological issues unrelated to the medication's primary action.
Choice C rationale
Dizziness is a common adverse effect of losartan. This is a direct consequence of its therapeutic action, which is to lower blood pressure. The resulting vasodilation and reduced blood pressure can lead to orthostatic hypotension, causing feelings of lightheadedness or dizziness, especially when a person changes positions, like standing up. The brain's reduced perfusion pressure triggers this sensation as a physiological response.
Choice D rationale
Hyperactivity is not an expected adverse effect of losartan. The medication primarily affects the cardiovascular system by modulating the RAAS to lower blood pressure. It does not have known stimulant properties that would lead to increased energy, restlessness, or hyperactivity. Such a finding would likely be attributed to other factors or a different underlying condition, not the pharmacological action of this medication. *.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale
Metformin extended-release tablets are designed with a special matrix that releases the medication gradually over time. Crushing or chewing the tablet would destroy this matrix, leading to an immediate and potentially unsafe release of the entire dose. This could cause a sudden drop in blood glucose and increase the risk of adverse gastrointestinal side effects.
Choice B rationale
Metformin is typically recommended to be taken with the evening meal to minimize gastrointestinal side effects such as nausea and diarrhea, which are common when starting the medication. Taking it in the morning on an empty stomach could increase the severity of these adverse effects due to the rapid concentration increase in the gastrointestinal tract.
Choice C rationale
Metformin is not associated with weight gain; in fact, it is often associated with a small amount of weight loss. This is due to its effect on reducing appetite and its ability to improve insulin sensitivity, which can help regulate metabolism and prevent the weight gain often seen with other diabetes medications.
Choice D rationale
Metformin is best taken with a meal to enhance its absorption and to mitigate common gastrointestinal side effects. Taking it on an empty stomach can increase the likelihood and severity of adverse effects like nausea, vomiting, and diarrhea because the medication can directly irritate the gastrointestinal mucosa
Correct Answer is A
Explanation
Choice A rationale
Chills are a systemic manifestation of an infectious process and are commonly associated with endometritis. Endometritis is an infection of the uterine lining, which can cause a systemic inflammatory response. This response often includes fever and chills, as the body's immune system fights the invading pathogens, causing a thermoregulatory cascade. A temperature of 100.4°F (38°C) or higher is typical.
Choice B rationale
Back pain can occur with various postpartum conditions, but it is not a primary or specific finding for endometritis. While uterine cramping and pelvic pain are characteristic due to the uterine inflammation, back pain is not as specific. More classic signs are fever, lower abdominal pain, uterine tenderness, and foul-smelling lochia due to the presence of bacteria.
Choice C rationale
Tachycardia, not bradycardia, is an expected finding in a client with endometritis. Tachycardia is a physiological response to fever, infection, and the systemic inflammatory process. The heart rate increases to compensate for increased metabolic demand and to circulate immune cells more efficiently. Bradycardia would be an unusual and unexpected finding.
Choice D rationale
Agitation is not a primary or typical finding of endometritis. Endometritis is a physical infection of the uterine lining. While discomfort and fever may cause irritability, agitation is not a specific expected symptom. This finding is more associated with neurological or psychiatric conditions, or severe complications like septic shock, which is a more advanced state. *.
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