A nurse is caring for a client who is taking Lisinopril (Prinivil, Zestril). Which of the following outcomes indicates a therapeutic effect of the medication?
Increase of high-density lipoprotein (HDL) cholesterol.
Increased heart rate.
Decreased blood pressure.
Increased blood pressure.
The Correct Answer is C
Choice A rationale
An increase of high-density lipoprotein (HDL) cholesterol is not the primary therapeutic effect of Lisinopril, which is an Angiotensin-Converting Enzyme (ACE) inhibitor and is not typically prescribed as a lipid-modifying agent. While improving overall cardiovascular health may indirectly benefit lipid profiles over time, the main pharmacological action is the inhibition of the renin-angiotensin-aldosterone system.
Choice B rationale
An increased heart rate is an undesirable and non-therapeutic effect of Lisinopril; in fact, ACE inhibitors are often used to manage conditions like heart failure where a decreased heart rate is sometimes a goal. Lisinopril works primarily on vascular smooth muscle to cause vasodilation, which ultimately lowers peripheral vascular resistance and does not directly increase cardiac chronotropy.
Choice C rationale
Decreased blood pressure is the primary and expected therapeutic outcome of Lisinopril, as it inhibits the conversion of Angiotensin I to the potent vasoconstrictor Angiotensin II. This inhibition leads to systemic vasodilation, reduced peripheral vascular resistance, and decreased aldosterone secretion, all contributing to a reduction in both systolic and diastolic blood pressure.
Choice D rationale
An increased blood pressure would indicate a lack of therapeutic effect or a potential failure of the medication to control the client's hypertension, necessitating a dose adjustment or change in antihypertensive regimen. Lisinopril is specifically prescribed to lower elevated blood pressure, making this outcome the opposite of the desired pharmacological action for hypertension management.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale
The pulmonary circulation begins when deoxygenated blood, returning from the systemic circulation, enters the right atrium and then passes into the right ventricle. The right ventricle is the chamber that contracts forcefully to push this deoxygenated blood through the pulmonary semilunar valve into the main pulmonary artery, initiating the flow toward the lungs for gas exchange.
Choice B rationale
The left atrium receives oxygenated blood from the lungs via the pulmonary veins and then pumps it into the left ventricle. This chamber is part of the systemic circulation loop, receiving the final product of pulmonary circulation, and is not the starting point for the flow of blood from the heart to the lungs.
Choice C rationale
The pulmonary artery is the vessel that transports deoxygenated blood from the right ventricle to the lungs. While it carries the blood to the lungs, it is the vessel following the starting chamber, which is the right ventricle, the contracting muscle that generates the initial pressure for the blood's journey.
Choice D rationale
The pulmonary veins carry oxygenated blood from the lungs back to the left atrium of the heart. These vessels are the termination point of the pulmonary circulation loop, after gas exchange has occurred in the capillaries of the lungs, and therefore they are not involved in the initial outflow to the lungs. —.
Correct Answer is C
Explanation
Choice C rationale
Hemoglobin is a complex protein found within red blood cells (erythrocytes) that is specifically responsible for oxygen transport. Each hemoglobin molecule contains four heme groups, each with an iron atom capable of binding reversibly with one molecule of oxygen. This allows oxygen picked up in the lungs to be efficiently transported to peripheral tissues where it is released for cellular use.
Choice A rationale
Platelets, also known as thrombocytes, are small, anuclear cells critical for hemostasis, the process of stopping bleeding. Their primary function involves aggregating at the site of vascular injury to form a platelet plug and releasing clotting factors to initiate the coagulation cascade. They have no role in oxygen transport.
Choice B rationale
Neutrophils are the most abundant type of white blood cell (leukocyte) and are a key component of the innate immune system. Their primary function is phagocytosis, engulfing and destroying invading pathogens like bacteria. Like other leukocytes, they are involved in immune defense, not oxygen transport.
Choice D rationale
Lymphocytes are a type of white blood cell crucial for adaptive immunity. They include T cells (involved in cell-mediated immunity) and B cells (responsible for producing antibodies in humoral immunity). Their function is centered on recognizing and destroying specific foreign antigens, not transporting respiratory gases.
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