A nurse is evaluating a client who has hypertension and is taking lisinopril, an angiotensin II receptor blocker (ARB). Which of the following outcomes indicates that the medication is effective?

The client has no edema in the lower extremities.

The client has a urine output of 30 mL/hr.

The client has a blood pressure of 120/78 mm Hg.

The client has a serum creatinine level of 1.2 mg/dL.

Answer and Explanation

The Correct Answer is C

The client has a blood pressure of 120/78 mm Hg. This indicates that the medication is effective because it lowers the blood pressure below the hypertensive levels. In adults 60 years of age or older, this is typically defined as a systolic pressure below 150 mm Hg and a diastolic pressure below 90 mm Hg.

Choice A is wrong because the client has no edema in the lower extremities. This is not a specific outcome of lisinopril, an angiotensin II receptor blocker (ARB). Edema can be caused by many factors, such as heart failure, kidney disease, or venous insufficiency. Lisinopril does not directly affect fluid retention or edema.

Choice B is wrong because the client has a urine output of 30 mL/hr. This is a low urine output that may indicate dehydration, kidney impairment, or urinary obstruction. Lisinopril is expected to increase urine output by reducing the blood pressure and improving the renal blood flow.

Choice D is wrong because the client has a serum creatinine level of 1.2 mg/dL. This is a high serum creatinine level that may indicate kidney damage or reduced kidney function. Lisinopril is expected to lower the serum creatinine level by preventing the progression of kidney disease and protecting the kidney from further injury.

Normal ranges of urine output, blood pressure, and serum creatinine are:

• Urine output: 800 to 2000 mL/day or 40 to 80 mL/hr

• Blood pressure: less than 120/80 mm Hg for adults

• Serum creatinine: 0.6 to 1.2 mg/dL for males and 0.5 to 1.1 mg/dL for females

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Correct Answer is A

Explanation

The nurse should monitor the client’s serum potassium level closely because furosemide is a loop diuretic that can cause hypokalemia, which increases the risk of cardiac arrhythmias and digitalis toxicity. The nurse should also monitor the client’s fluid status, blood pressure, and renal function.

Choice B is wrong because Serum calcium is wrong because furosemide does not affect calcium levels significantly. Calcium levels are more likely to be affected by thiazide diuretics, which can cause hypercalcemia.

Choice C is wrong because Serum albumin is wrong because furosemide does not affect albumin levels significantly. Albumin levels are more likely to be affected by liver disease, malnutrition, or nephrotic syndrome.

Choice D is wrong because Serum glucose is wrong because furosemide does not affect glucose levels significantly. Glucose levels are more likely to be affected by diabetes mellitus, corticosteroids, or stress.

Normal ranges for the laboratory values are:

• Serum potassium: 3.5-5.0 mEq/L

• Serum calcium: 8.5-10.5 mg/dL

• Serum albumin: 3.5-5.0 g/dL

• Serum glucose: 70-110 mg/dL

A. Beta blockers B. Calcium channel blockers C. Angiotensin II receptor blockers (ARBs) D. Direct acting vasodilators E. Adrenergic drugs.

Correct Answer is E

Explanation

Adrenergic drugs.These are drugs that stimulate the sympathetic nervous system by mimicking or enhancing the effects of epinephrine and norepinephrine, the chemical messengers that activate adrenergic receptors.Adrenergic drugs can increase blood pressure, heart rate, cardiac output, vascular tone, and renin release by acting on different types of adrenergic receptors.

Choice A is wrong because beta blockers are drugs that inhibit the sympathetic nervous system by blocking the beta adrenergic receptors, which are responsible for increasing heart rate and contractility. Beta blockers can lower blood pressure and reduce cardiac workload.

Choice B is wrong because calcium channel blockers are drugs that inhibit the movement of calcium ions across the cell membrane of smooth muscle cells, which are found in blood vessels and the heart.Calcium channel blockers can relax blood vessels and lower blood pressure, as well as reduce heart rate and contractility.

Choice C is wrong because angiotensin II receptor blockers (ARBs) are drugs that block the action of angiotensin II, a hormone that causes vasoconstriction and stimulates the release of aldosterone, which increases sodium and water retention.

ARBs can lower blood pressure by dilating blood

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A nurse is evaluating a client who has hypertension and is taking lisinopril, an angiotensin II receptor blocker (ARB). Which of the following outcomes indicates that the medication is effective?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has heart failure and is prescribed furosemide. Which of the following laboratory values should the nurse monitor closely?

Correct Answer is A

Explanation

Which drugs act on the sympathetic nervous system, which regulates blood pressure by controlling heart rate, cardiac output, vascular tone, and renin release?

Correct Answer is E

Explanation

A nurse is assessing a client who has heart failure and is receiving metoprolol. Which of the following statements by the client indicates a therapeutic effect of the medication?

A nurse is teaching a client who has heart failure and is prescribed captopril. Which of the following instructions should the nurse include? (Select all that apply.).

A nurse is caring for a client who has hypertension and is prescribed metoprolol, a beta blocker. The nurse should monitor the client for which of the following adverse effects?

The nurse is teaching a patient with heart failure about dietary modifications to reduce fluid retention and improve cardiac function. Which of the following foods should the nurse advise the patient to limit or avoid?

The nurse is reviewing the discharge instructions with a patient who has heart failure and is prescribed losartan (Cozaar). Which of the following statements by the patient indicates understanding of the teaching? (Select all that apply.)

Which drug blocks the binding of angiotensin II to its receptors on blood vessels and adrenal glands, preventing its vasoconstrictive and aldosterone-stimulating effects?

Which drug increases the excretion of water and sodium by the kidneys, reducing blood volume and blood pressure?

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