A nurse understands that a common reason why a patient is prescribed a combination of diuretics is because?
They are a part of the initial diuretic therapy.
They decrease the risk of hypokalemia while still excreting sodium.
They boost the blood-pressure-lowering effect of other medications.
They have fewer side effects when used in a drug combination.
The Correct Answer is B
Hypokalemia is a condition where the blood potassium level is too low, which can cause muscle weakness, arrhythmias, and other problems. Diuretics are drugs that increase urine output and help remove excess fluid from the body. Some diuretics, such as loop diuretics, also cause potassium loss in the urine. To prevent hypokalemia, a combination of diuretics may be prescribed, such as a loop diuretic with a potassium-sparing diuretic or a thiazide diuretic. These combinations help balance the potassium level while still removing sodium and water.
Choice A is wrong because they are not a part of the initial diuretic therapy. Combination diuretic therapy is usually reserved for patients who have resistant edema or hypertension that does not respond to monotherapy.
Choice C is wrong because they do not boost the blood-pressure-lowering effect of other medications. Diuretics can lower blood pressure by reducing blood volume and relaxing blood vessels, but they are not used to enhance the effect of other antihypertensive drugs.
Choice D is wrong because they do not have fewer side effects when used in a drug combination. Combination diuretic therapy can increase the risk of electrolyte imbalances, such as hyponatremia, hypokalemia, hypomagnesemia, and metabolic alkalosis. It can also cause hypotension, dehydration, and worsening renal function. Therefore, combination diuretic therapy should be used with caution and close monitoring.
Normal ranges for blood potassium level are 3.5 to 5.0 mmol/L or 3.5 to 5.0 mEq/L. Normal ranges for blood sodium level are 135 to 145 mmol/L or 135 to 145 mEq/L.
Normal ranges for blood pressure are less than 120/80 mm Hg for normal, 120-129/less than 80 mm Hg for elevated, 130-139/80-89 mm Hg for stage 1 hypertension, and 140 or higher/90 or higher mm Hg for stage 2 hypertension.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Nitroglycerin is a medication that dilates the blood vessels and improves blood flow to the heart. It is used to treat angina, a condition that causes chest pain due to reduced oxygen supply to the heart. However, nitroglycerin can lose its effectiveness over time if it is used continuously. This is called tolerance, and it means that the patient will need higher doses of the medication to achieve the same relief. To avoid tolerance, patients who use transdermal nitroglycerin patches are instructed to remove the patch at bedtime and apply a new one in the morning. This creates a nitrate-free interval of about 8 to 12 hours, which allows the body to restore its sensitivity to nitroglycerin.
Choice A is wrong because an allergic response is not a common side effect of nitroglycerin. Some patients may experience skin irritation or rash at the site of application, but this is usually mild and does not require discontinuation of the medication.
Choice C is wrong because overdosage is unlikely with transdermal nitroglycerin patches. The patches deliver a controlled amount of nitroglycerin through the skin over a period of time. The risk of overdosage is higher with other forms of nitroglycerin, such as tablets or sprays, which are taken as needed for acute angina attacks.
Choice D is wrong because forgetting to remove the patch in the morning is not a serious problem. The patch will continue to deliver nitroglycerin until it is removed, but it will not cause harm to the patient. However, it may reduce the effectiveness of the next patch if there is no nitrate-free interval between them.
Correct Answer is A
Explanation
Lisinopril belongs to the class of drugs calledangiotensin-converting enzyme (ACE) inhibitors.ACE inhibitors work by blocking the enzyme that converts angiotensin I to angiotensin II, a hormone that causes blood vessels to narrow and raise blood pressure.By inhibiting this enzyme, ACE inhibitors relax and widen the blood vessels, lower blood pressure, and improve blood flow to the heart and kidneys.
Choice B.Candesartan is wrong because it belongs to the class of drugs calledangiotensin II receptor blockers (ARBs).ARBs work by blocking the action of angiotensin II on its receptors, preventing it from causing blood vessel constriction and high blood pressure.ARBs are similar to ACE inhibitors in their effects, but they do not affect the enzyme or the level of bradykinin, a peptide that can cause cough and angioedema as side effects of ACE inhibitors.
Choice C.Metoprolol is wrong because it belongs to the class of drugs calledbeta blockers.Beta blockers work by blocking the effects of adrenaline and other hormones that stimulate the heart and blood vessels, causing them to beat slower and with less force.Beta blockers lower blood pressure and reduce the workload on the heart.
Choice D.Amlodipine is wrong because it belongs to the class of drugs calledcalcium channel blockers.Calcium channel blockers work by blocking the entry of calcium into the muscle cells of the heart and blood vessels, causing them to relax and dilate.Calcium channel blockers lower blood pressure and improve blood flow to the heart.
Normal ranges for blood pressure vary depending on age, gender, and other factors, but generally, a systolic blood pressure (the top number) of less than 120 mmHg and a diastolic blood pressure (the bottom number) of less than 80 mmHg are considered normal for adults.A blood pressure of 130/80 mmHg or higher is considered high and may require treatment with medication.
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