A patient has 2+ pitting edema of the lower extremities bilaterally. Auscultation of the lungs reveals crackles bilaterally, and the serum potassium level is 6 mEq/L, which is above normal level. Which agent ordered by the prescriber should the nurse question?
Beta blockers
Alpha 2 agonists
Calcium channel blockers
Aldosterone antagonists
The Correct Answer is D
Choice A reason: This is not the agent that the nurse should question. Beta blockers are a class of medications that lower the blood pressure and heart rate by blocking the beta receptors in the heart and blood vessels. They can be used to treat hypertension, angina, heart failure, and arrhythmias. They do not cause edema or hyperkalemia.
Choice B reason: This is not the agent that the nurse should question. Alpha 2 agonists are a class of medications that lower the blood pressure by stimulating the alpha 2 receptors in the brain, which reduce the sympathetic nervous system activity. They can be used to treat hypertension, especially in patients with renal impairment. They do not cause edema or hyperkalemia.
Choice C reason: This is not the agent that the nurse should question. Calcium channel blockers are a class of medications that lower the blood pressure and heart rate by blocking the calcium channels in the heart and blood vessels, which cause vasodilation and reduced cardiac contractility. They can be used to treat hypertension, angina, and arrhythmias. They may cause edema, but not hyperkalemia.
Choice D reason: This is the agent that the nurse should question. Aldosterone antagonists are a class of medications that lower the blood pressure and reduce fluid retention by blocking the action of aldosterone, a hormone that regulates the sodium and potassium balance in the body. They can be used to treat hypertension and heart failure, especially in patients with low renin levels. However, they can cause hyperkalemia, which can be dangerous for the patient. The nurse should question the prescriber about the rationale for prescribing this agent and monitor the patient's potassium level closely.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: This is not the cause of pulmonary symptoms in left heart failure. Decreased cardiac output is a consequence of left heart failure, which affects the perfusion of vital organs and tissues.
Choice B reason: This is not the cause of pulmonary symptoms in left heart failure. Bronchoconstriction is a feature of asthma and chronic obstructive pulmonary disease (COPD), which affect the airways and cause wheezes and shortness of breath.
Choice C reason: This is not the cause of pulmonary symptoms in left heart failure. Inflammatory pulmonary edema is a type of non-cardiogenic pulmonary edema, which occurs when the alveolar-capillary membrane is damaged by an inflammatory process, such as pneumonia or sepsis.
Choice D reason: This is the correct cause of pulmonary symptoms in left heart failure. Pulmonary vascular congestion is a result of increased pressure in the pulmonary circulation, which occurs when the left ventricle fails to pump blood effectively to the aorta and the rest of the body. This causes fluid to leak into the alveoli and interstitial spaces, leading to cough, dyspnea, crackles, and pink frothy sputum.
Correct Answer is B
Explanation
Choice A reason: Montelukast does not increase vessel permeability. It blocks the effects of leukotrienes, which are inflammatory mediators that cause vessel permeability, bronchoconstriction, and mucus secretion. By blocking leukotrienes, montelukast reduces vessel permeability and inflammation.
Choice B reason: Montelukast reduces bronchoconstriction and mucus secretion. It blocks the effects of leukotrienes, which are inflammatory mediators that cause bronchoconstriction and mucus secretion. By blocking leukotrienes, montelukast improves airflow and reduces asthma symptoms.
Choice C reason: Montelukast does not increase inflammation. It blocks the effects of leukotrienes, which are inflammatory mediators that cause inflammation, bronchoconstriction, and mucus secretion. By blocking leukotrienes, montelukast reduces inflammation and prevents asthma exacerbations.
Choice D reason: Montelukast does not increase bronchoconstriction. It blocks the effects of leukotrienes, which are inflammatory mediators that cause bronchoconstriction, mucus secretion, and inflammation. By blocking leukotrienes, montelukast reduces bronchoconstriction and improves airflow.
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