A patient is taking an ACE inhibitor for hypertension. The patient reports a constant, dry, hacking cough. The nurse would expect the provider to change the current treatment to which of the following medications?

Hydralazine

An antiplatelet medication

An angiotensin in receptor blocker (ARB)

Nitroglycerin

Answer and Explanation

The Correct Answer is C

A. Hydralazine is a vasodilator, but it does not have the same mechanism of action as ACE inhibitors or ARBs and would not be an appropriate substitute.

B. An antiplatelet medication is not appropriate for addressing a cough and is typically used for cardiovascular conditions like preventing blood clots.

C. ARBs, such as losartan, are a class of medications that work similarly to ACE inhibitors by blocking the effects of angiotensin II, but they do not cause the common side effect of a dry, hacking cough, which is seen with ACE inhibitors. This makes ARBs a good alternative for patients who experience this side effect.

D. Nitroglycerin is a vasodilator used in acute conditions like chest pain, not for managing hypertension or a cough related to ACE inhibitors.

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Correct Answer is C

Explanation

A. Bilateral lower extremity reddening when legs are dangled could be seen in other conditions like deep vein thrombosis (DVT) but is not typical of CVI.

B. Shiny white skin with "hole-punch" ulcers is more characteristic of arterial insufficiency rather than venous insufficiency.

C. Chronic venous insufficiency (CVI) is characterized by impaired venous return, which leads to fluid buildup, skin changes, and ulcer formation. The skin becomes leathery and brown due to hemosiderin deposition from blood pooling in the lower extremities. Ulcers often occur around the ankles and have irregular borders.

D. Red, swollen, tender areas in one calf are more indicative of DVT, not chronic venous insufficiency.

A. Avoid straining or blowing your nose forcefully. B. Brush your teeth vigorously to avoid gum infections. C. if a dose of the medication is missed, double the dose at the next scheduled time D. Rotate injection sites when on this medication

Correct Answer is A

Explanation

A. Warfarin is an anticoagulant, which increases the risk of bleeding. Activities like straining or forceful nose blowing can increase the risk of bleeding, particularly nasal or internal bleeding, so the nurse should advise the client to avoid these actions.

B. Brushing teeth vigorously is not recommended with warfarin because it can lead to bleeding gums. The nurse should suggest using a soft toothbrush and brushing gently.

C. If a dose of warfarin is missed, the client should not double the dose. They should take the missed dose as soon as they remember, unless it's close to the time for the next dose, in which case they should skip the missed dose and resume the normal dosing schedule.

D. Warfarin is an oral medication, so rotating injection sites is not applicable. This advice is more relevant for injectable medications like insulin or heparin.

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A patient is taking an ACE inhibitor for hypertension. The patient reports a constant, dry, hacking cough. The nurse would expect the provider to change the current treatment to which of the following medications?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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