A patient with type 2 diabetes is taking a beta-blocker as part of treatment for hypertension.
The nurse needs to monitor for which potential complication?
Dehydration.
Hyperkalemia.
Hypoglycemia.
Angina.
The Correct Answer is C
Choice A rationale
Dehydration is not a primary complication directly associated with beta-blocker use. Beta-blockers, such as propranolol or metoprolol, primarily affect the cardiovascular system by blocking beta-adrenergic receptors, which decreases heart rate and blood pressure. Dehydration is typically caused by inadequate fluid intake or excessive fluid loss from conditions like vomiting, diarrhea, or diuresis.
Choice B rationale
Hyperkalemia is an elevated potassium level, which is a rare side effect of non-selective beta-blockers, but not a primary complication to monitor for in a patient taking a beta-blocker for hypertension. Hyperkalemia is more commonly associated with conditions like renal failure or the use of certain medications, such as ACE inhibitors or potassium-sparing diuretics.
Choice C rationale
Beta-blockers can mask the physiological signs of hypoglycemia in patients with diabetes, such as tremors, palpitations, and tachycardia. This occurs because the drugs block the sympathetic nervous system's compensatory response to low blood glucose, which normally involves the release of epinephrine. Consequently, a patient may not recognize a hypoglycemic event until it becomes severe.
Choice D rationale
Angina is a symptom of myocardial ischemia, and beta-blockers are often used to prevent it, not cause it. By reducing the heart rate and contractility, beta-blockers decrease myocardial oxygen demand. This effect helps to prevent chest pain associated with angina, making it a therapeutic benefit rather than a potential complication.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A rationale
Thiazide diuretics, such as hydrochlorothiazide, lower blood pressure by inhibiting sodium and chloride reabsorption in the distal convoluted tubule of the kidneys. This increases the excretion of water and salt, reducing blood volume and thereby lowering blood pressure.
Choice B rationale
ACE inhibitors, like lisinopril, lower blood pressure by blocking the conversion of angiotensin I to angiotensin II. Angiotensin II is a potent vasoconstrictor, so inhibiting its formation leads to vasodilation and reduced blood pressure, also reducing aldosterone secretion.
Choice C rationale
Calcium channel blockers (CCBs) inhibit the influx of calcium ions into vascular smooth muscle and cardiac cells. This leads to the relaxation of the muscle walls, causing vasodilation and a decrease in peripheral vascular resistance, which in turn lowers blood pressure.
Choice D rationale
Beta-blockers, such as metoprolol, lower blood pressure by blocking the effects of epinephrine and norepinephrine. This leads to a decrease in heart rate, myocardial contractility, and cardiac output, thereby reducing blood pressure. They do not directly block calcium entry into muscle cells.
Correct Answer is B
Explanation
Choice A rationale
Metoprolol is a beta-blocker that reduces myocardial oxygen demand by decreasing heart rate, contractility, and blood pressure. While it is effective for long-term management and prevention of angina, it is not the preferred choice for immediate relief of an acute anginal attack due to its slower onset of action. Its primary role is prophylaxis.
Choice B rationale
Nitroglycerin is a potent vasodilator that works by relaxing vascular smooth muscle, primarily affecting veins, which reduces venous return (preload) and myocardial oxygen demand. It also dilates coronary arteries, increasing blood flow and oxygen supply to the heart muscle. Its rapid onset makes it the drug of choice for acute angina.
Choice C rationale
Amlodipine is a calcium channel blocker that works by inhibiting the influx of calcium into vascular smooth muscle and myocardial cells, causing vasodilation and reduced peripheral resistance. Although it is used for the long-term management of chronic stable angina, its onset of action is not rapid enough for immediate relief during an acute attack.
Choice D rationale
Aspirin is an antiplatelet agent that works by irreversibly inhibiting cyclooxygenase (COX) enzyme, preventing the formation of thromboxane A2. This reduces platelet aggregation and clot formation, which is crucial in preventing myocardial infarction in the setting of unstable angina, but it does not provide immediate relief from chest pain.
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