A provider has ordered captopril [Capoten] for a patient who has hypertension. The patient reports a history of swelling of the tongue and lips after taking enalapril [Vasotec] in the past. Which action by the nurse is correct?

Administer the captopril and monitor for adverse effects

Request an order to administer fosinopril instead of captopril

Hold the dose and notify the provider

Reassure the patient that this is not a serious side effect

Answer and Explanation

The Correct Answer is C

Choice A reason: Administering captopril risks angioedema, as the patient’s history of tongue and lip swelling with enalapril (another ACE inhibitor) suggests a class effect due to bradykinin accumulation. This is potentially life-threatening, requiring avoidance, not monitoring, making this choice unsafe and incorrect.

Choice B reason: Fosinopril, another ACE inhibitor, carries the same angioedema risk as captopril and enalapril due to similar bradykinin effects. Switching within the same drug class doesn’t address the patient’s history of adverse reactions, making this choice inappropriate and potentially dangerous.

Choice C reason: Holding captopril and notifying the provider is correct, as the patient’s history of angioedema with enalapril indicates a high risk with captopril, another ACE inhibitor. Alternative classes (e.g., ARBs) should be considered to avoid life-threatening reactions, making this the safest and correct action.

Choice D reason: Angioedema (tongue and lip swelling) is a serious, potentially fatal side effect of ACE inhibitors, not benign. Reassuring the patient minimizes the risk, which could delay intervention. The history warrants avoiding captopril and consulting the provider, making this choice incorrect and unsafe.

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Correct Answer is B

Explanation

Choice A reason: Hydrochlorothiazide is for chronic hypertension, not acute pulmonary edema. Furosemide acts rapidly to relieve fluid overload, so this is incorrect for emergency use.

Choice B reason: Furosemide is the drug of choice for pulmonary edema, rapidly reducing fluid overload and relieving symptoms like frothy sputum. This is the correct choice.

Choice C reason: Mannitol is used for cerebral edema, not pulmonary edema. Furosemide targets acute fluid overload in the lungs, so this is incorrect for this scenario.

Choice D reason: Spironolactone is for chronic heart failure, not acute pulmonary edema. Furosemide’s rapid diuresis is needed, so this is incorrect for immediate treatment.

A. Poor medication compliance B. Increased force of ventricular contraction C. Decreased force of ventricular contraction D. Lack of exercise

Correct Answer is C

Explanation

Choice A reason: Poor medication compliance may worsen heart failure but isn’t directly linked to crackles and shortness of breath. These symptoms result from fluid overload due to reduced cardiac output, not solely non-adherence. This choice is less specific to the physiological cause described.

Choice B reason: Increased ventricular contraction force, as with inotropes like digoxin, improves cardiac output, reducing fluid backup. Crackles and shortness of breath indicate fluid overload from poor heart function, not enhanced contraction, making this choice incorrect for the symptoms’ cause.

Choice C reason: Decreased ventricular contraction force in heart failure reduces cardiac output, causing blood to back up into the lungs, leading to pulmonary edema. This manifests as crackles and shortness of breath due to fluid accumulation, making this the correct physiological explanation for the symptoms.

Choice D reason: Lack of exercise may contribute to overall heart failure progression but doesn’t directly cause crackles and shortness of breath. These symptoms stem from acute fluid overload due to impaired cardiac pumping, not deconditioning, making this choice incorrect for the immediate cause.

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A provider has ordered captopril [Capoten] for a patient who has hypertension. The patient reports a history of swelling of the tongue and lips after taking enalapril [Vasotec] in the past. Which action by the nurse is correct?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A patient is brought to the emergency department with shortness of breath, a respiratory rate of 30 breaths per minute, intercostal retractions, and frothy, pink sputum. The nurse caring for this patient will expect to administer which drug?

Correct Answer is B

Explanation

A patient who has heart failure. The patient complains of shortness of breath, and the nurse auscultates crackles in the lungs. The nurse understands that these symptoms are the result of

Correct Answer is C

Explanation

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