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
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["C","D","E"]
Explanation
Choice A reason: Affinity is not about dosage form but the strength of drug-receptor binding. Dosage is unrelated to receptor interaction, so this is incorrect for affinity’s definition.
Choice B reason: Low affinity means weak attraction to receptors, not strong. High affinity indicates strong binding, so this statement is incorrect.
Choice C reason: High affinity means strong attraction between drug and receptor, enhancing binding and effect. This is accurate, making it a correct choice.
Choice D reason: Affinity influences potency; higher affinity often means greater potency at lower doses. This relationship is correct, making it a correct choice.
Choice E reason: Affinity is the strength of attraction between drug and receptor, a fundamental pharmacological concept. This definition is accurate, so this is a correct choice.
Correct Answer is A
Explanation
Choice A reason: Patient weight: 198 lbs ÷ 2.2 = 90 kg. Dose: 1 mg/kg × 90 kg = 90 mg. Volume: 90 mg ÷ (30 mg/0.3 mL) = 90 × 0.3/30 = 0.9 mL. This delivers the correct anticoagulant dose for conditions like DVT, making it the accurate choice.
Choice B reason: For 90 kg (198 lbs ÷ 2.2), the dose is 90 mg. Volume: 90 mg ÷ (30 mg/0.3 mL) = 0.9 mL. Choice B (1.2 mL) delivers 120 mg (1.2 × 30/0.3), overdosing Lovenox, increasing bleeding risk, making it incorrect.
Choice C reason: The correct volume for 90 mg is 0.9 mL (90 ÷ 30 mg/0.3 mL). Choice C (0.6 mL) delivers 60 mg (0.6 × 30/0.3), underdosing Lovenox, reducing anticoagulant efficacy, which could fail to prevent thrombosis, making this choice incorrect.
Choice D reason: For 90 mg, the volume is 0.9 mL. Choice D (0.3 mL) delivers 30 mg (0.3 × 30/0.3), significantly underdosing Lovenox for a 90 kg patient, risking inadequate anticoagulation and thrombotic events, making this choice incorrect.
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