Exhibits
Review H and P, nurse's notes, and prescriptions.
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The thiazide diuretic works to decrease the client's blood pressure by
The Correct Answer is {"dropdown-group-1":"A","dropdown-group-2":"D","dropdown-group-3":"C"}
• Decreasing serum sodium levels: Thiazide diuretics reduce blood pressure primarily by promoting the excretion of sodium and water through the kidneys. This decreases blood volume, leading to lower blood pressure by reducing preload and overall circulatory volume.
• Reducing systemic vascular resistance: ACE inhibitors like lisinopril lower blood pressure by inhibiting the conversion of angiotensin I to angiotensin II, a potent vasoconstrictor. This results in vasodilation and reduced systemic vascular resistance, decreasing the workload on the heart.
• Increasing heart rate: Neither thiazide diuretics nor ACE inhibitors primarily increase heart rate. In fact, reflex tachycardia may occur but is not their main mechanism of blood pressure reduction.
• Reducing stroke volume: ACE inhibitors reduce blood pressure by decreasing both systemic vascular resistance and stroke volume through afterload reduction and mild diuretic effect, which reduces cardiac workload.
• Suppressing the appetite: Neither drug class acts by suppressing appetite. Weight management is important for hypertension control but is unrelated to the direct pharmacologic effects of these medications.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. Insomnia may occur while taking the medication: St. John’s wort can cause side effects such as insomnia and restlessness, so the client’s report aligns with known reactions and requires no correction.
B. Sensitivity to the sun can develop: Photosensitivity is a documented adverse effect of St. John’s wort, increasing the risk of sunburn; client awareness of this is appropriate and beneficial.
C. Another form of contraception is not needed: St. John’s wort can reduce the effectiveness of hormonal contraceptives by inducing liver enzymes that metabolize these drugs faster, increasing the risk of unintended pregnancy. This requires correction and further instruction.
D. Hard candy can be used for a dry mouth: Using hard candy to manage dry mouth is an acceptable supportive measure and does not conflict with medication use or safety.
Correct Answer is A
Explanation
A. Administer an additional dose of naloxone: Naloxone has a shorter half-life than many opioids, so symptoms of overdose, including respiratory depression, can return after its effects wear off. Administering an additional dose promptly reverses opioid toxicity and improves breathing.
B. Prepare to initiate cardiopulmonary resuscitation (CPR): Although respiratory depression is critical, CPR is not immediately indicated unless the client is unresponsive with absent pulse or cardiac arrest. The priority is to restore adequate breathing first.
C. Determine if results of the drug toxicity screen are available: While helpful for diagnosis, waiting for lab results delays urgent treatment needed to address life-threatening respiratory depression. Immediate intervention takes precedence.
D. Initiate a second intravenous access site: Establishing additional IV access may be useful but is not the first priority in an emergency situation where respiratory failure requires immediate reversal with naloxone.
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