How do ACE inhibitors primarily reduce blood pressure?
By decreasing afterload
By removing excess fluid
By increasing heart rate
By blocking the conversion of angiotensin I into angiotensin II
The Correct Answer is D
A. By decreasing afterload: ACE inhibitors indirectly reduce afterload by causing vasodilation, but the primary mechanism is through inhibition of angiotensin II formation. The decrease in afterload is a consequence, not the main action.
B. By removing excess fluid: ACE inhibitors do not directly remove fluid. Diuretics achieve fluid removal. ACE inhibitors may reduce fluid retention indirectly by decreasing aldosterone levels, but this is secondary.
C. By increasing heart rate: ACE inhibitors do not increase heart rate. Heart rate may remain unchanged or even decrease slightly due to improved cardiac efficiency. Tachycardia is not a mechanism of action.
D. By blocking the conversion of angiotensin I into angiotensin II: ACE inhibitors prevent the formation of angiotensin II, a potent vasoconstrictor, which leads to vasodilation and reduced systemic vascular resistance. This action lowers blood pressure and reduces workload on the heart.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. 30 minutes–1 hour:Regular insulin is a short-acting insulin that begins to lower blood glucose within 30 minutes, peaks at 2–4 hours, and lasts 5–8 hours. Serving the meal within 30–60 minutes of administration helps prevent hypoglycemia during the onset of insulin action.
B. 30 minutes–3 hours:While the onset is around 30 minutes, waiting up to 3 hours risks hypoglycemia because the insulin would already be active before the patient eats. The meal should be provided promptly, not delayed.
C. 1.5 to 2 hours after administering:Waiting 1.5–2 hours delays food intake until the insulin is near its peak effect, increasing the risk of hypoglycemia. This timing is unsafe for regular insulin.
D. 2–4 hours after administering:Providing food 2–4 hours post-injection coincides with the insulin peak, which greatly increases the risk of hypoglycemia. Meals must be timed closer to administration for safety.
Correct Answer is D
Explanation
A. By neutralizing existing stomach acid through its alkaline properties:Neutralizing existing acid is the mechanism of antacids, not H2 receptor antagonists. Cimetidine does not chemically neutralize acid; it reduces acid production.
B. By stimulating the production of bicarbonate to buffer the stomach acid:Bicarbonate secretion is a natural protective mechanism of the gastric mucosa, but cimetidine does not stimulate bicarbonate. This does not explain its acid-reducing effect.
C. By inhibiting the proton pump enzyme, preventing hydrogen ion exchange in parietal cells:Proton pump inhibitors (e.g., omeprazole) act on the H⁺/K⁺ ATPase enzyme in parietal cells. Cimetidine works through H2 receptor antagonism, not by directly inhibiting the proton pump.
D. By selectively blocking H2 receptors in the stomach which suppresses gastric acid secretion:Cimetidine binds to H2 receptors on gastric parietal cells, preventing histamine from stimulating acid production. This decreases both basal and meal-stimulated gastric acid secretion, effectively reducing GERD symptoms.
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