Patient Data

Select from Word Choices to complete the sentence.

The thiazide diuretic works to decrease the client's blood pressure by

, and the angiotensin converting enyzme (ACE) inhibitor works to decrease the client's blood pressure by

and
_

Answer and Explanation

The Correct Answer is {"dropdown-group-1":"B","dropdown-group-2":"D","dropdown-group-3":"A"}

Increasing heart rate: Increasing heart rate is not the mechanism of thiazide diuretics or ACE inhibitors. It would raise blood pressure by increasing cardiac workload. Effective antihypertensives aim to lower or stabilize heart rate, not increase it.
Reducing stroke volume: Thiazide diuretics reduce stroke volume by lowering blood volume through sodium and water excretion. This decreases cardiac output and helps lower blood pressure, particularly in volume-sensitive hypertension.
Suppressing the appetite: Suppressing appetite is unrelated to the action of thiazide diuretics or ACE inhibitors. These drugs target fluid balance and vascular tone, not the central nervous system mechanisms that regulate hunger.
Decreasing serum sodium levels: Both thiazide diuretics and ACE inhibitors contribute to decreased serum sodium levels, which helps lower blood volume. This reduction supports blood pressure control but must be monitored to avoid hyponatremia.
Reducing systemic vascular resistance: ACE inhibitors lower blood pressure by reducing systemic vascular resistance through vasodilation. Blocking angiotensin II prevents arterial constriction, easing the workload on the heart and lowering afterload.

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Correct Answer is B

Explanation

A. Insomnia may occur while taking the medication: St. John's wort can increase central nervous system stimulation, leading to side effects like insomnia, restlessness, and anxiety. Educating the client that sleep disturbances may occur is appropriate and consistent with known herb effects.

B. Another form of contraception is not needed: St. John's wort can induce cytochrome P450 enzymes, leading to faster metabolism and reduced effectiveness of hormonal contraceptives like birth control pills. Clients must be advised to use an additional non-hormonal contraceptive method to prevent unintended pregnancy.

C. Hard candy can be used for a dry mouth: Dry mouth is a recognized side effect of St. John's wort. Sucking on hard candy, increasing oral hydration, or chewing sugarless gum are appropriate and effective ways to manage this discomfort.

D. Sensitivity to the sun can develop: Photosensitivity is a well-documented adverse effect of St. John's wort. Clients should be instructed to use sunscreen, wear protective clothing, and limit sun exposure to prevent sunburns or skin reactions.

A. Hearing has decreased. B. White blood cell count of 6,000/mm3 (6 x 10^9/L). C. Decreased blood urea nitrogen. D. Reports of photophobia.

Correct Answer is A

Explanation

A. Hearing has decreased: Gentamicin is an aminoglycoside antibiotic known for its potential to cause ototoxicity, leading to hearing loss, tinnitus, or balance disturbances. Early signs of auditory damage, such as decreased hearing, must be promptly recognized because ototoxicity can be irreversible if the drug is not discontinued or adjusted quickly.

B. White blood cell count of 6,000/mm³ (6 × 10⁹/L): A WBC count within the range of 5,000 to 10,000/mm³ is considered normal. A value of 6,000/mm³ does not suggest bone marrow suppression or infection-related complications and is not an indicator of gentamicin toxicity.

C. Decreased blood urea nitrogen: Gentamicin is more commonly associated with nephrotoxicity, which typically leads to increased BUN and creatinine levels due to kidney injury. A decreased BUN level would not suggest an adverse reaction to gentamicin and would not be expected.

D. Reports of photophobia: Photophobia is not a recognized adverse effect of gentamicin. Visual disturbances like photophobia are more commonly associated with other medications or conditions, not aminoglycoside toxicity.

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Patient Data Select from Word Choices to complete the sentence. The thiazide diuretic works to decrease the client's blood pressure by ______, and the angiotensin converting enyzme (ACE) inhibitor works to decrease the client's blood pressure by ________ and _______

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A female client with mild depression reports to the nurse recently starting St. John's wort. Which information provided by the client requires further instruction?

Correct Answer is B

Explanation

A male client has been receiving the antibiotic gentamicin sulfate, IV piggyback every 12 hours for several days. Which observation by the nurse indicates that the client may be experiencing an adverse effect of gentamicin? Reference Range: White Blood Cell [5,000 to 10,000/mm3 (5 to 10 10^9/L)]

Correct Answer is A

Explanation

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Patient Data

Select from Word Choices to complete the sentence.

The thiazide diuretic works to decrease the client's blood pressure by

, and the angiotensin converting enyzme (ACE) inhibitor works to decrease the client's blood pressure by

and
_