The nurse administers losartan 50 mg PO to a client. One hour after administration, the client calls the nurse and complains of tingling of the lips. The nurse notes that the client's lips are edematous and recognizes that the client is experiencing anaphylaxis and notifies the healthcare provider. The client requires supplemental oxygen and a fluid bolus. Which statement is true regarding this situation?
The client had an allergic reaction to losartan.
The client had an expected side effect of the medication.
The client should have a prescription change to enalapril.
The client should avoid taking the medication with food.
The Correct Answer is A
Choice A reason: The client had an allergic reaction to losartan, a drug that belongs to the class of angiotensin II receptor blockers (ARBs). ¹ Anaphylaxis is a severe and potentially life-threatening allergic reaction that can cause swelling of the lips, tongue, throat, and face, as well as difficulty breathing, low blood pressure, and shock. ² The client needs immediate medical attention and treatment with oxygen, fluids, and epinephrine. ³
Choice B reason: The client did not have an expected side effect of the medication. Losartan is used to treat high blood pressure and heart failure by blocking the action of angiotensin II, a hormone that causes blood vessels to constrict and retain salt and water. ¹ Some common side effects of losartan include dizziness, headache, fatigue, cough, and nausea. ⁴ Anaphylaxis is not a common or expected side effect of losartan, but a rare and serious adverse reaction.
Choice C reason: The client should not have a prescription change to enalapril. Enalapril is another drug that lowers blood pressure and heart failure, but it belongs to the class of angiotensin-converting enzyme (ACE) inhibitors. ⁵ ACE inhibitors and ARBs have similar mechanisms of action and effects, but they differ in how they block the angiotensin system. However, both classes of drugs can cause allergic reactions and anaphylaxis in some people, especially those who have a history of allergy to either drug. The client should avoid both ACE inhibitors and ARBs and use another type of blood pressure medication.
Choice D reason: The client should not avoid taking the medication with food. Food does not affect the absorption or effectiveness of losartan. ⁴ The client can take the medication with or without food, as directed by the provider. However, the client should avoid grapefruit and grapefruit juice, as they can interact with losartan and increase the risk of side effects.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason: Performing daily weights is the best method to evaluate the client's response to furosemide, a drug that reduces fluid retention and swelling by increasing the urine output. ¹ Daily weights can help monitor the changes in the client's fluid status and the effectiveness of the drug. The nurse should weigh the client at the same time each day, using the same scale and clothing.
Choice B reason: Taking the blood pressure is not the best method to evaluate the client's response to furosemide. Furosemide can also lower the blood pressure by reducing the volume of fluid in the blood vessels. ¹ However, blood pressure can be influenced by many other factors, such as heart rate, stress, or medications. Blood pressure is not a reliable indicator of the client's fluid status or the effectiveness of the drug.
Choice C reason: Auscultating breath sounds is not the best method to evaluate the client's response to furosemide. Furosemide can help improve the breath sounds by reducing the fluid accumulation in the lungs, which can cause shortness of breath or crackles. ¹ However, breath sounds can also be affected by other factors, such as lung infections, asthma, or allergies. Breath sounds are not a reliable indicator of the client's fluid status or the effectiveness of the drug.
Choice D reason: Measuring urinary output is not the best method to evaluate the client's response to furosemide. Furosemide can increase the urinary output by stimulating the kidneys to excrete more water and electrolytes. ¹ However, urinary output can also vary depending on the fluid intake, kidney function, or other medications. Urinary output is not a reliable indicator of the client's fluid status or the effectiveness of the drug.
Correct Answer is A
Explanation
Choice A reason: This is the correct answer. Stool for occult blood is a diagnostic test that detects the presence of hidden blood in the feces. This can indicate bleeding in the gastrointestinal tract, which is the most common cause of chronic iron deficiency anemia. Iron deficiency anemia is a condition where the body does not have enough iron to produce hemoglobin, the protein that carries oxygen in the red blood cells.
Choice B reason: Vitamin B12 level is not the diagnostic test that is used to detect the most common cause of chronic iron deficiency anemia. Vitamin B12 level is a blood test that measures the amount of vitamin B12 in the body. Vitamin B12 is a nutrient that is essential for the production of red blood cells and the maintenance of the nervous system. Vitamin B12 deficiency can cause pernicious anemia, a type of megaloblastic anemia where the red blood cells are large and immature.
Choice C reason: Schilling's test is not the diagnostic test that is used to detect the most common cause of chronic iron deficiency anemia. Schilling's test is a urine test that evaluates the absorption of vitamin B12 in the body. It involves giving the client an oral dose of radioactive vitamin B12 and an intramuscular injection of non-radioactive vitamin B12. The urine is then collected and measured for the amount of radioactive vitamin B12. Schilling's test can help diagnose pernicious anemia and other causes of vitamin B12 malabsorption.
Choice D reason: Bone marrow aspiration study is not the diagnostic test that is used to detect the most common cause of chronic iron deficiency anemia. Bone marrow aspiration study is a procedure that involves taking a sample of bone marrow from the hip or sternum and examining it under a microscope. Bone marrow is the soft tissue inside the bones that produces blood cells. Bone marrow aspiration study can help diagnose various blood disorders, such as leukemia, lymphoma, and aplastic anemia.
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