The nurse is providing discharge instructions to a client who is prescribed lisinopril, an ACE inhibitor. Which statement by the client demonstrates proper understanding of the discharge instructions?

I will review the ingredients before using salt substitutes.

If I feel unwell, it is okay that I miss a dose.

It is okay if I feel dizzy when I stand after sitting for a while.

It is okay to incorporate an unlimited amount of potatoes, bananas, and oranges in my diet.

Answer and Explanation

The Correct Answer is A

Choice A reason: Lisinopril can cause hyperkalemia due to reduced potassium excretion. Salt substitutes often contain potassium chloride, which can exacerbate this risk. Reviewing ingredients prevents excessive potassium intake, which could lead to dangerous cardiac arrhythmias, demonstrating proper understanding of dietary precautions.

Choice B reason: Missing a dose of lisinopril if feeling unwell is dangerous, as it may worsen hypertension or heart failure. Consistent dosing is critical to maintain therapeutic effects, and this statement indicates a misunderstanding requiring further teaching on medication adherence.

Choice C reason: Dizziness upon standing (orthostatic hypotension) is a side effect of lisinopril due to vasodilation and reduced blood pressure. Accepting this as normal without reporting it could delay intervention for excessive hypotension, indicating a need for further education.

Choice D reason: Unlimited intake of high-potassium foods like potatoes, bananas, and oranges can lead to hyperkalemia in clients taking lisinopril, risking cardiac arrhythmias. This statement reflects a lack of understanding of dietary potassium restrictions, necessitating further teaching on safe dietary practices.

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Correct Answer is A

Explanation

Choice A reason: SSRIs increase serotonin levels in the brain, effectively managing GAD with a low risk of dependence. Side effects like nausea or headache are generally mild and transient, making SSRIs safer compared to other classes, as they do not cause significant physiological dependence or severe adverse effects.

Choice B reason: Tricyclic antidepressants affect multiple neurotransmitters, effectively treating GAD but with significant side effects like anticholinergic effects (dry mouth, constipation) and potential cardiotoxicity. They carry a higher risk of overdose and side effects compared to SSRIs, making them less safe for long-term use in GAD.

Choice C reason: Benzodiazepines enhance GABA activity, providing rapid anxiety relief but with a high risk of physiological dependence and withdrawal. Side effects like sedation and cognitive impairment, along with abuse potential, make them less safe than SSRIs for long-term GAD management.

Choice D reason: MAOIs inhibit monoamine oxidase, increasing neurotransmitter levels for GAD treatment. However, they have significant side effects, including hypertensive crises from dietary tyramine, and require strict dietary restrictions. Their risk profile and potential for severe interactions make them less safe than SSRIs.

A. Give half of the prescribed dose B. Give the full dose as ordered C. Delay the dose until the pulse is below 60 D. Omit the dose and record the pulse rate as the reason

Correct Answer is B

Explanation

Choice A reason: Giving half the dose of metoprolol is inappropriate without a medical order, as it may reduce therapeutic efficacy. The client’s vital signs (BP 132/78, HR 86) are stable, indicating no need to alter the prescribed dose, which is intended to manage hypertension and heart failure.

Choice B reason: Metoprolol, a beta-blocker, reduces heart rate and blood pressure in hypertension and heart failure. The client’s vital signs (BP 132/78, HR 86) are within acceptable ranges, indicating the full 25 mg dose is safe and appropriate to maintain therapeutic control of their condition.

Choice C reason: Delaying the dose until the pulse is below 60 is unnecessary, as the client’s heart rate of 86 is not bradycardic. Metoprolol is indicated for heart rates above 60 in heart failure and hypertension, and withholding it could worsen blood pressure control.

Choice D reason: Omitting the dose due to a pulse of 86 is inappropriate, as this heart rate is not dangerously low. Metoprolol is prescribed to manage hypertension and heart failure, and withholding it without clinical justification could lead to uncontrolled symptoms or disease progression.

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The nurse is providing discharge instructions to a client who is prescribed lisinopril, an ACE inhibitor. Which statement by the client demonstrates proper understanding of the discharge instructions?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Which of the four classes of medications used for Generalized Anxiety Disorder (GAD) is considered the safest because of low incidence of side effects and lack of physiological dependence?

Correct Answer is A

Explanation

A nurse is preparing to administer metoprolol 25 mg PO to a client with a history of hypertension and heart failure. The client’s vital signs are: BP 132/78 mm Hg, HR 86 beats per minute, and respiratory rate 18 breaths per minute. Which action should the nurse take?

Correct Answer is B

Explanation

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