Which drug increases the excretion of water and sodium by the kidneys, reducing blood volume and blood pressure?

Angiotensin-converting enzyme (ACE) inhibitors

Diuretics

Adrenergic drugs

Direct acting vasodilators.

Answer and Explanation

The Correct Answer is B

Diuretics are drugs that increase the excretion of water and sodium by the kidneys, reducing blood volume and blood pressure. Diuretics lower blood pressure by dilating peripheral arterioles and decreasing blood volume by increasing the excretion of sodium and water.

Choice A is wrong because angiotensin-converting enzyme (ACE) inhibitors do not increase the excretion of water and sodium by the kidneys. ACE inhibitors block the conversion of angiotensin I to angiotensin II, a potent vasoconstrictor and stimulator of aldosterone secretion. By reducing angiotensin II levels, ACE inhibitors lower blood pressure by dilating blood vessels and decreasing sodium and water retention.

Choice C is wrong because adrenergic drugs do not increase the excretion of water and sodium by the kidneys. Adrenergic drugs act on the sympathetic nervous system, which regulates heart rate, blood pressure, and other functions. Depending on the type and location of adrenergic receptors, adrenergic drugs can have different effects on blood pressure. Some adrenergic drugs can increase blood pressure by stimulating alpha receptors, which cause vasoconstriction. Other adrenergic drugs can decrease blood pressure by stimulating beta receptors, which cause vasodilation and decreased cardiac output.

Choice D is wrong because direct acting vasodilators do not increase the excretion of water and sodium by the kidneys. Direct acting vasodilators are drugs that relax the smooth muscle of blood vessels, causing them to widen and lower blood pressure. Direct acting vasodilators do not affect the renin-angiotensin-aldosterone system or the sympathetic nervous system, which regulate sodium and water balance.

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Correct Answer is C

Explanation

Angiotensin II receptor blockers (ARBs) block the binding of angiotensin II to its receptors on blood vessels and adrenal glands, preventing its vasoconstrictive and aldosterone-stimulating effects

Choice A is wrong because beta blockers do not block angiotensin II receptors, but rather beta-adrenergic receptors, which are involved in the sympathetic nervous system.Beta blockers reduce heart rate and blood pressure by inhibiting the effects of adrenaline and noradrenaline

Choice B is wrong because calcium channel blockers do not block angiotensin II receptors, but rather calcium channels, which are involved in the contraction of smooth muscle cells.Calcium channel blockers relax blood vessels and lower blood pressure by reducing the influx of calcium into the cells

Choice D is wrong because direct acting vasodilators do not block angiotensin II receptors, but rather act directly on the smooth muscle cells of blood vessels, causing them to relax and dilate.Direct acting vasodilators lower blood pressure by decreasing peripheral resistance

A. Administer diltiazem as ordered by physician B. Instruct patient to change positions slowly C. Notify physician immediately D. Hold diltiazem and notify physician if symptoms persist. E. Hold diltiazem and notify physician if symptoms persist.

Correct Answer is B

Explanation

This is because diltiazem (Cardizem) is a calcium channel blocker that lowers blood pressure and can cause orthostatic hypotension, which is a sudden drop in blood pressure when standing up from a sitting or lying position. This can lead to dizziness and lightheadedness, which can increase the risk of falls and injuries. Changing positions slowly can help prevent or reduce these symptoms by allowing the body to adjust to the change in blood pressure.

Choice A) Administer diltiazem as ordered by physician is wrong because it does not address the patient’s complaint of dizziness and lightheadedness, which are side effects of the medication.

The nurse should monitor the patient’s blood pressure and heart rate before and after administering diltiazem, and report any abnormal findings to the physician.

Choice C) Notify physician immediately is wrong because it is not necessary to notify the physician immediately for a common and mild side effect of diltiazem, unless the patient has other signs of severe hypotension, such as fainting, chest pain, or confusion.

The nurse should educate the patient about the possible side effects of diltiazem and how to prevent or manage them.

Choice D) Hold diltiazem and notify physician if symptoms persist is wrong because it is not appropriate to hold a prescribed medication without a valid reason or an order from the physician.

Holding diltiazem could cause the patient’s blood pressure to rise and increase the risk of complications from atrial fibrillation, such as stroke or heart failure.

The nurse should administer diltiazem as ordered and monitor the patient’s response.

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Which drug increases the excretion of water and sodium by the kidneys, reducing blood volume and blood pressure?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Which drug blocks the binding of angiotensin II to its receptors on blood vessels and adrenal glands, preventing its vasoconstrictive and aldosterone-stimulating effects?

Correct Answer is C

Explanation

The nurse is caring for a patient with atrial fibrillation who has been prescribed diltiazem (Cardizem). The patient reports feeling dizzy and lightheaded when standing up quickly from a sitting position or when getting out of bed in the morning. What action should the nurse take?

Correct Answer is B

Explanation

A nurse is assessing a client who has heart failure and is receiving metoprolol. Which of the following statements by the client indicates a therapeutic effect of the medication?

A nurse is evaluating a client who has hypertension and is taking lisinopril, an angiotensin II receptor blocker (ARB). Which of the following outcomes indicates that the medication is effective?

The nurse is caring for a patient with atrial fibrillation who has been prescribed warfarin (Coumadin). The patient’s INR level is 3.5, which is above therapeutic range. What action should the nurse take?

A nurse is planning to administer mannitol to a client who has heart failure and pulmonary edema. Which of the following actions should the nurse take before giving the medication?

A nurse is teaching a client who has hypertension and is prescribed nifedipine, a calcium channel blocker, about self-care measures. Which of the following instructions should the nurse include? (Select all that apply.)

A nurse is evaluating a client who has heart failure and is receiving warfarin. Which of the following statements by the client indicates a need for further teaching?

The nurse is reviewing the discharge instructions with a patient who has heart failure and is prescribed losartan (Cozaar). Which of the following statements by the patient indicates understanding of the teaching? (Select all that apply.)

Which drug increases the excretion of water and sodium by the kidneys, reducing blood volume and blood pressure?