A 46-year-old client with a high body-mass index and a sedentary lifestyle has been diagnosed with hypertension after serial blood pressure readings. The clinician has opted to begin the client on lisinopril (Zestril). The nurse should recognize that the therapeutic effect of this drug is achieved in what way?

By directly relaxing vascular smooth muscle

By blocking aldosterone from binding to mineralocorticoid receptors

By blocking the movement of calcium ions into arterial smooth muscles

By inhibiting the transformation of angiotensin I to angiotensin II

Answer and Explanation

The Correct Answer is D

A. By directly relaxing vascular smooth muscle is not how lisinopril primarily works; it does not act directly on smooth muscle but rather affects hormonal pathways.

B. By blocking aldosterone from binding to mineralocorticoid receptors is a secondary effect of the angiotensin-converting enzyme (ACE) inhibitors but not the primary action of lisinopril itself.

C. By blocking the movement of calcium ions into arterial smooth muscles describes the action of calcium channel blockers, not ACE inhibitors like lisinopril.

D. By inhibiting the transformation of angiotensin I to angiotensin II is the correct answer because lisinopril inhibits the ACE enzyme, reducing the production of angiotensin II, which lowers blood pressure and decreases strain on the heart.

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Correct Answer is A

Explanation

A. Phenylephrine is a decongestant that can raise blood pressure, making it contraindicated for individuals with hypertension. Advising a patient with hypertension to avoid phenylephrine is essential to prevent potential cardiovascular complications.

B. While patients with diabetes should be cautious about certain medications, phenylephrine is not specifically contraindicated in this condition.

C. A 17-year-old female with an upper respiratory infection typically does not have contraindications for phenylephrine unless there are underlying conditions not mentioned.

D. Gout does not have a direct contraindication for phenylephrine use, so the patient may not need to avoid it unless other health issues are present.

A. Suspect an allergic reaction and administer antihistamines. B. Suspect a bleeding complication and notify the healthcare provider. C. Suspect a hypersensitivity reaction and discontinue the heparin immediately. D. Suspect an infection and initiate antibiotic therapy.

Correct Answer is B

Explanation

A. Bruising and bleeding gums are not indicative of an allergic reaction, which would typically present with different symptoms such as rash, itching, or swelling. Administering antihistamines would not address the underlying issue.

B. The development of bruising and bleeding gums in a patient on heparin therapy suggests a bleeding complication, which is a known risk of anticoagulation therapy. The nurse should notify the healthcare provider to assess the situation and possibly adjust treatment or perform further evaluations.

C. While hypersensitivity reactions can occur with medications, the symptoms presented here are more aligned with bleeding complications than with hypersensitivity. Discontinuing heparin without consulting the provider could put the patient at risk for thromboembolic events.

D. The symptoms do not indicate an infection; therefore, initiating antibiotic therapy would not be appropriate in this context.

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Naxlex Comprehensive Predictor Exams

Which patient should be advised by the nurse to avoid over-the-counter cold and allergy preparations that contain phenylephrine?

Correct Answer is A

Explanation

A patient receiving heparin therapy develops bruising and bleeding gums. What should the nurse suspect and what is the appropriate action?

Correct Answer is B

Explanation

Drugs can produce a wide variety of effects in addition to the desired pharmacological effect. Sometimes the drug dose can be adjusted so that the desired effect is achieved without producing undesired secondary reactions. Which are examples of this secondary action?

The nurse is caring for a client who is experiencing pulmonary edema. The client is treated with furosemide. What will the nurse monitor most closely?

A client taking diltiazem, a calcium channel blocker, for hypertension has come to the clinic for a follow-up appointment. The nurse will assess the client for which adverse effects?

A client with a long-standing diagnosis of angina has been prescribed nitroglycerin and diltiazem. In addition to monitoring the client's heart rate, the nurse should prioritize what assessment?

A postsurgical client has been receiving morphine by patient-controlled analgesia for 2 days. What action by the nurse best addresses potential adverse effects?

A nurse is preparing to administer short-acting insulin to a patient with type 1 diabetes. Which of the following should the nurse keep in mind regarding this insulin type?

The nurse is caring for a 38-year-old client who has been diagnosed with asthma and is prescribed albuterol. What assessment finding should the nurse most likely attribute to adverse medication effects?

The nursing instructor has been teaching about antivirals, actions and effects. The instructor realizes that a student needs further instruction when the student makes which statement?