A nurse is assessing a client who is taking losartan.
Which of the following findings should the nurse identify as an adverse effect of this medication?
Hypertension.
Double vision.
Dizziness.
Hyperactivity.
The Correct Answer is C
Choice A rationale
Losartan is an angiotensin II receptor blocker (ARB) which works by preventing angiotensin II from binding to its receptors in vascular smooth muscle, thereby causing vasodilation and lowering blood pressure. Hypertension is the condition losartan is prescribed to treat, not an adverse effect, because its mechanism directly counteracts the vasoconstrictive effects of angiotensin II. The intended therapeutic effect is a reduction in systemic vascular resistance and blood pressure.
Choice B rationale
Double vision, also known as diplopia, is not a recognized common or significant adverse effect of losartan. The mechanism of action of losartan primarily targets the renin-angiotensin-aldosterone system (RAAS), influencing blood pressure regulation and fluid balance, not directly affecting the central nervous system or ocular motor function. This symptom would be more indicative of neurological or ophthalmological issues unrelated to the medication's primary action.
Choice C rationale
Dizziness is a common adverse effect of losartan. This is a direct consequence of its therapeutic action, which is to lower blood pressure. The resulting vasodilation and reduced blood pressure can lead to orthostatic hypotension, causing feelings of lightheadedness or dizziness, especially when a person changes positions, like standing up. The brain's reduced perfusion pressure triggers this sensation as a physiological response.
Choice D rationale
Hyperactivity is not an expected adverse effect of losartan. The medication primarily affects the cardiovascular system by modulating the RAAS to lower blood pressure. It does not have known stimulant properties that would lead to increased energy, restlessness, or hyperactivity. Such a finding would likely be attributed to other factors or a different underlying condition, not the pharmacological action of this medication. *.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale
Administering a vasoconstrictor is a potential intervention for shock but it is not the first action. The client's hypotension and tachycardia are indicative of hypovolemic shock due to profuse vomiting, leading to fluid loss. The body's initial compensatory mechanism involves vasoconstriction to maintain blood pressure, so further constriction without addressing the volume deficit can worsen tissue perfusion.
Choice B rationale
The client is exhibiting signs of hypovolemic shock, including a low blood pressure of 86/58 mmHg, a high pulse of 114/min, and a high respiratory rate of 27/min. These are physiological compensations for reduced circulating blood volume. Increasing the intravenous infusion rate directly addresses the primary problem by rapidly replacing lost fluid volume, thereby increasing preload, stroke volume, cardiac output, and ultimately, blood pressure.
Choice C rationale
Elevating the client's feet can temporarily increase venous return to the heart and improve blood pressure. However, this is a passive measure that does not address the underlying fluid deficit causing the hypovolemic shock. It is a helpful adjunctive action but is not the definitive first-line intervention required to correct the circulatory collapse in this scenario.
Choice D rationale
Initiating oxygen therapy is a supportive measure for shock because it helps improve tissue oxygenation, which is compromised due to poor perfusion. While beneficial, it does not correct the root cause of the shock, which is the lack of circulating fluid volume. The most immediate and life-saving intervention is to restore fluid volume to improve cardiac output and blood pressure
Correct Answer is A
Explanation
Choice A rationale
Metformin extended-release tablets are designed with a special matrix that releases the medication gradually over time. Crushing or chewing the tablet would destroy this matrix, leading to an immediate and potentially unsafe release of the entire dose. This could cause a sudden drop in blood glucose and increase the risk of adverse gastrointestinal side effects.
Choice B rationale
Metformin is typically recommended to be taken with the evening meal to minimize gastrointestinal side effects such as nausea and diarrhea, which are common when starting the medication. Taking it in the morning on an empty stomach could increase the severity of these adverse effects due to the rapid concentration increase in the gastrointestinal tract.
Choice C rationale
Metformin is not associated with weight gain; in fact, it is often associated with a small amount of weight loss. This is due to its effect on reducing appetite and its ability to improve insulin sensitivity, which can help regulate metabolism and prevent the weight gain often seen with other diabetes medications.
Choice D rationale
Metformin is best taken with a meal to enhance its absorption and to mitigate common gastrointestinal side effects. Taking it on an empty stomach can increase the likelihood and severity of adverse effects like nausea, vomiting, and diarrhea because the medication can directly irritate the gastrointestinal mucosa
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