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. *.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale
Encouraging the client to ambulate to the bathroom would be inappropriate and potentially harmful. The client is experiencing worsening pain, tingling, and is on a gurney en route to surgery for a fractured radius. Ambulation could exacerbate the injury, increase pain, and risk further complications. Mobility should be restricted until the fracture is stabilized and the client is post-operative.
Choice B rationale
This is the correct action as it assesses for potential complications of compartment syndrome, a critical and urgent condition. The worsening pain and tingling are classic symptoms. Compartment syndrome occurs when pressure builds within the fascial compartments, compromising circulation. A loss of peripheral pulses and delayed capillary refill are late signs of impaired circulation and are key indicators for this limb-threatening emergency.
Choice C rationale
Elevating the arm above the heart would decrease arterial blood flow to the injured extremity, which could worsen tissue perfusion and potentially lead to ischemia. For a client with a suspected circulatory compromise, such as with compartment syndrome, the arm should be kept at the level of the heart to maintain adequate blood flow.
Choice D rationale
Administering a sedative could mask the client's symptoms, particularly the level of pain and changes in mental status, which are crucial indicators of their deteriorating condition. The client's pain is a vital sign that needs to be continuously monitored, and sedation would hinder the nurse's ability to accurately assess for changes in their neurovascular status. .
Correct Answer is A
Explanation
Choice A rationale
The ST segment represents the time from the end of ventricular depolarization to the beginning of ventricular repolarization. It is identified as the flat baseline following the QRS complex and preceding the T wave. This segment is isoelectric, meaning it's at the same level as the PR segment, and any deviation can indicate myocardial ischemia or injury.
Choice B rationale
The peak of the R wave represents the peak of ventricular depolarization. It signifies the moment of maximum electrical activity in the ventricles, as the impulse spreads through the ventricular walls. It is a critical point in the QRS complex, but it is not the location of the ST segment.
Choice C rationale
The beginning of the P wave marks the onset of atrial depolarization. This electrical event represents the contraction of the atria as they pump blood into the ventricles. The P wave is the first deflection in the cardiac cycle and occurs well before the QRS complex and the ST segment.
Choice D rationale
The interval between the S wave and the T wave is not a standard electrocardiographic term. The correct terminology is the ST segment, which is a segment, not an interval, and it specifically follows the S wave and precedes the T wave. An interval would typically include a wave, like the QT interval. *.
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