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 C
Explanation
Choice A rationale
A nonstress test (NST) does not require the client to fast. The client can eat and drink normally, and sometimes a sugary beverage is even encouraged to stimulate fetal movement, as the test aims to record fetal heart rate accelerations in response to these movements.
Choice B rationale
The nonstress test is a screening tool used to assess fetal well-being by measuring the fetal heart rate's response to fetal movement. It does not provide information about genetic problems, which are typically identified through genetic testing or prenatal diagnostic procedures such as amniocentesis.
Choice C rationale
A key component of the nonstress test involves the mother noting fetal movements. The client is given a marker, often a button, to press each time she feels the baby move. This action correlates the mother's perception of movement with the fetal heart rate accelerations recorded on the monitor.
Choice D rationale
Oxytocin is not administered during a nonstress test. The purpose of this test is to assess the baby's baseline heart rate and accelerations without external stimulation. Oxytocin is used in a contraction stress test, which is a different procedure to evaluate how the baby handles uterine contractions. *.
Correct Answer is A
Explanation
Choice A rationale
For a preschooler, play is the primary mechanism for coping and learning. A pounding board allows the child to express frustration and aggression in a safe, appropriate manner. This type of play helps to relieve tension and anxiety associated with hospitalization. It provides a healthy outlet for emotions that the child may not be able to articulate verbally, which is crucial for this developmental stage.
Choice B rationale
Preschoolers have a limited understanding of complex language. Using medical terminology can be frightening and confusing to them, increasing their anxiety. Nurses should use simple, concrete language that the child can understand, such as "checking your arm" instead of "taking your blood pressure," to help them feel more secure and cooperative with care.
Choice C rationale
Preschoolers thrive on routine and predictability. Establishing a new routine can be disruptive and increase their stress and fear. The nurse should strive to maintain as much of the child's home routine as possible to provide a sense of security and normalcy. This helps them feel more in control and less overwhelmed by the hospital environment.
Choice D rationale
A preschooler may experience separation anxiety when a parent leaves the room. Performing assessments while the parent is present helps the child feel more secure and supported. The parent can also provide comfort and help distract the child, which can make procedures easier and less frightening for the child. This promotes a trusting relationship between the child, parent, and nurse.
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