A patient has 2+ pitting edema of the lower extremities bilaterally. Auscultation of the lungs reveals crackles bilaterally, and the serum potassium level is 6 mEq/L, which is above normal level. Which agent ordered by the prescriber should the nurse question?
Beta blockers
Alpha 2 agonists
Calcium channel blockers
Aldosterone antagonists
The Correct Answer is D
Choice A reason: This is not the agent that the nurse should question. Beta blockers are a class of medications that lower the blood pressure and heart rate by blocking the beta receptors in the heart and blood vessels. They can be used to treat hypertension, angina, heart failure, and arrhythmias. They do not cause edema or hyperkalemia.
Choice B reason: This is not the agent that the nurse should question. Alpha 2 agonists are a class of medications that lower the blood pressure by stimulating the alpha 2 receptors in the brain, which reduce the sympathetic nervous system activity. They can be used to treat hypertension, especially in patients with renal impairment. They do not cause edema or hyperkalemia.
Choice C reason: This is not the agent that the nurse should question. Calcium channel blockers are a class of medications that lower the blood pressure and heart rate by blocking the calcium channels in the heart and blood vessels, which cause vasodilation and reduced cardiac contractility. They can be used to treat hypertension, angina, and arrhythmias. They may cause edema, but not hyperkalemia.
Choice D reason: This is the agent that the nurse should question. Aldosterone antagonists are a class of medications that lower the blood pressure and reduce fluid retention by blocking the action of aldosterone, a hormone that regulates the sodium and potassium balance in the body. They can be used to treat hypertension and heart failure, especially in patients with low renin levels. However, they can cause hyperkalemia, which can be dangerous for the patient. The nurse should question the prescriber about the rationale for prescribing this agent and monitor the patient's potassium level closely.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: Abnormally dilated arteries and veins are not a result of atherosclerosis. They are a sign of aneurysms or varicose veins, which are caused by different factors.
Choice B reason: Arterial wall thinning and weakening are not a result of atherosclerosis. They are a sign of arteriosclerosis, which is a general term for the loss of elasticity and flexibility of the arteries.
Choice C reason: Autonomic nervous system imbalances are not a result of atherosclerosis. They are a sign of dysautonomia, which is a disorder of the nervous system that affects the regulation of vital functions.
Choice D reason: Abnormal thickening and hardening of vessel walls are a result of atherosclerosis. They are caused by the accumulation of plaque, which is composed of cholesterol, fatty substances, calcium, and other materials.
Correct Answer is A
Explanation
Choice A reason: This is the correct mechanism of action of propranolol. Propranolol is a beta blocker medication, which means that it blocks the beta receptors in the heart and blood vessels. This reduces the sympathetic stimulation in cardiac muscle, which lowers the heart rate, contractility, and oxygen demand. This also reduces the renin release from the kidneys, which lowers the blood pressure.
Choice B reason: This is not the mechanism of action of propranolol. Propranolol does not increase the diuretic response in the renal tubules. This is the effect of diuretic medications, such as furosemide or hydrochlorothiazide, which increase the urine output and decrease the blood volume and pressure.
Choice C reason: This is not the mechanism of action of propranolol. Propranolol does not inhibit the conversion of angiotensin I to angiotensin II. This is the effect of angiotensin-converting enzyme (ACE) inhibitors, such as lisinopril or enalapril, which block the formation of angiotensin II, a potent vasoconstrictor that raises the blood pressure.
Choice D reason: This is not the mechanism of action of propranolol. Propranolol does not block alpha receptors throughout the body. This is the effect of alpha blockers, such as doxazosin or prazosin, which block the alpha receptors in the blood vessels and cause vasodilation, which lowers the blood pressure.
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