A patient who has just begun taking an angiotensin-converting enzyme (ACE) inhibitor calls the nurse and reports feeling very dizzy when standing up, and asks if the medication should be discontinued. What is the nurse's best response?
Stop taking the medication immediately.
Cut the pill in half and take a reduced dosage.
Rise to a sitting or standing position slowly; your symptoms will resolve.
I will schedule you to visit the health care provider today.
The Correct Answer is C
Choice A reason: This is not the best response by the nurse. Stopping the medication abruptly can cause rebound hypertension and other complications. The patient should not stop taking the medication without consulting their health care provider.
Choice B reason: This is not the best response by the nurse. Cutting the pill in half and taking a reduced dosage can affect the efficacy and safety of the medication. The patient should not change the dosage of the medication without consulting their health care provider.
Choice C reason: This is the best response by the nurse. Dizziness is a common side effect of ACE inhibitors, especially when the patient changes position or stands up quickly. This is due to the orthostatic hypotension (a drop in blood pressure when standing up) caused by the vasodilation effect of the medication. However, this side effect is usually mild and transient, and can be prevented by rising slowly from a sitting or lying position, drinking plenty of fluids, and avoiding alcohol.
Choice D reason: This is not the best response by the nurse. Scheduling the patient to visit the health care provider today is not necessary, unless the dizziness is severe, persistent, or accompanied by other symptoms, such as chest pain, fainting, or palpitations. The patient should be advised to monitor their blood pressure and report any significant changes or concerns to their health care provider.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: Hereditary decrease in IgE responsiveness is not related to airway hyper-responsiveness in extrinsic asthma. IgE is an antibody that binds to allergens and triggers the release of histamine and other inflammatory mediators from mast cells. A decrease in IgE responsiveness would reduce the allergic reaction, not increase it.
Choice B reason: Increased sympathetic nervous system response is not related to airway hyper-responsiveness in extrinsic asthma. The sympathetic nervous system is the part of the autonomic nervous system that prepares the body for fight or flight. It stimulates the bronchodilation, or the widening of the airways, by activating the beta2 receptors on the smooth muscle cells. This would improve the airflow, not obstruct it.
Choice C reason: The release of stress hormones is not related to airway hyper-responsiveness in extrinsic asthma. Stress hormones, such as cortisol and adrenaline, are secreted by the adrenal glands in response to stress. They have anti-inflammatory and bronchodilator effects, which would reduce the symptoms of asthma, not worsen them.
Choice D reason: Exposure to an allergen causing mast cell degranulation is related to airway hyper-responsiveness in extrinsic asthma. Mast cell degranulation is the process of releasing histamine and other inflammatory mediators from the granules inside the mast cells. These substances cause bronchoconstriction, or the narrowing of the airways, by stimulating the smooth muscle contraction and mucus secretion. This leads to the symptoms of asthma, such as wheezing, coughing, and dyspnea.
Correct Answer is D
Explanation
Choice A reason: This is not a symptom that would indicate withholding a nonselective beta-adrenergic blocker. Hyperglycemia is a high level of glucose in the blood, which can be caused by diabetes or other conditions. Nonselective beta-adrenergic blockers do not affect blood glucose levels directly, but they may mask the signs of hypoglycemia (low blood glucose) in diabetic patients.
Choice B reason: This is not a symptom that would indicate withholding a nonselective beta-adrenergic blocker. Dizziness is a common side effect of many medications, especially those that lower blood pressure. Nonselective beta-adrenergic blockers can cause dizziness by reducing the heart rate and cardiac output, but this is usually mild and transient.
Choice C reason: This is not a symptom that would indicate withholding a nonselective beta-adrenergic blocker. Peripheral edema is swelling of the ankles, feet, or legs, which can be caused by heart failure, kidney disease, or venous insufficiency. Nonselective beta-adrenergic blockers do not cause peripheral edema, but they may worsen it in patients with heart failure.
Choice D reason: This is a symptom that would indicate withholding a nonselective beta-adrenergic blocker. Wheezing is a high-pitched sound that occurs when breathing is obstructed, usually due to asthma or chronic obstructive pulmonary disease (COPD). Nonselective beta-adrenergic blockers can aggravate or cause wheezing by blocking the beta-2 receptors in the lungs, which normally cause bronchodilation (widening of the airways). Therefore, nonselective beta-adrenergic blockers are contraindicated in patients with asthma or COPD.
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