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.

Answer and Explanation

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.

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Correct Answer is D

Explanation

Choice A reason: Decreased cardiac output would result in a decrease in blood pressure, not an increase. Cardiac output is the amount of blood pumped by the heart per minute.

Choice B reason: Decreased vascular resistance would also result in a decrease in blood pressure, not an increase. Vascular resistance is the force that opposes the blood flow in the blood vessels.

Choice C reason: Hypovolemia would also result in a decrease in blood pressure, not an increase. Hypovolemia is the condition of having low blood volume due to fluid loss or dehydration.

Choice D reason: Vasoconstriction would result in an increase in blood pressure. Vasoconstriction is the narrowing of the blood vessels, which increases the vascular resistance and the blood pressure.

A. the cells of the myocardium become hypertrophic. B. the resulting hypoxia leads to ischemic injury and myocardial cell death. C. there is a temporary alteration in electrolyte balance that can be corrected. D. there is too much pressure on the heart and the ventricles begin to dysfunction.

Correct Answer is B

Explanation

Choice A reason: The cells of the myocardium become hypertrophic in response to increased workload or pressure, not as a result of myocardial infarction. Hypertrophy is an adaptive mechanism that can lead to impaired ventricular function over time.

Choice B reason: The resulting hypoxia leads to ischemic injury and myocardial cell death. This is the main cause of impaired ventricular function after a myocardial infarction. The loss of viable myocardial tissue reduces the contractility and pumping ability of the heart.

Choice C reason: There is a temporary alteration in electrolyte balance that can be corrected. This is not the primary cause of impaired ventricular function after a myocardial infarction. Electrolyte imbalance can occur due to fluid loss, renal impairment, or medication side effects, but it can be managed with appropriate interventions.

Choice D reason: There is too much pressure on the heart and the ventricles begin to dysfunction. This is not the direct cause of impaired ventricular function after a myocardial infarction. Increased pressure on the heart can result from hypertension, valvular disease, or pulmonary embolism, but it is not related to myocardial ischemia or necrosis.

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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?

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Correct Answer is D

Explanation

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Correct Answer is B

Explanation

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