The nurse is caring for a client who is receiving the ACE inhibitor lisinopril. Which of the following outcomes should the nurse anticipate?

Decreased heart rate.

Decrease in chest pain.

Hypokalemia.

Decreased blood pressure.

Answer and Explanation

The Correct Answer is D

Choice A reason: A decreased heart rate is not a typical outcome of ACE inhibitor therapy. ACE inhibitors primarily work by relaxing blood vessels, which lowers blood pressure. They do not directly affect the heart rate. While some blood pressure medications can influence heart rate, this is not a common effect of ACE inhibitors like lisinopril.

Choice B reason: A decrease in chest pain is also not a primary outcome of ACE inhibitor therapy. While lowering blood pressure can help reduce the workload on the heart and potentially decrease angina (chest pain), this is more of an indirect effect. ACE inhibitors are primarily used for hypertension and heart failure, not specifically for pain relief.

Choice C reason: Hypokalemia, or low potassium levels, is not an expected outcome of taking an ACE inhibitor. In fact, ACE inhibitors can lead to hyperkalemia (high potassium levels) because they decrease aldosterone production, which causes the body to retain potassium. Patients on ACE inhibitors are often monitored for signs of hyperkalemia rather than hypokalemia.

Choice D reason: The correct and expected outcome of taking lisinopril, an ACE inhibitor, is decreased blood pressure. ACE inhibitors prevent the conversion of angiotensin I to angiotensin II, a potent vasoconstrictor. By reducing levels of angiotensin II, ACE inhibitors help relax blood vessels, which lowers blood pressure and makes it easier for the heart to pump blood. This is the primary therapeutic effect of the medication.

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Correct Answer is A

Explanation

Choice A reason: The arterial blood gas values pH 7.25, HCO3- 19 mEq/L, and PaCO2 30 mm Hg are indicative of metabolic acidosis, which is commonly seen in chronic kidney disease (CKD). In CKD, the kidneys lose their ability to excrete hydrogen ions and retain bicarbonate, leading to a decrease in blood pH (acidosis) and a reduction in bicarbonate (HCO3-). The PaCO2 value is slightly lower as a compensatory mechanism by the lungs to help balance the pH.

Choice B reason: The values pH 7.30, HCO3- 26 mEq/L, and PaCO2 50 mm Hg suggest a state of respiratory acidosis with partial metabolic compensation. This is not typically expected in chronic kidney disease. Respiratory acidosis occurs when there is hypoventilation, leading to an accumulation of carbon dioxide (CO2) in the blood. The bicarbonate (HCO3-) level is within the normal range, indicating that it is not the primary disorder in this context.

Choice C reason: The values pH 7.50, HCO3- 20 mEq/L, and PaCO2 32 mm Hg are consistent with respiratory alkalosis, where the pH is elevated due to hyperventilation leading to a loss of CO2. This condition is not typically associated with chronic kidney disease. The bicarbonate level is slightly below normal but not enough to indicate a significant metabolic disorder.

Choice D reason: The values pH 7.55, HCO3- 30 mEq/L, and PaCO2 31 mm Hg indicate metabolic alkalosis, which is characterized by an elevated pH and increased bicarbonate. This condition can occur due to excessive loss of acids (e.g., vomiting) or an increase in bicarbonate but is not typically expected in chronic kidney disease.

A. Instruct the client to exercise the fingers and wrist. B. Call the healthcare provider to report the loss of the radial pulse. C. Continue to assess the arm every hour for any additional changes. D. Administer morphine IV.

Correct Answer is B

Explanation

Choice A reason: Instructing the client to exercise the fingers and wrist is not the immediate priority. While maintaining mobility is important in burn care, the absence of a radial pulse indicates a potential vascular compromise that needs urgent attention.

Choice B reason: Calling the healthcare provider to report the loss of the radial pulse is the correct and immediate action. The absence of a radial pulse suggests that the edema is causing compartment syndrome, which can lead to tissue ischemia and necrosis if not promptly treated. This is a medical emergency requiring immediate intervention, possibly including a fasciotomy to relieve pressure.

Choice C reason: Continuing to assess the arm every hour for additional changes is important, but it is not the immediate priority. The absence of a radial pulse indicates a critical issue that needs immediate reporting and intervention, rather than waiting for further changes.

Choice D reason: Administering morphine IV can help manage the client's pain, which is significant at 8/10. However, it does not address the underlying issue of the absent radial pulse and potential compartment syndrome. Pain management is important but secondary to resolving the vascular compromise.

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The nurse is caring for a client who is receiving the ACE inhibitor lisinopril. Which of the following outcomes should the nurse anticipate?

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Naxlex Comprehensive Predictor Exams

A nurse is reviewing the arterial blood gas values of a client who has chronic kidney disease. Which of the following sets of values should the nurse expect?

Correct Answer is A

Explanation

A client is admitted to the emergency department with a full-thickness burn to the right arm. Upon assessment, the arm is edematous, the fingers are mottled, and the radial pulse is now absent. The client states that the pain is 8/10. What is the priority action the nurse should take?

Correct Answer is B

Explanation

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