The nurse is reviewing the discharge instructions with a patient who has heart failure and is prescribed losartan (Cozaar). Which of the following statements by the patient indicates understanding of the teaching? (Select all that apply.)

“I will weigh myself every morning and report any changes.”

“I will take this medication with food to prevent stomach upset.”

“I will call my doctor if I have a sore throat or fever.”

“I will use sunscreen when I go outside.”

“I will drink plenty of fluids to stay hydrated.”

Answer and Explanation

Correct Answer : A,C

Losartan (Cozaar) is an angiotensin II receptor blocker (ARB) that is used to treat heart failure by lowering blood pressure and reducing fluid retention.

Patients taking losartan should:

• Weigh themselves every morning and report any changes.

This helps to monitor fluid status and detect signs of worsening heart failure. Weight gain of more than 2 kg (4.4 lb) in a week or 1 kg (2.2 lb) in a day should be reported to the health care provider.

• Call their doctor if they have a sore throat or fever. This could indicate an infection or a rare but serious side effect of losartan called angioedema, which causes swelling of the face, lips, tongue, or throat.

The other choices are wrong because:

• Losartan does not need to be taken with food to prevent stomach upset. It can be taken with or without food.

• Losartan does not increase the sensitivity to sunlight. However, some other medications for heart failure, such as diuretics, may do so.

• Drinking plenty of fluids to stay hydrated is not recommended for patients with heart failure, as it may worsen fluid retention and overload the heart. Patients should follow their prescribed fluid restriction and limit their sodium intake.

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Correct Answer is C

Explanation

Angiotensin II receptor blockers (ARBs) block the binding of angiotensin II to its receptors on blood vessels and adrenal glands, preventing its vasoconstrictive and aldosterone-stimulating effects

Choice A is wrong because beta blockers do not block angiotensin II receptors, but rather beta-adrenergic receptors, which are involved in the sympathetic nervous system.Beta blockers reduce heart rate and blood pressure by inhibiting the effects of adrenaline and noradrenaline

Choice B is wrong because calcium channel blockers do not block angiotensin II receptors, but rather calcium channels, which are involved in the contraction of smooth muscle cells.Calcium channel blockers relax blood vessels and lower blood pressure by reducing the influx of calcium into the cells

Choice D is wrong because direct acting vasodilators do not block angiotensin II receptors, but rather act directly on the smooth muscle cells of blood vessels, causing them to relax and dilate.Direct acting vasodilators lower blood pressure by decreasing peripheral resistance

A. Administer diltiazem as ordered by physician B. Instruct patient to change positions slowly C. Notify physician immediately D. Hold diltiazem and notify physician if symptoms persist. E. Hold diltiazem and notify physician if symptoms persist.

Correct Answer is B

Explanation

This is because diltiazem (Cardizem) is a calcium channel blocker that lowers blood pressure and can cause orthostatic hypotension, which is a sudden drop in blood pressure when standing up from a sitting or lying position. This can lead to dizziness and lightheadedness, which can increase the risk of falls and injuries. Changing positions slowly can help prevent or reduce these symptoms by allowing the body to adjust to the change in blood pressure.

Choice A) Administer diltiazem as ordered by physician is wrong because it does not address the patient’s complaint of dizziness and lightheadedness, which are side effects of the medication.

The nurse should monitor the patient’s blood pressure and heart rate before and after administering diltiazem, and report any abnormal findings to the physician.

Choice C) Notify physician immediately is wrong because it is not necessary to notify the physician immediately for a common and mild side effect of diltiazem, unless the patient has other signs of severe hypotension, such as fainting, chest pain, or confusion.

The nurse should educate the patient about the possible side effects of diltiazem and how to prevent or manage them.

Choice D) Hold diltiazem and notify physician if symptoms persist is wrong because it is not appropriate to hold a prescribed medication without a valid reason or an order from the physician.

Holding diltiazem could cause the patient’s blood pressure to rise and increase the risk of complications from atrial fibrillation, such as stroke or heart failure.

The nurse should administer diltiazem as ordered and monitor the patient’s response.

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The nurse is reviewing the discharge instructions with a patient who has heart failure and is prescribed losartan (Cozaar). Which of the following statements by the patient indicates understanding of the teaching? (Select all that apply.)

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Naxlex Comprehensive Predictor Exams

Which drug blocks the binding of angiotensin II to its receptors on blood vessels and adrenal glands, preventing its vasoconstrictive and aldosterone-stimulating effects?

Correct Answer is C

Explanation

The nurse is caring for a patient with atrial fibrillation who has been prescribed diltiazem (Cardizem). The patient reports feeling dizzy and lightheaded when standing up quickly from a sitting position or when getting out of bed in the morning. What action should the nurse take?

Correct Answer is B

Explanation

A nurse is caring for a client who has heart failure and is receiving carvedilol (Coreg). The nurse should monitor which of the following laboratory values to determine therapeutic effectiveness of this medication?

A nurse is assessing a client who has heart failure and is receiving metoprolol. Which of the following statements by the client indicates a therapeutic effect of the medication?

A nurse is caring for a client who has hypertension and is prescribed metoprolol, a beta blocker. The nurse should monitor the client for which of the following adverse effects?

The nurse is teaching a patient with heart failure about dietary modifications to reduce fluid retention and improve cardiac function. Which of the following foods should the nurse advise the patient to limit or avoid?

Which drug increases the excretion of water and sodium by the kidneys, reducing blood volume and blood pressure?

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A nurse is planning to administer mannitol to a client who has heart failure and pulmonary edema. Which of the following actions should the nurse take before giving the medication?