Up to one-third of patients who take ACE inhibitors for hypertension report which symptom after beginning therapy?
Decreased white blood cells.
Swelling of the face and lips.
Chronic cough.
Renal failure.
The Correct Answer is C
ACE inhibitors are a type of medication used to treat high blood pressure and heart failure. They work by blocking the production of a hormone called angiotensin II, which narrows the blood vessels and increases blood pressure. By preventing this hormone from acting, ACE inhibitors lower blood pressure and reduce the workload on the heart. One of the most common side effects of ACE inhibitors is a dry cough, which occurs in 12–19% of people who take them. The cough is caused by the accumulation of a substance called bradykinin, which is normally broken down by angiotensin-converting enzyme (ACE). When ACE is inhibited, bradykinin levels increase and cause irritation and inflammation in the airways.
Choice A is wrong because decreased white blood cells are not a common side effect of ACE inhibitors.
However, some people may develop a condition called neutropenia, which is a low level of a type of white blood cell called neutrophils. This can increase the risk of infections and may require stopping the medication.
Choice B is wrong because swelling of the face and lips is not a common side effect of ACE inhibitors.
However, some people may develop a rare but serious allergic reaction called angioedema, which is a swelling of the deeper layers of the skin and mucous membranes.
This can affect the face, lips, tongue, throat, or other parts of the body and can cause difficulty breathing or swallowing. Angioedema can be life-threatening and requires immediate medical attention.
Choice D is wrong because renal failure is not a common side effect of ACE inhibitors.
However, some people may experience a decrease in kidney function or an increase in blood levels of creatinine, which is a waste product filtered by the kidneys.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Hypokalemia is a condition of low potassium levels in the blood, which can be caused by diuretics such as furosemide (Lasix) that increase the excretion of potassium in the urine. Potassium is an important electrolyte that helps regulate the function of nerves and muscles, including the heart.Low potassium levels can cause symptoms such as confusion, tremors, muscle cramps, and nausea, which are consistent with the patient’s presentation.
Choice B, renal failure, is wrong because furosemide is used to treat fluid retention and edema caused by kidney disease, not to cause it.Renal failure would also cause symptoms such as decreased urine output, swelling, fatigue, and shortness of breath, which are not mentioned in the question.
Choice C, hyperkalemia, is wrong because hyperkalemia is a condition of high potassium levels in the blood, which can be caused by kidney disease or certain medications that decrease the excretion of potassium in the urine.Hyperkalemia can cause symptoms such as weakness, irregular heartbeat, paralysis, and chest pain, which are different from the patient’s symptoms.
Choice D, heart failure, is wrong because furosemide is also used to treat fluid retention and edema caused by heart failure, not to cause it.Heart failure would also cause symptoms such as shortness of breath, coughing, fatigue, and rapid weight gain, which are not mentioned in the question.
Normal ranges for potassium levels in the blood are 3.5 to 5.0 milliequivalents per liter (mEq/L) for adults and 3.4 to 4.7 mEq/L for children.
A level below 3.5 mEq/L is considered hypokalemic and a level above 5.0 mEq/L is considered hyperkalemic.
Correct Answer is B
Explanation
Class IV antidysrhythmics or calcium channel blockers have the action ofdecreasing the flow of calcium ionsinto the cardiac and vascular smooth muscle cells, thusdecreasing heart rate and contractions.
This leads to vasodilation and myocardial depression, which can help control arrhythmias, hypertension and angina.
Choice A is wrong because calcium channel blockers do not increase blood vessel spasm, but rather relax them by inhibiting the calcium influx that causes contraction.
Choice C is wrong because calcium channel blockers do not promote platelet aggregation, but rather inhibit it by interfering with the calcium-dependent binding of fibrinogen to platelets.
Choice D is wrong because calcium channel blockers do not enhance sympathetic nervous system activity, but rather counteract it by reducing the cardiac output and peripheral resistance.
Some normal ranges for reference are:
• Heart rate: 60-100 beats per minute
• Blood pressure: 120/80 mmHg
• Calcium: 8.5-10.5 mg/dL
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