Which adverse effect of an angiotensin converting enzyme inhibitor (ACE inhibitor) will the nurse expect to assess in a hypertensive patient?

Insomnia

Bradycardia

Chest pain

Hyperkalemia

Answer and Explanation

The Correct Answer is D

Choice A reason: This is not an adverse effect of ACE inhibitors. Insomnia is a common side effect of stimulant medications, such as caffeine or amphetamine, which increase the activity of the central nervous system and cause difficulty falling or staying asleep.

Choice B reason: This is not an adverse effect of ACE inhibitors. Bradycardia is a slow heart rate, usually below 60 beats per minute. ACE inhibitors do not cause bradycardia, but rather lower the blood pressure by blocking the formation of angiotensin II, a potent vasoconstrictor.

Choice C reason: This is not an adverse effect of ACE inhibitors. Chest pain is a sign of angina or myocardial infarction, which are caused by reduced blood flow to the heart muscle. ACE inhibitors can actually prevent or treat these conditions by improving the blood flow and reducing the workload of the heart.

Choice D reason: This is an adverse effect of ACE inhibitors. Hyperkalemia is a high level of potassium in the blood, which can cause cardiac arrhythmias and muscle weakness. ACE inhibitors can cause hyperkalemia by reducing the secretion of aldosterone, a hormone that regulates the sodium and potassium balance in the body.

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Correct Answer is A

Explanation

Choice A reason: Decrease in wheezing present on auscultation indicates that albuterol was effective. Albuterol is a bronchodilator that relaxes the smooth muscles of the airways and reduces the airway resistance. This improves the airflow and reduces the wheezing sound that is caused by the turbulent flow of air through the narrowed airways.

Choice B reason: Respiratory rate increased to 38 breaths/min does not indicate that albuterol was effective. It indicates that the patient is still experiencing respiratory distress and hypoxia. The normal respiratory rate for adults is 12 to 20 breaths/min. A high respiratory rate can also be a side effect of albuterol, as it can stimulate the sympathetic nervous system and increase the heart rate and blood pressure.

Choice C reason: Sputum production is clear and watery does not indicate that albuterol was effective. It indicates that the patient has a productive cough and is expelling mucus from the lungs. Sputum production is not directly affected by albuterol, as it does not have anti-inflammatory or mucolytic properties.

Choice D reason: Use of neck muscles does not indicate that albuterol was effective. It indicates that the patient is using accessory muscles to breathe and is exerting more effort to inhale. This is a sign of severe respiratory distress and airway obstruction. Albuterol should relieve the bronchospasm and reduce the need for accessory muscle use.

A. No change in affinity of hemoglobin with oxygen B. Decrease in affinity of hemoglobin with oxygen C. Increase in affinity of hemoglobin with oxygen D. Decrease in blood CO2

Correct Answer is B

Explanation

Choice A reason: Respiratory acidosis does not cause no change in affinity of hemoglobin with oxygen. It causes a decrease in affinity of hemoglobin with oxygen, which means that hemoglobin releases more oxygen to the tissues. This is known as the Bohr effect, which is a physiological response to low pH and high CO2 levels.

Choice B reason: Respiratory acidosis causes a decrease in affinity of hemoglobin with oxygen, which means that hemoglobin releases more oxygen to the tissues. This is the correct statement that describes the expected finding in this patient. The decrease in affinity of hemoglobin with oxygen is a compensatory mechanism that tries to restore the oxygen balance in the body.

Choice C reason: Respiratory acidosis does not cause an increase in affinity of hemoglobin with oxygen. It causes a decrease in affinity of hemoglobin with oxygen, which means that hemoglobin releases more oxygen to the tissues. An increase in affinity of hemoglobin with oxygen would mean that hemoglobin holds on to oxygen more tightly, which would worsen the hypoxia in the patient.

Choice D reason: Respiratory acidosis does not cause a decrease in blood CO2. It causes an increase in blood CO2, which is the primary cause of the low pH. A decrease in blood CO2 would indicate respiratory alkalosis, which is a condition of high pH and low CO2 levels.

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Which adverse effect of an angiotensin converting enzyme inhibitor (ACE inhibitor) will the nurse expect to assess in a hypertensive patient?

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