Which antihypertensive medication is not recommended for patients with chronic obstructive pulmonary disease (COPD) and asthma?
Propranolol (Inderal): a beta-adrenergic receptor blocker.
Captopril (Capoten): an ACE inhibitor.
Diltiazem (Cardizem): a calcium antagonist.
Hydrochlorothiazide (HydroDIURIL): a diuretic.
The Correct Answer is A
Choice A rationale
Propranolol (Inderal) is a beta-adrenergic receptor blocker, also known as a beta-blocker. Beta-blockers can increase airway reactivity and may interfere with the activity of beta-agonists. They should be used with great caution or not at all in patients with chronic asthma.
However, beta blockers are safe for use in most patients with COPD, but less so in patients with asthma. Therefore, Propranolol (Inderal) is not recommended for patients with chronic obstructive pulmonary disease (COPD) and asthma.
Choice B rationale
Captopril (Capoten) is an ACE inhibitor, which is among the most widely used antihypertensive drugs. They are not contraindicated in asthma or COPD, but they can induce a bothersome cough that, although not damaging to the lungs, can be confused with cough due to underlying pulmonary diseases such as asthma and COPD1.
Choice C rationale
Diltiazem (Cardizem) is a calcium antagonist. There is no specific contraindication for using calcium antagonists in patients with COPD or asthma. These medications work by relaxing the muscles of your heart and blood vessels, but they do not have a direct effect on airway reactivity or lung function.
Choice D rationale
Hydrochlorothiazide (HydroDIURIL) is a diuretic. Diuretics help your body get rid of excess salt and water, primarily by stimulating your kidneys. They do not have a direct effect on airway reactivity or lung function, and there is no specific contraindication for using them in patients with COPD or asthma.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A rationale
A Ventricular septal defect (VSD) is a hole in the wall separating the two lower chambers of the heart. While it can cause cyanosis, it would not typically cause cyanosis only during crying or after feeding.
Choice B rationale
An Atrioventricular canal (AVC) defect is a combination of heart problems resulting in a defect in the center of the heart. While it can cause cyanosis, it would not typically cause cyanosis only during crying or after feeding.
Choice C rationale
Tetralogy of Fallot is a rare condition caused by a combination of four heart defects that are present at birth. These defects, which affect the structure of the heart, cause oxygen-poor blood to flow out of the heart and into the rest of the body. Infants and children with Tetralogy of Fallot usually have blue-tinged skin because their blood doesn’t carry enough oxygen. This is often more noticeable during episodes of crying or feeding.
Choice D rationale
An Atrial septal defect (ASD) is a hole in the wall between the two upper chambers of your heart (atria). The condition is present at birth (congenital). Small defects might be found by chance and never cause a problem. Some small atrial septal defects close during infancy or early childhood. While it can cause cyanosis, it would not typically cause cyanosis only during crying or after feeding.
Correct Answer is B
Explanation
Choice A rationale
A pleural friction rub is an audible raspy breathing sound, a medical sign present in some patients with pleurisy and other conditions affecting the chest cavity. It is not a typical symptom of cardiac tamponade.
Choice B rationale
Distended neck veins are a result of the collapsed blood vessels that should return blood to the heart. This is a common symptom of cardiac tamponade.
Choice C rationale
Widening pulse pressure occurs with valvular heart disease, not typically with cardiac tamponade.
Choice D rationale
Bradycardia, or a slower-than-normal heart rate, is not typically associated with cardiac tamponade.
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