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

Angiotensin-converting enzyme (ACE) inhibitors

Diuretics

Adrenergic drugs

Direct acting vasodilators.

Answer and Explanation

The Correct Answer is B

Diuretics are drugs that increase the excretion of water and sodium by the kidneys, reducing blood volume and blood pressure. Diuretics lower blood pressure by dilating peripheral arterioles and decreasing blood volume by increasing the excretion of sodium and water.

Choice A is wrong because angiotensin-converting enzyme (ACE) inhibitors do not increase the excretion of water and sodium by the kidneys. ACE inhibitors block the conversion of angiotensin I to angiotensin II, a potent vasoconstrictor and stimulator of aldosterone secretion. By reducing angiotensin II levels, ACE inhibitors lower blood pressure by dilating blood vessels and decreasing sodium and water retention.

Choice C is wrong because adrenergic drugs do not increase the excretion of water and sodium by the kidneys. Adrenergic drugs act on the sympathetic nervous system, which regulates heart rate, blood pressure, and other functions. Depending on the type and location of adrenergic receptors, adrenergic drugs can have different effects on blood pressure. Some adrenergic drugs can increase blood pressure by stimulating alpha receptors, which cause vasoconstriction. Other adrenergic drugs can decrease blood pressure by stimulating beta receptors, which cause vasodilation and decreased cardiac output.

Choice D is wrong because direct acting vasodilators do not increase the excretion of water and sodium by the kidneys. Direct acting vasodilators are drugs that relax the smooth muscle of blood vessels, causing them to widen and lower blood pressure. Direct acting vasodilators do not affect the renin-angiotensin-aldosterone system or the sympathetic nervous system, which regulate sodium and water balance.

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Correct Answer is A

Explanation

The nurse should monitor the serum potassium level to determine the therapeutic effectiveness of carvedilol (Coreg), which is a beta-blocker that can lower the heart rate and blood pressure. Carvedilol can also cause hyperkalemia, which is a high level of potassium in the blood that can lead to cardiac arrhythmias and muscle weakness.Therefore, the nurse should monitor the serum potassium level and report any values above 5.0 mEq/L to the provider.

Choice B) Serum sodium level is wrong because carvedilol does not affect the sodium level significantly.Sodium level is more relevant for diuretics, which can cause hyponatremia (low sodium) or hypernatremia (high sodium) depending on the type and dose of the medication.

Choice C) Serum magnesium level is wrong because carvedilol does not affect the magnesium level significantly.

Magnesium level is more relevant for digoxin, which is another medication used for heart failure that can cause hypomagnesemia (low magnesium) or hypermagnesemia (high magnesium).Hypomagnesemia can increase the risk of digoxin toxicity, while hypermagnesemia can decrease the effectiveness of digoxin.

Choice D) Serum calcium level is wrong because carvedilol does not affect the calcium level significantly.

Calcium level is more relevant for calcium channel blockers, which are another class of medications used for heart failure that can lower the heart rate and blood pressure by blocking the entry of calcium into the cardiac and vascular smooth muscle cells.

Calcium channel blockers can cause hypocalcemia (low calcium) or hypercalcemia (high calcium), which can affect the cardiac contractility and conduction.

The normal ranges for serum electrolytes are:

• Potassium: 3.5 to 5.0 mEq/L

• Sodium: 135 to 145 mEq/L

• Magnesium: 1.5 to 2.5 mEq/L

• Calcium: 8.5 to 10.5 mg/dL

A. Avoid salt substitutes that contain potassium. B. Report any dry cough to the provider. C. Take the medication on an empty stomach. D. Drink at least 3 L of fluids per day. E. Rise slowly from a sitting or lying position.

Correct Answer is ["A","B","C","E"]

Explanation

Captopril is an angiotensin-converting enzyme (ACE) inhibitor that is used to treat heart failure by lowering blood pressure and reducing the workload on the heart.

The nurse should include the following instructions when teaching a client who is prescribed captopril:

• Avoid salt substitutes that contain potassium.Captopril can increase the potassium levels in the blood, which can lead to hyperkalemia.Salt substitutes that contain potassium can further increase the risk of hyperkalemia, which can cause cardiac arrhythmias and muscle weakness.

• Report any dry cough to the provider.A dry cough is a common side effect of captopril and other ACE inhibitors.It is caused by the accumulation of bradykinin, a substance that dilates blood vessels and causes inflammation in the lungs.

The cough can be annoying and interfere with sleep and quality of life.The provider may switch the client to another type of medication if the cough is bothersome.

• Take the medication on an empty stomach.Food can decrease the absorption and effectiveness of captopril.The client should take the medication at least 1 hour before or 2 hours after meals.

• Rise slowly from a sitting or lying position.Captopril can cause orthostatic hypotension, which is a sudden drop in blood pressure when changing positions.

This can lead to dizziness, fainting, and falls.The client should rise slowly and sit on the edge of the bed for a few minutes before standing up.

Choice D is wrong because drinking at least 3 L of fluids per day is not recommended for clients with heart failure.

Excessive fluid intake can worsen the symptoms of heart failure, such as edema, shortness of breath, and fatigue.The client should limit fluid intake to 2 L or less per day, unless instructed otherwise by the provider.

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

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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?

Correct Answer is A

Explanation

A nurse is teaching a client who has heart failure and is prescribed captopril. Which of the following instructions should the nurse include? (Select all that apply.).

Correct Answer is ["A","B","C","E"]

Explanation

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

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 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?

A patient with atrial fibrillation has been prescribed digoxin (Lanoxin). The nurse should monitor which laboratory value to evaluate therapeutic effectiveness?

A nurse is evaluating a client who has hypertension and is taking lisinopril, an angiotensin II receptor blocker (ARB). Which of the following outcomes indicates that the medication is effective?

A nurse is evaluating a client who has heart failure and is receiving warfarin. Which of the following statements by the client indicates a need for further teaching?

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?

A nurse is teaching a client who has hypertension and is prescribed nifedipine, a calcium channel blocker, about self-care measures. Which of the following instructions should the nurse include? (Select all that apply.)