Review Practice Exercise 4

Drugs Used to Treat Hypertension > Pharmacology

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Practice Exercise 4

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Total Questions : 2

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Question 1:

A patient is prescribed losartan (Cozaar). The nurse teaches the patient that an angiotensin II receptor blocker (ARB) acts by doing what?

A. Inhibiting angiotensin-converting enzyme B. Blocking angiotensin II from AT1 receptors C. Preventing the release of angiotensin I D. Promoting the release of aldosterone

Answer and Explanation

Choice A:

Inhibiting angiotensin-converting enzymeThis describes the action of ACE inhibitors (e.g., captopril, lisinopril), not ARBs. ACE inhibitors block the conversion of angiotensin I to angiotensin II, while ARBs act further down the pathway by blocking angiotensin II’s receptor sites.

Choice B:

Blocking angiotensin II from AT1 receptorsARBs such as losartan work by selectively blocking angiotensin II from binding to AT₁ receptors located in the vascular smooth muscle, heart, and adrenal cortex. This prevents the vasoconstrictive and sodium-retaining effects of angiotensin II. Consequently, blood vessels relax, aldosterone secretion decreases, and sodium and water excretion are enhanced.Rationales for incorrect answers:

Choice C:

Preventing the release of angiotensin INo antihypertensive class directly prevents the release of angiotensin I. Angiotensin I formation depends on renin activity, which ARBs do not inhibit. Instead, ARBs specifically block the effect of angiotensin II at the receptor level.

Choice D:

Promoting the release of aldosteroneARBs actually inhibit aldosterone secretion, which leads to increased sodium and water excretion and potassium retention. Promoting aldosterone release would worsen hypertension, not treat it.

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Question 2:

The nurse preparing the drug irbesartan (Avapro) from the drug class angiotensin II receptor blockers knows that this drug works by which mechanism?

A. Inhibiting the conversion of angiotensin I to angiotensin II B. Binding to and blocking angiotensin II receptor sites C. Preventing the release of catecholamines D. Blocking the stimulation of mineralocorticoid receptors

Answer and Explanation

Choice A:

Inhibiting the conversion of angiotensin I to angiotensin IIThis describes the mechanism of ACE inhibitors, not ARBs. ACE inhibitors block the angiotensin-converting enzyme, preventing formation of angiotensin II, while ARBs act further downstream at the receptor level.

Choice B:

Binding to and blocking angiotensin II receptor sitesIrbesartan selectively blocks angiotensin II from binding to AT₁ receptors in vascular smooth muscle and the adrenal gland. By preventing this binding, it inhibits vasoconstriction and aldosterone secretion, leading to decreased sodium and water retention and a subsequent reduction in blood pressure.Rationales for incorrect answers:

Choice C:

Preventing the release of catecholaminesThis mechanism relates to adrenergic blockers (e.g., beta-blockers), which reduce sympathetic nervous system activity. ARBs do not influence catecholamine release or adrenergic receptor activity.

Choice D:

Blocking the stimulation of mineralocorticoid receptorsThis action pertains to aldosterone antagonists (e.g., spironolactone, eplerenone), which block aldosterone at the receptor level in the kidneys. ARBs indirectly reduce aldosterone secretion but do not directly block its receptors.

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Practice Exercise 4

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