Review Practice Exercise 7

Drugs Used to Treat Hypertension > Pharmacology

Exam Review

Practice Exercise 7

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Question 1:

A nurse in an acute care facility is infusing IV nitroprusside for a client who is in hypertensive crisis. For which of the following adverse reactions should the nurse monitor this client?

A. Intestinal ileus B. Neutropenia C. Delirium D. Hyperthermia

Answer and Explanation

Choice A:

Intestinal ileusNitroprusside does not directly affect gastrointestinal motility. Ileus is unrelated to its mechanism of action or toxicity profile.

Choice B:

NeutropeniaNeutropenia is not an adverse effect associated with nitroprusside therapy. This hematologic reaction is more commonly linked with drugs such as captopril or chemotherapeutic agents.

Choice C:

DeliriumWhen nitroprusside is metabolized, it releases cyanide ions, which are then converted to thiocyanate by the liver. Accumulation of these metabolites—especially during prolonged infusions or in renal dysfunction—can cause central nervous system toxicity, manifesting as delirium, disorientation, psychosis, or seizures. The nurse should monitor the client’s neurological status, serum thiocyanate levels, and ensure the infusion rate does not exceed recommended limits.Rationales for incorrect answers:

Choice D:

HyperthermiaHyperthermia is not a known adverse reaction to nitroprusside. Instead, metabolic acidosis, hypotension, and altered mental status are signs of toxicity.

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Practice Exercise 7

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