1. A patient who has just begun taking an angiotensin converting enzyme (ACE) inhibitor calls
the nurse and reports feeling very dizzy when standing up
... [Show More] and asks if the medication should
be discontinued. What is the nurse’s best response?
a. “Stop taking the medication immediately.”
b. “Rise to a sitting or standing position slowly; your symptoms will resolve.”
c. “I will schedule you to visit the health care provider today.”
d. “Cut the pill in half and take a reduced dosage.”
ANS: B
Dizziness is a common initial adverse effect of this medication, which is usually transient. The
patient should be instructed to rise from a lying position slowly to avoid orthostatic
hypotension and avoid falling. Medications should not be stopped immediately unless a
serious adverse effect occurs. Because this is a common occurrence with ACE inhibitors, there
is no need for a visit to the health care provider. A change in dosage will not alter the effect
and should not be made without the advice of the primary care provider.
DIF: Cognitive Level: Application REF: Page 348 OBJ: 2
TOP: Nursing Process Step: Implementation
MSC: NCLEX Client Needs Category: Physiological Integrity
NOT: CONCEPT(S): Clinical Judgment; Patient Education; Safety
2. Which nursing assessment confirms that the angiotensin II receptor blocker (ARB) that a
patient is taking is effective?
a. Weight loss of more than 2 pounds/week
b. LDL cholesterol levels have decreased.
c. Urinary output is increased.
d. Blood pressure has decreased.
ANS: D
The primary therapeutic outcome expected from angiotensin II receptor antagonists is
reduction of blood pressure to within a normal range. Angiotensin II receptor antagonists bind
angiotensin II receptor sites in the vascular smooth muscle, brain, heart, kidneys, and adrenal
gland. The blood pressure-elevating (vasoconstricting) and sodium-retaining effects of
angiotensin II are thus blocked. Weight loss, although advisable for treatment of hypertension,
is not affected by ARBs. ARBs do not affect cholesterol levels. Urine output is not affected by
ARBs.
DIF: Cognitive Level [Show Less]