Deck 31: Drugs Affecting the Renin-Angiotensin-Aldosterone System

Question 1

How do additional amounts of aldosterone secreted by the kidneys raise blood pressure?

A)Excretion of sodium and chloride to retain water
B)Excretion of potassium and hydrogen to retain water
C)Decreasing sodium absorption,which increases blood volume
D)Enhanced sodium reabsorption,which increases blood volume

Answer 1

Enhanced sodium reabsorption,which increases blood volume

Question 2

The nurse knows that the secretion of renin is controlled by which items? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

A)Juxtaglomerular (JG)cells
B)Macula densa
C)Sympathetic nervous system
D)Parasympathetic nervous system
E)Cardiovascular system

Answer 2

Juxtaglomerular (JG)cells
Macula densa
Sympathetic nervous system

Question 3

The nurse is reviewing the primary functions of the angiotensin-converting enzyme (ACE).The nurse knows that which is the primary function of this enzyme? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

A)Forming angiotensin I
B)Forming angiotensin II
C)Breaking down bradykinin
D)Breaking down histamine
E)Forming kininase

Answer 3

Forming angiotensin II
Breaking down bradykinin

Question 4

Angiotensin receptor blockers (ARBs)work in the body to lower blood pressure by which mechanism of action?

A)Inhibiting the stimulation of aldosterone secretion
B)Blocking the conversion of angiotensin I to angiotensin II
C)Blocking AT₁ receptors,which prevent angiotensin from raising blood pressure
D)Blocking the formation of renin in the RAAS system

Question 5

Which peptide circulating in the blood can cause profound vasoconstriction?

A)Fibrogen
B)Sodium
C)Kinase
D)Angiotensin II

Question 6

Which clinical manifestations occur as the result of the cardiac remodeling caused by angiotensin II?

A)Hypotrophy of myocyte cells
B)A breakdown of fatty plaque deposits
C)Hypotension and dehydration
D)Myocardial infarction and cerebrovascular accident

Question 7

Angiotensin-converting enzyme (ACE)inhibitor drugs function in the control of blood pressure by which mechanism of action?

A)Blocking the effects of angiotensin II
B)Blocking the conversion of angiotensin I to angiotensin II
C)Blocking the conversion of angiotensin II to angiotensinogen
D)Directly inhibiting renin

Question 8

The angiotensin-converting enzyme (ACE)converts angiotensin I almost instantly to which substance?

A)Angiotensin II
B)Aldosterone
C)Angiotensinogen
D)Renin

Question 9

A nursing student asks the nurse educator why the actions of aldosterone lead to high blood pressure.Which of the educator's responses explain this phenomenon? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

A)"Aldosterone increases sodium reabsorption and the excretion of potassium and hydrogen by acting on the distal tubules."
B)"Aldosterone increases sodium reabsorption and the excretion of potassium and hydrogen by acting on the collecting tubules."
C)"Aldosterone increases sodium reabsorption and the excretion of potassium and hydrogen by acting on Bowman's capsule."
D)"Aldosterone increases sodium reabsorption and the excretion of potassium and hydrogen by acting on the glomerulus."
E)"Aldosterone increases sodium reabsorption and the excretion of potassium and hydrogen by acting on the Loop of Henle."

Question 10

The kidneys respond to which occurrences in the body by releasing renin?

A)Lowered blood pressure; dehydration
B)Lowered blood pressure; decreased cardiac output
C)Increased blood pressure; increased peripheral resistance
D)Increased blood pressure; stress,anxiety

Question 11

Which group of cells in the kidneys makes up the apparatus that helps control renin secretion?

A)The red blood cells and slit pores
B)The nephron and Bowman's capsule
C)The juxtaglomerular (JG)cells and the macula densa
D)The tubular and the glomerulus

Question 12

An adult client is prescribed lisinopril therapy for hypertension.Why is it important to rule out pregnancy prior to starting this medication?

A)Lisinopril is pregnancy category C and D.
B)Lisinopril can cause hyperkalemia in pregnant women.
C)Lisinopril is pregnancy category B.
D)Lisinopril can cause hypotension in late pregnancy.

Question 13

Aldosterone antagonist drugs work to lower blood pressure by which mechanism of action?

A)Blocking the formation of renin in the RAAS pathway
B)Blocking receptors for aldosterone in the kidneys
C)Blocking receptors for aldosterone in the adrenal glands
D)Blocking the AT₁ receptors in the RAAS pathway

Question 14

A seasoned nurse is explaining the multiple mechanisms by which angiotensin II raises blood pressure to a novice nurse.What should the seasoned nurse include in the explanation? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

A)Direct vasoconstriction
B)Increased sympathetic nervous system activity
C)Cardiac remodeling
D)Direct effect on the kidneys
E)Direct increase on the reabsorption of sodium

Question 15

The nurse is reviewing a list of medications that decrease blood pressure.Which medications decrease blood pressure by blocking the receptors for aldosterone in the kidneys? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

A)Benazepril (Lotensin)
B)Azilsartan (Edarbi)
C)Eplerenone (Inspra)
D)Aliskiren (Tekturna)
E)Spironolactone (Aldactone)

Question 16

Which organ has the primary responsibility in converting angiotensin I to angiotensin II?

A)The lungs
B)The kidneys
C)The heart
D)The liver

Question 17

Angiotensin-converting enzyme (ACE)inhibitor drugs prevent ACE from breaking down which substances,resulting in some of the serious adverse effects of the ACE inhibitors?

A)Aldosterone
B)Bradykinin
C)Renin
D)RAAS

Question 18

The secretion,storage,and synthesizing of renin are controlled in which cells of the kidney?

A)The distal loop
B)The baroreceptors
C)Henle's loop
D)The juxtaglomerular cells

Question 19

Angiotensinogen is a protein that is continuously circulating in the blood stream.Where is it synthesized in the body?

A)The lungs
B)The liver
C)The gallbladder
D)The kidneys

Question 20

The arterioles of which organ are most sensitive to the vasopressin action of angiotensin II?

A)The lungs
B)The liver
C)The kidneys
D)The heart

Question 21

The client is starting on lisinopril therapy for hypertension and heart failure.The nurse instructs the client to return for laboratory monitoring because of the risk of which adverse effect?

A)Hyperkalemia
B)Hyponatremia
C)Hypernatremia
D)Hypokalemia

Question 22

The major difference in adverse effect profile between ACE inhibitors and ARBs is that ARBs do not cause which clinical manifestation?

A)Headache
B)Dizziness
C)Angioedema
D)Cough

Question 23

Which are the most common adverse effects of lisinopril therapy?

A)Hypotension,cough,and rash
B)Rash,hypokalemia,and constipation
C)Hypertension,hypokalemia,and productive cough
D)Hypotension,hyperkalemia,and urinary frequency

Question 24

A client who is prescribed losartan for hypertension is instructed to avoid using alcohol because of the risk of which adverse reaction?

A)Alcohol intoxication
B)Angioedema
C)Lowered blood pressure
D)Increased blood pressure

Question 25

The nurse knows it is essential to monitor which laboratory values while a client is being treated with ACE inhibitors and ARBs? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

A)Electrolyte levels
B)Liver function
C)BUN and creatinine levels
D)Lipid profiles
E)ECG

Question 26

The nurse is reviewing the diet history of a client prescribed lisinopril therapy for hypertension.Which part of the client's current dietary intake must be altered while on lisinopril therapy?

A)Use of fish oil supplements
B)Use of calcium supplements
C)Use of potassium supplements
D)Use of multiple vitamins