Deck 44: Drugs Acting on the Renin-Angiotensin-Aldosterone System

Question 1

A prescriber orders ramipril [Altace] for an obese patient with type 2 diabetes mellitus who has developed hypertension. The nurse provides teaching before dismissing the patient home. Which statement by the patient indicates understanding of the teaching?

A) "I am less likely to develop diabetic nephropathy when taking this medication."
B) "I should check my blood sugar more often, because hyperglycemia is a side effect of this drug."
C) "Taking this medication helps reduce my risk of stroke and heart attack."
D) "This medication will probably prevent the development of diabetic retinopathy."

Answer 1

"Taking this medication helps reduce my risk of stroke and heart attack."

Question 2

A patient with hypertension is prescribed an angiotensin-converting enzyme (ACE)inhibitor. The nurse reviewing this patient's chart before administering the medication will be most concerned about which other disease process?

A) Bronchial asthma
B) Coronary artery disease
C) Diabetes mellitus
D) Renal artery stenosis

Answer 2

Renal artery stenosis

Question 3

A nurse is reviewing a patient's medications before administration. Which drug-to-drug interactions will most concern the nurse in a patient with a history of heart failure and a potassium level of 5.5 mEq/L?

A) Furosemide [Lasix] and enalapril [Vasotec]
B) Amlodipine [Norvasc] and spironolactone [Aldactone]
C) Captopril [Capoten] and spironolactone [Aldactone]
D) Metoprolol [Lopressor] and furosemide [Lasix]

Answer 3

Captopril [Capoten] and spironolactone [Aldactone]

Question 4

A female patient taking an ACE inhibitor learns that she is pregnant. What will the nurse tell this patient?

A) The fetus most likely will have serious congenital defects.
B) The fetus must be monitored closely while the patient is taking this drug.
C) The patient's prescriber probably will change her medication to an ARB.
D) The patient should stop taking the medication and contact her provider immediately.

Question 5

A patient who is taking furosemide [Lasix] and digoxin will begin taking captopril [Capoten]. The nurse is providing information about the drug. Which statement by the patient indicates a need for further teaching?

A) "I can use acetaminophen for analgesia if needed."
B) "I should stop taking the Lasix about a week before starting the Capoten."
C) "I should take this medication on a full stomach."
D) "I will need to have blood tests done every 2 weeks for a few months."

Question 6

A patient who stops taking an ACE inhibitor because of its side effects will begin taking an angiotensin II receptor blocker (ARB)medication. Which side effect of ACE inhibitors will not occur with an ARB medication?

A) Angioedema
B) Cough
C) Hyperkalemia
D) Renal failure

Question 7

A female patient who is not taking any other medications is prescribed aliskiren [Tekturna],a direct renin inhibitor (DRI). The nurse reviews medication information with the patient. Which statement by the patient indicates understanding of the teaching?

A) "If I get pregnant, I should stop taking this drug by the second trimester."
B) "If I take this drug with a high-fat meal, it will be more effective."
C) "I should restrict my potassium intake while taking this drug."
D) "I should take this medication 1 hour before sitting down to a meal."

Question 8

A provider has ordered captopril [Capoten] for a patient who has hypertension. The patient reports a history of swelling of the tongue and lips after taking enalapril [Vasotec] in the past. Which action by the nurse is correct?

A) Administer the captopril and monitor for adverse effects.
B) Hold the dose and notify the provider.
C) Request an order to administer fosinopril instead of captopril.
D) Reassure the patient that this is not a serious side effect.

Question 9

A nurse administers an ACE inhibitor to a patient who is taking the drug for the first time. What will the nurse do?

A) Instruct the patient not to get up without assistance.
B) Make sure the patient takes a potassium supplement.
C) Report the presence of a dry cough to the prescriber.
D) Request an order for a diuretic to counter the side effects of the ACE inhibitor.

Question 10

A female patient who begins taking spironolactone [Aldactone] as an adjunct to furosemide [Lasix] complains that her voice is deepening. What will the nurse do?

A) Contact the provider to obtain an order for a complete blood count (CBC) and liver function tests.
B) Explain that this drug binds with receptors for steroid hormones, causing this effect.
C) Report this side effect to the provider and request another medication for this patient.
D) Teach the patient to report any associated cough, which may indicate a more severe side effect.

Question 11

A patient begins taking an ACE inhibitor and complains of a dry cough. What does the nurse correctly tell the patient about this symptom?

A) It indicates that a serious side effect has occurred.
B) It is a common side effect that occurs in almost all patients taking the drug.
C) It may be uncomfortable enough that the drug will need to be discontinued.
D) It occurs frequently in patients taking the drug but will subside over time.

Question 12

A patient who has been taking an antihypertensive medication for several years is recovering from a myocardial infarction. The prescriber changes the patient's medication to an ACE inhibitor. The patient asks the nurse why a new drug is necessary. What is the nurse's response?

A) "ACE inhibitors can prevent or reverse pathologic changes in the heart's structure."
B) "ACE inhibitors help lower LDL cholesterol and raise HDL cholesterol."
C) "ACE inhibitors increase venous return to the heart, improving cardiac output."
D) "ACE inhibitors regulate electrolytes that affect the cardiac rhythm."