Nursing practice questions with comprehensive rationales
NurseDive Free Nursing Practice Question
A. Rebound hypertension
Rebound hypertension can occur if antihypertensive medications are abruptly stopped, but it is not a direct reason for switching from an ACE inhibitor to an angiotensin II receptor blocker.
B. Persistent cough
A persistent cough is a well-known side effect of ACE inhibitors due to the accumulation of bradykinin. If the client experienced this side effect, it would likely prompt the healthcare provider to switch to an angiotensin II receptor blocker, which does not typically cause this issue.
C. Transient ischemic attack
A transient ischemic attack (TIA) would require urgent intervention but is not a reason for changing from an ACE inhibitor to an angiotensin II receptor blocker.
D. Non-adherence to ACE inhibitor treatment
Non-adherence to ACE inhibitor treatment may lead to ineffective blood pressure control but would not directly justify a switch to a different class of medication.
This question is an excerpt from Nurse Dive's nursing test bank - Med Surg Exam Antelope Valley College Proctored Exam. Take the full exam now
Full Explanation
A. Rebound hypertension can occur if antihypertensive medications are abruptly stopped, but it is not a direct reason for switching from an ACE inhibitor to an angiotensin II receptor blocker.
B. A persistent cough is a well-known side effect of ACE inhibitors due to the accumulation of bradykinin. If the client experienced this side effect, it would likely prompt the healthcare provider to switch to an angiotensin II receptor blocker, which does not typically cause this issue.
C. A transient ischemic attack (TIA) would require urgent intervention but is not a reason for changing from an ACE inhibitor to an angiotensin II receptor blocker.
D. Non-adherence to ACE inhibitor treatment may lead to ineffective blood pressure control but would not directly justify a switch to a different class of medication.
Similar Questions
A male college student has presented to the campus medical clinic reporting cold symptoms that he has been experiencing for the past 2 weeks. He tells the nurse that he has been taking OTC decongestants twice daily since the onset of the cold. What teaching point should the nurse provide to this student?
A. "It's best to take small doses of decongestants several times daily rather than two larger doses each day."
Taking smaller doses of decongestants several times a day may be appropriate for some medications but does not address the risk of rebound congestion associated with prolonged use.
B. "You can probably expect to get relief within the next few days or a week at the longest."
Expecting relief within a few days may not be realistic if the cold symptoms persist for 2 weeks, indicating a potential need for further evaluation.
C. “Over-the-counter decongestants don't normally work; you'll likely need to get a prescription for something more effective."
OTC decongestants can be effective, and many patients find relief from symptoms without requiring a prescription.
D. "You might find yourself more congested than ever as your body compensates for your use of these drugs."
Using decongestants for an extended period can lead to rebound congestion, where nasal passages become more congested once the medication is stopped, making this a crucial point for the nurse to communicate.
Full Explanation
A. Taking smaller doses of decongestants several times a day may be appropriate for some medications but does not address the risk of rebound congestion associated with prolonged use.
B. Expecting relief within a few days may not be realistic if the cold symptoms persist for 2 weeks, indicating a potential need for further evaluation.
C. OTC decongestants can be effective, and many patients find relief from symptoms without requiring a prescription.
D. Using decongestants for an extended period can lead to rebound congestion, where nasal passages become more congested once the medication is stopped, making this a crucial point for the nurse to communicate.
A patient is prescribed metoclopramide for the treatment of gastroparesis. Which of the following is a primary effect of metoclopramide?
A. Reduces gastric acid secretion
While metoclopramide may have some effect on gastric acid secretion, its primary role is not to reduce it.
B. Enhances gastrointestinal motility
Metoclopramide primarily enhances gastrointestinal motility, which helps to facilitate gastric emptying and is especially useful in treating conditions like gastroparesis.
C. Relieves abdominal pain
Metoclopramide does not specifically relieve abdominal pain; it focuses more on motility and nausea.
D. Acts as an antiemetic by inhibiting serotonin
Although metoclopramide does have antiemetic properties, it primarily acts as a dopamine receptor antagonist rather than directly inhibiting serotonin.
Full Explanation
A. While metoclopramide may have some effect on gastric acid secretion, its primary role is not to reduce it.
B. Metoclopramide primarily enhances gastrointestinal motility, which helps to facilitate gastric emptying and is especially useful in treating conditions like gastroparesis.
C. Metoclopramide does not specifically relieve abdominal pain; it focuses more on motility and nausea.
D. Although metoclopramide does have antiemetic properties, it primarily acts as a dopamine receptor antagonist rather than directly inhibiting serotonin.
A patient receiving metoclopramide is also taking an antidepressant. What should the nurse monitor for?
A. Decreased appetite
Decreased appetite may occur but is not the most critical concern in this context.
B. Increased risk of serotonin syndrome
The combination of metoclopramide, which can influence serotonin pathways, with certain antidepressants, especially SSRIs, increases the risk of serotonin syndrome, a potentially life-threatening condition.
C. Elevated blood pressure
While some antidepressants can influence blood pressure, monitoring for elevated blood pressure is not the primary concern with metoclopramide.
D. Enhanced antidepressant effects
There is no evidence to suggest that metoclopramide enhances the effects of antidepressants; the focus should be on potential adverse interactions instead.
Full Explanation
A. Decreased appetite may occur but is not the most critical concern in this context.
B. The combination of metoclopramide, which can influence serotonin pathways, with certain antidepressants, especially SSRIs, increases the risk of serotonin syndrome, a potentially life-threatening condition.
C. While some antidepressants can influence blood pressure, monitoring for elevated blood pressure is not the primary concern with metoclopramide.
D. There is no evidence to suggest that metoclopramide enhances the effects of antidepressants; the focus should be on potential adverse interactions instead.