NCLEX
Review
-
Pharmacology
of
the
CVS
Methyldopa
(antihypertensive)
is
being
initiated
for
a
client
with
hypertension.
Which
health
teaching
would
be
most
appropriate
for
this
drug?
a.
Avoid
hot
baths
and
showers
and
prolonged
standing
in
one
position.
b.
This
drug
may
discolour
the
urine
a
pinkish
brown.
c.
This
drug
may
cause
bloating
and
weight
gain.
d.
The
tablet
should
be
taken
only
with
food
or
milk.
Answer:
a
Rationale:
Hot
baths
and
showers,
prolonged
standing
in
one
position,
and
strenuous
exercise
may
enhance
orthostatic
hypotension.
Options
b,
c,
and
d
are
incorrect.
Methyldopa
does
not
discolour
the
urine.
Bloating
and
weight
gain
are
not
typical
adverse
effects
of
methyldopa,
and
methyldopa
can
be
taken
without
food
A
client
is
receiving
hydralazine
(vasodilator)
for
elevated
blood
pressure
levels.
The
nurse's
care
plan
will
include
monitoring
the
client
for
which
adverse
effect?
a.
Atelectasis.
b.
Crystalluria.
c.
Photosensitivity.
d.
Orthostatic
hypotension.
Answer:
d
Rationale:
Orthostatic
hypotension
is
a
common
adverse
effect
of
vasodilators
such
as
hydralazine
(Apresoline).
Options
a,
b,
and
c
are
incorrect.
Hydralazine
does
not
typically
cause
atelectasis.
Crystalluria
is
not
an
adverse
effect
of
hydralazine
and
it
does
not
cause
photosensitivity. The
nurse
is
preparing
to
administer
the
first
dose
of
enalapril
(ACE
inhibitor).
Identify
the
potential
adverse
effects
of
this
medication.
Select
all
that
apply.
a.
Reflex
hypertension.
b.
Hyperkalemia.
c.
Persistent
cough.
d.
Angioedema.
e.
Hypotension.
Answer:
b,
c,
d,
e
Rationale:
Adverse
effects
of
ACE
inhibitors
such
as
enalapril
(Vasotec)
include
persistent
cough
and
orthostatic
hypotension.
Hyperkalemia
may
occur
and
can
be
a
major
concern
for
those
clients
with
CKD
and
in
clients
who
are
taking
potassium-sparing
diuretics.
Though
rare,
the
most
serious
adverse
effect
of
ACE
inhibitors
is
the
development
of
angioedema.
Option
a
is
incorrect.
Hypotension
with
reflex
tachycardia
is
a
possibility
depending
on
how
low
or
how
fast
the
blood
pressure
decreases
A
client
is
receiving
nitroprusside
(vasodilator)
and
is
being
monitored
in
the
intensive
care
unit.
Because
of
toxic
cyanide
metabolites
that
develop,
which
of
the
following
should
the
nurse
evaluate
in
the
client?
Select
all
that
apply.
a.
Cardiac
status
and
cardiac
output.
b.
Renal
function
and
creatinine
levels.
c.
Past
history
of
alcohol
use.
d.
Level
of
consciousness.
e.
Skin
colour
and
turgor.
Answer:
a,
b,
d
Rationale:
Thiocyanate
poisoning
may
develop
more
quickly
in
clients
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