Nursing Pharmacology: Beta Blockers, ACE Inhibitors and Diuretics
15 practice questions · 15 flashcards · made from study notes
Terms in this set (15)
- What suffix do beta blockers typically end in?
- -olol
- Beta blockers reduce heart rate, contractility, and blood pressure by blocking which receptors?
- beta-adrenergic receptors
- Non-selective beta blockers like propranolol block beta-2 receptors in the lungs, which can cause ___ and should be used with caution in patients with asthma or COPD.
- bronchoconstriction
- Before administering a beta blocker, what two vital signs should the nurse check, and what are the typical holding parameters?
- Apical pulse and blood pressure; hold if heart rate is below 60 bpm or systolic pressure is low.
- Beta blockers can mask signs of hypoglycemia, such as tachycardia, in patients with which condition?
- diabetes
- What can happen if beta blockers are stopped abruptly?
- Rebound tachycardia, hypertension, or angina.
- What suffix is common for ACE inhibitors?
- -pril
- A common side effect of ACE inhibitors is a dry, persistent cough caused by the build-up of ___.
- bradykinin
- What is the rare but serious adverse effect of ACE inhibitors characterized by swelling of the face, lips, and tongue that can block the airway?
- Angioedema
- ACE inhibitors can cause an electrolyte imbalance called ___.
- hyperkalemia
- ACE inhibitors are contraindicated during ___.
- pregnancy
- What is the primary action of diuretics in the body?
- Increase urine output.
- Furosemide is an example of a loop diuretic. What electrolyte imbalance is a common concern with its use, and what signs should the nurse monitor for?
- Hypokalemia (muscle weakness, cramps, dysrhythmias).
- Spironolactone is a potassium-sparing diuretic that blocks ___, and can cause ___.
- aldosterone; hyperkalemia
- List three key nursing interventions for a patient on any diuretic.
- Monitor daily weight at the same time each day, intake and output, blood pressure, and electrolytes. Administer dose in the morning to avoid nocturia.
Practice questions (15)
1.A patient with a history of asthma is prescribed a new medication for hypertension. Which of the following beta blockers should be used with caution in this patient due to its mechanism of action?
- APropranolol
- BMetoprolol
- CAtenolol
- DCarvedilol
Show answer
Answer: Propranolol
Propranolol is a non-selective beta blocker, meaning it blocks both beta-1 receptors in the heart and beta-2 receptors in the lungs. Blocking beta-2 receptors can lead to bronchoconstriction, which is dangerous for a patient with asthma. Metoprolol and atenolol are cardioselective and primarily target beta-1 receptors, making them safer choices.
2.What is the primary mechanism of action for ACE inhibitors like lisinopril?
Show answer
Answer: They block the angiotensin-converting enzyme, which prevents the conversion of angiotensin I to angiotensin II.
This question directly assesses the user's understanding of how ACE inhibitors work at a physiological level, which is a core concept. Knowing that they prevent the formation of angiotensin II, a potent vasoconstrictor, is key to understanding their use in treating hypertension.
3.True or False: A patient taking the loop diuretic furosemide should be monitored for hyperkalemia (high potassium).
- ATrue
- BFalse
Show answer
Answer: False
This question targets a common point of confusion. Loop diuretics like furosemide cause potassium loss, leading to hypokalemia (low potassium), not hyperkalemia. It's crucial for nurses to monitor for signs of low potassium, such as muscle weakness and dysrhythmias.
4.A patient on lisinopril develops a persistent, dry cough. Which alternative medication class is mentioned as not causing this specific side effect due to its different mechanism of action?
- ABeta Blockers (-olol)
- BAngiotensin Receptor Blockers (ARBs) (-sartan)
- CLoop Diuretics (e.g., furosemide)
- DThiazide Diuretics (e.g., hydrochlorothiazide)
Show answer
Answer: Angiotensin Receptor Blockers (ARBs) (-sartan)
Understanding why a cough occurs with ACE inhibitors (bradykinin buildup) and knowing that ARBs offer a similar therapeutic effect without this side effect is a key clinical application point. ARBs, like losartan, work further down the renin-angiotensin-aldosterone system.
5.For which of the following conditions are beta blockers like metoprolol commonly used?
- AHypokalemia and hyperuricemia
- BEdema and nocturia
- CHypertension, angina, and heart failure
- DKidney protection in diabetics and angioedema
Show answer
Answer: Hypertension, angina, and heart failure
This question directly tests the recall of the primary uses for beta blockers as listed in the text. It ensures the learner can connect the drug class to its main therapeutic applications.
6.Which class of diuretics is identified as the most potent and is primarily used for conditions like edema and heart failure?
Show answer
Answer: Loop diuretics, such as furosemide.
This question requires the user to identify the most potent class of diuretics and its primary uses. Understanding the distinction between loop, thiazide, and potassium-sparing diuretics is fundamental for safe and effective administration.
7.True or False: Due to the risk of hyperkalemia, potassium-sparing diuretics like spironolactone should be used cautiously with ACE inhibitors.
- ATrue
- BFalse
Show answer
Answer: True
This question assesses the understanding of drug-drug interactions. Both ACE inhibitors and potassium-sparing diuretics can cause hyperkalemia. Using them together increases this risk, requiring careful monitoring. This is a critical safety concept.
8.A patient taking an ACE inhibitor like lisinopril reports swelling of their lips and tongue. What is this rare but serious adverse effect called?
Show answer
Answer: Angioedema
Recognizing the signs of angioedema and knowing its name is a critical safety competency for anyone administering ACE inhibitors. This adverse effect can be life-threatening as it can block the airway.
9.A patient with a history of asthma is prescribed a new medication for hypertension. Which of the following medications would require the nurse to question the provider due to the patient's respiratory history?
- AMetoprolol
- BFurosemide
- CLisinopril
- DPropranolol
Show answer
Answer: Propranolol
This question assesses the nurse's ability to apply knowledge of beta blocker types and their specific contraindications. Propranolol is a non-selective beta blocker that can cause bronchoconstriction by blocking beta-2 receptors in the lungs, which is dangerous for a patient with asthma. Metoprolol is cardioselective and less likely to cause this issue.
10.When administering a beta blocker like metoprolol, a nurse should hold the dose and notify the provider if the patient's apical pulse is below 60 beats per minute.
- ATrue
- BFalse
Show answer
Answer: True
This question tests a critical safety check for administering beta blockers. Bradycardia is a primary adverse effect, and a heart rate below 60 is a standard parameter for withholding the medication to prevent severe bradycardia.
11.A patient taking lisinopril develops a dry, persistent cough. What is the physiological reason for this common side effect?
Show answer
Answer: The cough is caused by the build-up of bradykinin, which occurs because ACE inhibitors block the angiotensin-converting enzyme that also breaks down bradykinin.
This question requires the nurse to recall the mechanism behind a very common side effect of ACE inhibitors. Understanding this helps in patient education and differentiating it from other respiratory symptoms.
12.A patient on furosemide for heart failure reports muscle weakness and cramps. Which electrolyte imbalance should the nurse suspect, and what is a key nursing action to address it?
Show answer
Answer: The nurse should suspect hypokalemia (low potassium). A key nursing action is to encourage the patient to eat potassium-rich foods and monitor their potassium levels.
This question challenges the nurse to connect patient-reported symptoms (muscle weakness, cramps) to a specific electrolyte imbalance (hypokalemia) caused by a loop diuretic and to identify an appropriate nursing intervention. This is a critical thinking skill for patient safety.
13.A patient is being discharged with a new prescription for lisinopril. What is the most critical piece of safety advice the nurse should provide regarding the first dose?
- ARise slowly from a sitting or lying position.
- BTake the medication with a potassium supplement.
- CMonitor for a dry cough and report it immediately.
- DAvoid taking the medication if your heart rate is below 60.
Show answer
Answer: Rise slowly from a sitting or lying position.
This question focuses on a key adverse effect associated with the initial dose of an ACE inhibitor. First-dose hypotension can be significant, and teaching the patient to change positions slowly is a crucial safety measure to prevent falls.
14.A patient taking spironolactone should be advised to avoid salt substitutes.
- ATrue
- BFalse
Show answer
Answer: True
This question challenges the nurse to integrate knowledge about potassium-sparing diuretics with common over-the-counter products. Salt substitutes are often potassium-based, and using them with spironolactone could lead to life-threatening hyperkalemia. This requires a deeper level of patient education.
15.A patient with diabetes is prescribed metoprolol. Why is it important for the nurse to educate this patient about monitoring their blood glucose levels more carefully?
Show answer
Answer: Beta blockers like metoprolol can mask the signs of hypoglycemia, such as tachycardia. The patient may not experience the usual warning signs of low blood sugar, making it crucial to monitor glucose levels directly.
This advanced question requires the nurse to understand a subtle but critical drug-disease interaction. Recognizing that a beta blocker can hide hypoglycemia symptoms is essential for preventing severe hypoglycemic events in patients with diabetes.
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