NURP-424- Exam 3 Practice Questions and Answers

NURP-424- Exam 3 Practice Questions and Answers Factors that Affect BP - Ans:-- Cardiac output - Peripheral resistance - Heart rate - Filling pressure - Contractility - Arteriolar tone - Blood volume - Venous tone Blood Pressure Medicine Action - Ans:-Reduce blood pressure by lowering cardiac output and peripheral resistance ©GRACEAMELIA 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED FIRST PUBLISH OCTOBER 2024 Page 2/49 ACE Inhibitors (-prils) - Ans:-- Block conversion of angiotensin I to angiotensin II which inhibits aldosterone and in return lowers BP by: - Decreasing output of the sympathetic nervous system - Increasing vasodilation of vascular smooth muscle - Decreasing retention of sodium and water (by decreasing aldosterone in the system) - Inhibit the degradation of bradykinin (anti-inflammatory mediator - the cause of the cough and angioedema) and increase the synthesis of vasodilating prostaglandins ACE Inhibitor Indications - Ans:-- HTN: less SE in Caucasian decent - Hypertensive proteinuric diabetes: helps with renal protection and prevention of nephropathy - Angina and ischemic heart disease: decreases peripheral vascular resistance which decrease cardiac output; decrease the thickening of the ventricular walls which leads to less O2 demand ©GRACEAMELIA 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED FIRST PUBLISH OCTOBER 2024 Page 3/49 - Post-MI: reduce morbidity and mortality by reducing myocardial injury and preventing ventricular remodeling - HF: reduce remodeling of the heart due to HTN ACE Inhibitor Caution & Conraindications - Ans:-- Avoid in bilateral renal artery stenosis - Avoid in idiopathic and hereditary angioedema - Avoid in pregnancy and lactation - Avoid concurrent use of ACE-I with ARB or aliskern - Caution in renal and hepatic impairment ©GRACEAMELIA 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED FIRST PUBLISH OCTOBER 2024 Page 4/49 - Limited data for 6 y.o. for HTN treatment. Approved for 6 y.o. ACE Inhibitor Adverse Effects - Ans:-- Dry cough - Hypotension - Hyperkalemia - Skin rash - Altered taste - Dizziness - HA - Fatigue ARBs (-sartans) - Ans:-- Indications: HTN, hypertensive proteinuric diabetes, angina and ischemic heart disease, post-MI, HF - Pharmacodynamics: block angiotensin II receptors and reduce the levels of aldosterone secretion which reduces the retention of sodium and water ©GRACEAMELIA 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED FIRST PUBLISH OCTOBER 2024 Page 5/49 - No effect on bradykinin so less likely to develop a cough or angioedema ARBs Caution & Contraindications - Ans:-- Avoid in bilateral renal artery stenosis - Avoid in idiopathic and hereditary angioedema - Avoid concurrent use of ACE-I with ARB or aliskern - Caution with other medications that cause hyperkalemia - Caution in renal and hepatic impairment - Approved for 6 y.o. ARBs Adverse Drug Effects - Ans:-- Dizziness - Hypotension ©GRACEAMELIA 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED FIRST PUBLISH OCTOBER 2024 Page 6/49 - Hyperkalemia - Fatigue - URI The initial dose for an angiotensin II receptor blocker (ARB) may need to be lower in which of these? - Ans:-For patients on ARBs, no change in dosage is required based on renal impairment; however, initial ARB doses may be lower for patients with impaired hepatic function. Liver function tests should be performed prior to initiating therapy and the dose may be increased as tolerated. The action of angiotensin-converting enzyme inhibitors (ACEIs), angiotensin II receptor blockers (ARBs), and direct renin inhibitors on the renin-angiotensin-aldosterone (RAA) system lowers blood pressure and reduces the adverse effects of which disease on the kidney? - Ans:-The action of ACEIs, ARBs, and direct renin inhibitors on the RAA system lowers blood pressure and reduces the