WEEK 6 STUDY GUIDE
Chapter 16. Drugs Affecting the Cardiovascular and Renal Systems
Multiple Choice
Identify the choice that best completes the statement or answers the question.
____ 1.Ray has been diagnosed with hypertension and an angiotensin-converting enzyme inhibitor is determined
to be needed. Prior to prescribing this drug, the NP should assess for:
1. Hypokalemia
2. Impotence
3. Decreased renal function
4. Inability to concentrate
3
____ 2.Angiotensin-converting enzyme inhibitors are the drug of choice in treating hypertension in diabetic
patients because they:
1. Improve insulin sensitivity
2. Improve renal hemodynamics
3. Reduce the production of angiotensin II
4. All of the above
4
____ 3.A potentially life-threatening adverse response to angiotensin-converting enzyme inhibitors is
angioedema. Which of the following statements is true about this adverse response?
1. Swelling of the tongue or hoarseness are the most common symptoms.
2. It appears to be related to the decrease in aldosterone production.
3. Presence of a dry, hacky cough indicates a high risk for this adverse response.
4. Because it takes time to build up a blood level, it occurs after being on the drug for about 1
week.
1
____ 4.Angiotensin-converting enzyme inhibitors are useful in a variety of disorders. Which of the following
statements are true about both its usefulness in the disorder and the reason for its use?
1. Stable angina because it decreases the thickening of vascular walls due to decreased
modified release.
, 2. Heart failure because it reduces remodeling of injured myocardial tissues.
3. Both 1 and 2 are true and the reasons are correct.
4. Both 1 and 2 are true but the reasons are wrong.
5. Neither 1 nor 2 are true.
3
____ 5.Despite good blood pressure control, an NP might change a patient’s drug from an angiotensin-
converting enzyme (ACE) inhibitor to an angiotensin II receptor blocker (ARB) because the ARB:
1. Is stronger than the ACE inhibitor
2. Does not produce a dry, hacky cough
3. Has no effect on the renal system
4. Reduces sodium and water retention
2
____ 6.While taking an angiotensin II receptor blocker (ARB), patients need to avoid certain over-the-counter
drugs without first consulting the provider because:
1. Cimetidine is metabolized by the CYP 3A4 isoenzymes
2. Nonsteroidal anti-inflammatory drugs reduce prostaglandin levels
3. Both 1 and 2
4. Neither 1 nor 2
3
____ 7.Laboratory monitoring for patients on angiotensin-converting enzyme inhibitors or angiotensin II
receptor blockers should include:
1. White blood cell counts with the drug dosage increased for elevations above 10,000 feet
2. Liver function tests with the drug dosage stopped for alanine aminotransferase values twice
that of normal
3. Serum creatinine levels with the drug dosage reduced for values greater than 2.5 mg/dL
4. Serum glucose levels with the drug dosage increased for levels greater than 120 mg
/dL
3
____ 8.Jacob has hypertension, for which a calcium channel blocker has been prescribed. This drug helps
control blood pressure because it:
1. Decreases the amount of calcium inside the cell
2. Reduces stroke volume
3. Increases the activity of the Na+/K+/ATPase pump indirectly
4. Decreases heart rate
, 1
____ 9.Which of the following adverse effects may occur due to a dihydropyridine-type calcium channel
blocker?
1. Bradycardia
2. Hepatic impairment
3. Increased contractility
4. Edema of the hands and feet
4
____ 10.Patient teaching related to amlodipine includes:
1. Increase calcium intake to prevent osteoporosis from a calcium blockade.
2. Do not crush the tablet; it must be given in liquid form if the patient has trouble swallowing
it.
3. Avoid grapefruit juice as it affects the metabolism of this drug.
4. Rise slowly from a supine position to reduce orthostatic hypotension.
3
____ 11.Vera, age 70, has isolated systolic hypertension. Calcium channel blocker dosages for her should be:
1. Started at about half the usual dosage
2. Not increased over the usual dosage for an adult
3. Given once daily because of memory issues in the older adult
4. Withheld if she experiences gastroesophageal reflux
1
____ 12.Larry has heart failure, which is being treated with digoxin because it exhibits:
1. Negative inotropism
2. Positive chronotropism
3. Both 1 and 2
4. Neither 1 nor 2
4
____ 13.Furosemide is added to a treatment regimen for heart failure that includes digoxin. Monitoring for this
combination includes:
1. Hemoglobin
2. Serum potassium
3. Blood urea nitrogen
4. Serum glucose
Chapter 16. Drugs Affecting the Cardiovascular and Renal Systems
Multiple Choice
Identify the choice that best completes the statement or answers the question.
____ 1.Ray has been diagnosed with hypertension and an angiotensin-converting enzyme inhibitor is determined
to be needed. Prior to prescribing this drug, the NP should assess for:
1. Hypokalemia
2. Impotence
3. Decreased renal function
4. Inability to concentrate
3
____ 2.Angiotensin-converting enzyme inhibitors are the drug of choice in treating hypertension in diabetic
patients because they:
1. Improve insulin sensitivity
2. Improve renal hemodynamics
3. Reduce the production of angiotensin II
4. All of the above
4
____ 3.A potentially life-threatening adverse response to angiotensin-converting enzyme inhibitors is
angioedema. Which of the following statements is true about this adverse response?
1. Swelling of the tongue or hoarseness are the most common symptoms.
2. It appears to be related to the decrease in aldosterone production.
3. Presence of a dry, hacky cough indicates a high risk for this adverse response.
4. Because it takes time to build up a blood level, it occurs after being on the drug for about 1
week.
1
____ 4.Angiotensin-converting enzyme inhibitors are useful in a variety of disorders. Which of the following
statements are true about both its usefulness in the disorder and the reason for its use?
1. Stable angina because it decreases the thickening of vascular walls due to decreased
modified release.
, 2. Heart failure because it reduces remodeling of injured myocardial tissues.
3. Both 1 and 2 are true and the reasons are correct.
4. Both 1 and 2 are true but the reasons are wrong.
5. Neither 1 nor 2 are true.
3
____ 5.Despite good blood pressure control, an NP might change a patient’s drug from an angiotensin-
converting enzyme (ACE) inhibitor to an angiotensin II receptor blocker (ARB) because the ARB:
1. Is stronger than the ACE inhibitor
2. Does not produce a dry, hacky cough
3. Has no effect on the renal system
4. Reduces sodium and water retention
2
____ 6.While taking an angiotensin II receptor blocker (ARB), patients need to avoid certain over-the-counter
drugs without first consulting the provider because:
1. Cimetidine is metabolized by the CYP 3A4 isoenzymes
2. Nonsteroidal anti-inflammatory drugs reduce prostaglandin levels
3. Both 1 and 2
4. Neither 1 nor 2
3
____ 7.Laboratory monitoring for patients on angiotensin-converting enzyme inhibitors or angiotensin II
receptor blockers should include:
1. White blood cell counts with the drug dosage increased for elevations above 10,000 feet
2. Liver function tests with the drug dosage stopped for alanine aminotransferase values twice
that of normal
3. Serum creatinine levels with the drug dosage reduced for values greater than 2.5 mg/dL
4. Serum glucose levels with the drug dosage increased for levels greater than 120 mg
/dL
3
____ 8.Jacob has hypertension, for which a calcium channel blocker has been prescribed. This drug helps
control blood pressure because it:
1. Decreases the amount of calcium inside the cell
2. Reduces stroke volume
3. Increases the activity of the Na+/K+/ATPase pump indirectly
4. Decreases heart rate
, 1
____ 9.Which of the following adverse effects may occur due to a dihydropyridine-type calcium channel
blocker?
1. Bradycardia
2. Hepatic impairment
3. Increased contractility
4. Edema of the hands and feet
4
____ 10.Patient teaching related to amlodipine includes:
1. Increase calcium intake to prevent osteoporosis from a calcium blockade.
2. Do not crush the tablet; it must be given in liquid form if the patient has trouble swallowing
it.
3. Avoid grapefruit juice as it affects the metabolism of this drug.
4. Rise slowly from a supine position to reduce orthostatic hypotension.
3
____ 11.Vera, age 70, has isolated systolic hypertension. Calcium channel blocker dosages for her should be:
1. Started at about half the usual dosage
2. Not increased over the usual dosage for an adult
3. Given once daily because of memory issues in the older adult
4. Withheld if she experiences gastroesophageal reflux
1
____ 12.Larry has heart failure, which is being treated with digoxin because it exhibits:
1. Negative inotropism
2. Positive chronotropism
3. Both 1 and 2
4. Neither 1 nor 2
4
____ 13.Furosemide is added to a treatment regimen for heart failure that includes digoxin. Monitoring for this
combination includes:
1. Hemoglobin
2. Serum potassium
3. Blood urea nitrogen
4. Serum glucose
