NCLEX Pharmacology: Cardiovascular Medications 3 — Questions and Answers
Question 1: A patient taking lisinopril develops a persistent dry cough. What is the likely cause?
- Accumulation of bradykinin from ACE inhibition (Correct answer)
- Beta-blockade of the bronchi
- Calcium channel blockade
- Diuretic-induced dehydration
Correct answer: Accumulation of bradykinin from ACE inhibition
ACE inhibitors increase bradykinin, causing a dry cough.
Question 2: Which serious adverse effect of ACE inhibitors requires immediate discontinuation and emergency care?
- Angioedema (Correct answer)
- Mild headache
- Constipation
- Dry mouth
Correct answer: Angioedema
Angioedema is a life-threatening swelling that requires stopping the drug immediately.
Question 3: The nurse should monitor which lab value in a patient on an ACE inhibitor due to risk of hyperkalemia?
- Potassium (Correct answer)
- Calcium
- Magnesium
- Glucose
Correct answer: Potassium
ACE inhibitors can cause potassium retention, so potassium must be monitored.
Question 4: Why are ACE inhibitors contraindicated in pregnancy?
- They cause fetal injury and death (Correct answer)
- They increase amniotic fluid
- They cause maternal hypertension
- They have no fetal effects
Correct answer: They cause fetal injury and death
ACE inhibitors are teratogenic and can cause fetal harm or death.
Question 5: A patient who cannot tolerate an ACE inhibitor cough may be switched to which drug ending in '-sartan'?
- Losartan (an ARB) (Correct answer)
- Metoprolol
- Amlodipine
- Hydrochlorothiazide
Correct answer: Losartan (an ARB)
ARBs like losartan provide similar effects without the bradykinin cough.
Question 6: What teaching is essential for a patient starting an ACE inhibitor regarding salt substitutes?
- Avoid potassium-based salt substitutes (Correct answer)
- Use them freely
- Double the amount used
- Switch to sea salt only
Correct answer: Avoid potassium-based salt substitutes
Potassium salt substitutes increase the risk of hyperkalemia with ACE inhibitors.
Question 7: First-dose hypotension is a concern with ACE inhibitors, so the nurse should advise the patient to do what?
- Rise slowly from a sitting or lying position (Correct answer)
- Take the first dose standing
- Skip the first dose
- Take it with a large meal of salt
Correct answer: Rise slowly from a sitting or lying position
Rising slowly reduces the risk of orthostatic hypotension and falls.
NCLEX Pharmacology: Cardiovascular Medications 3
A patient taking lisinopril develops a persistent dry cough.
What is the likely cause?