a client has a long history of hypertension which category of medications would the nurse expect to be ordered to avoid chronic kidney disease ckd
Logo

Nursing Elites

HESI RN

Evolve HESI Medical Surgical Practice Exam

1. A client has a long history of hypertension. Which category of medication would the nurse expect to be ordered to avoid chronic kidney disease (CKD)?

Correct answer: D

Rationale: The correct answer is D, Angiotensin-converting enzyme (ACE) inhibitor. ACE inhibitors inhibit the conversion of angiotensin I to angiotensin II, a potent vasoconstrictor. By blocking this conversion, ACE inhibitors promote vasodilation and improve perfusion to the kidneys. Additionally, ACE inhibitors block the breakdown of bradykinin and prostaglandin, further contributing to vasodilation. They also lead to increased renin and decreased aldosterone levels. These effects help in reducing blood pressure and protecting the kidneys in clients with hypertension. Antibiotics are used to fight infections, histamine blockers reduce inflammation, and bronchodilators widen the bronchi, none of which address the underlying processes involved in slowing the progression of chronic kidney disease (CKD) in hypertensive clients.

2. In a client with congestive heart failure, the nurse would be correct in withholding a dose of digoxin without specific instruction from the healthcare provider if the client's

Correct answer: C

Rationale: The correct answer is C. Hypokalemia can precipitate digitalis toxicity in individuals on digoxin, increasing the risk of dangerous dysrhythmias. A serum potassium level of 3 mEq/L is below the normal range (3.5 to 5.5 mEq/L) and indicates hypokalemia, which can potentiate the effects of digoxin. Choices A, B, and D are not directly related to the potential for digitalis toxicity. Serum digoxin level of 1.5 ng/mL is within the therapeutic range, blood pressure of 104/68 mmHg is not a contraindication for administering digoxin, and an apical pulse of 68/min is within the normal range and not a reason to withhold digoxin.

3. A healthcare professional is reviewing the results of renal function testing in a client with renal calculi. Which finding indicates to the healthcare professional that the client’s blood urea nitrogen (BUN) level is within the normal range?

Correct answer: B

Rationale: The normal BUN ranges from 5 to 20 mg/dL. A BUN level of 18 mg/dL falls within this normal range. Values of 25 and 35 mg/dL are elevated, suggesting potential renal insufficiency. Choice A (2 mg/dL) is abnormally low and not indicative of a normal BUN level.

4. What is the primary action of insulin in the body?

Correct answer: B

Rationale: The correct answer is B: To promote the absorption of glucose into cells. Insulin facilitates the uptake of glucose by cells, thereby decreasing blood glucose levels. Choice A is incorrect as insulin does not directly affect blood pressure. Choice C is inaccurate as insulin works to lower, not increase, blood glucose levels. Choice D is incorrect because insulin's primary role is to lower, not increase, blood glucose levels by promoting glucose uptake into cells.

5. Which of the following indicates a potential complication of diabetes mellitus?

Correct answer: B

Rationale: A blood pressure of 160/100 mm Hg indicates hypertension, which is a common complication of diabetes mellitus due to atherosclerotic changes. Hypertension is a significant risk factor for cardiovascular diseases, which are prevalent in individuals with diabetes. Inflamed and painful joints (Choice A) are not directly related to diabetes complications but may be seen in conditions like arthritis. Stooped posture (Choice C) is more indicative of musculoskeletal issues like osteoporosis, not necessarily a typical complication of diabetes. Hemoglobin level of 9 g/dL (90 g/L) (Choice D) could signify anemia, which can occur in diabetes but is not a primary complication often associated with the disease.

Similar Questions

Which of the following is a common cause of acute kidney injury?
A 20-year-old female client calls the nurse to report a lump she found in her breast. Which response is the best for the nurse to provide?
When preparing to examine a client’s skin using a Wood light, what should the nurse do to facilitate this procedure?
The nurse is obtaining a health history from a new client who has a history of kidney stones. Which statement by the client indicates an increased risk for renal calculi?
The provider has ordered Kayexalate and sorbitol to be administered to a patient. The nurse caring for this patient would expect which serum electrolyte values prior to administration of this therapy?

Access More Features

HESI RN Basic
$69.99/ 30 days

  • 5,000 Questions with answers
  • All HESI courses Coverage
  • 30 days access

HESI RN Premium
$149.99/ 90 days

  • 5,000 Questions with answers
  • All HESI courses Coverage
  • 30 days access

Other Courses