ARBs (Angiotensin II Receptor Blockers) NCLEX questions for nursing students!
ARBs (angiotensin II receptor blockers) are medications used to help lower the blood pressure. The nurse should be aware of how the drug works, why it is ordered, nursing implications, adverse reactions, and how to teach the patient how to take the medication.
This quiz is part of a pharmacology NCLEX question review series and will include various medications. This series will test your knowledge on nursing implications, side effects, patient teaching, therapeutic effects, and more.
Don’t forget to watch the lecture on angiotensin II receptor blockers before taking the quiz.
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Angiotensin II Receptors Blockers (ARBs) NCLEX
1. You’re teaching a patient about how angiotensin II receptor blockers (ARBs) work. Which statement below BEST describes how these medications work on the body?
A. “They prevent Angiotensin II Type I Receptors from binding with Angiotensin II.”
B. “These medications prevent the activation of Angiotensin II Type II Receptors from binding with Angiotensin II.”
C. “They inhibit angiotensin-converting-enzyme (ACE) from converting an Angiotensin I to Angiotensin II.”
D. “These medications prevent Angiotensin II Type I Receptors from binding with angiotensin-converting-enzyme (ACE).”
The answer is A. ARBs prevent Angiotensin II Type I Receptors from binding with Angiotensin II. Remember ACE Inhibitors inhibit angiotensin-converting-enzyme (ACE) from converting Angiotensin I to Angiotensin II.
2. A physician writes a new medication order for a patient who has cardiovascular disease. The medication is an angiotensin II receptor blocker (ARB). What new medication on the patient’s scheduled medication list is an ARB?
The answer is B. Remember ARBs end with “SARTAN”. Losartan is an ARB.
3. A patient who developed a dry, persistent cough while taking an ACE Inhibitor is switched to an angiotensin II receptor blocker (ARB). The patient reports the cough is now gone, but asks you to explain how this medication helped alleviate the cough. What is the correct response?
A. “ARBs prevent ACE (angiotensin-converting-enzyme) from breaking down bradykinin so a dry, persistent cough is less likely.”
B. “ARBs increase ACE (angiotensin-converting-enzyme) which helps decrease bradykinin levels and helps alleviate the cough.”
C. “ARBs do not inhibit ACE (angiotensin-converting-enzyme), which is a substance that inactivates bradykinin by breaking it down; therefore, a cough is not likely with this medication.”
D. “ARBs prevent Angiotensin II Type I receptor sites from activating bradykinin in the lungs.”
The answer is C. ACE Inhibitors can cause a dry, persistent cough in some patients because it inhibits ACE from inactivating bradykinin by breaking it down….therefore, levels of bradykinin increase and lead to coughing. ARBs do NOT inhibit ACE (angiotensin-converting-enzyme), which is a substance that inactivates bradykinin by breaking it down; therefore, a cough is not likely with this medication.
4. Select all the pharmacodynamic effects of angiotensin II receptor blockers (ARBs):
C. Sodium conservation
D. Sodium excretion
E. Water conservation
F. Water excretion
The answers are A, D, and F. ARBs prevent Angiotensin II Type I Receptors from binding with Angiotension II. This leads to vasodilation of vessels and decreases the release of aldosterone, which leads to sodium and water excretion (potassium is conserved…so watch out for hyperkalemia).
5. What conditions are Angiotensin II Receptor Blockers (ARBs) used to treat? Select all that apply:
B. Renal stenosis
C. Diabetic nephropathy in type 2 diabetics
D. Atrial flutter
E. Heart failure
The answers are A, C, and E. ARBs can treat hypertension, diabetic nephropathy in type 2 diabetics (which is kidney disease in type 2 diabetics), and heart failure.
6. A patient is taking an Angiotensin II Receptor Blocker (ARB). What finding below is an adverse side effect of this medication and should be reported to the physician?
A. BUN 10
B. Creatinine 1 mg/dL
C. Potassium 6.8 mEq/L
D. ALT 20 U/L
The answer is C. ARBs can lead to hyperkalemia due to how they decrease the release of aldosterone and cause the kidneys to excrete sodium and water, but conserve potassium. A normal potassium level is 3.5-5 mEq/L.
7. As the nurse you know to tell the patient that the best way to PREVENT rebound hypertension while taking an Angiotensin II Receptor Blocker (ARB) is to?
A. assess the blood pressure daily with a self-monitoring device
B. never abruptly stop taking the medication
C. avoid taking the medication with milk or grapefruit juice
D. avoid taking over-the-counter medications
The answer is B. The patient should NEVER just quit taking the medication because rebound hypertension can occur.
8. You’re providing discharge teaching to a patient that will be taking an Angiotensin II Receptor Blocker (ARB) at home. What statement by the patient requires you to re-educate them about this medication?
A.“This medication does not cure hypertension. Therefore, I will need to also make lifestyle changes.”
B. “I will always stand and change positions slowly.”
C. “A persistent, dry cough is not common with this medication.”
D. “This medication can decrease potassium levels. So, I will consume a diet rich in potassium to help keep my level normal.”
The answer is D. ARBs can cause a HIGH potassium level. Therefore, the patient should avoid consuming a diet rich in potassium and using salt-substitutes with potassium.
9. Your patient is prescribed an Angiotensin II Receptor Blocker (ARB) for the treatment of blood pressure management. Which statement below BEST describes how this medication will manage blood pressure in a patient?
A. “This medication will increase systemic vascular resistance (SVR) and decrease blood pressure, while decreasing blood volume through the excretion of sodium and water.”
B. “This medication will decrease systemic vascular resistance (SVR) and decrease blood pressure, while decreasing blood volume through the excretion of sodium and water.”
C. “ARBs will cause vasoconstriction and increase renal blood flow and volume.”
D. “ARBs will cause vasodilation and the kidneys to retain sodium and water.”
The answer is B. ARBs will decrease systemic vascular resistance (SVR) and decrease blood pressure, while decreasing blood volume through the excretion of sodium and water.”
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