A nurse is assessing the appropriateness of her patient's ...

[Haya94]

A nurse is assessing the appropriateness of her patient's medications.
 
  The nurse understands that it would be most dangerous for the patient taking an angiotensin-converting enzyme (ACE) inhi-bitor if the patient had which of the following co-morbidities? a. Coronary artery disease
  b. Heart failure
  c. Renal artery stenosis
  d. Diabetes mellitus

Question 2

A nurse suspects that a patient is exhibiting signs and symptoms of physical dependence on a central nervous system drug. The nurse should plan to implement which of the following inter-ventions?
 
  a. Increase the drug dose to prevent withdrawal per the prescriber's orders.
  b. Monitor the patient for signs and symptoms of tolerance.
  c. Taper the medication to prevent withdrawal as prescribed.
  d. Augment the central nervous system drug with another, less potent central nerv-ous system drug as prescribed.

[stillxalice]

Answer to Question 1

C
ACE inhibitors can cause severe renal insufficiency in patients with bilateral renal artery stenosis or stenosis in the artery to a single remaining kidney.
Coronary artery disease, heart failure, and diabetes mellitus are not co-morbidities that pose a contraindication in a patient taking an ACE inhibitor.

Answer to Question 2

C
Physical dependence would require the dose to be decreased and eventually tapered off to pre-vent an abstinence syndrome, which is specific to physical withdrawal.
A dose increase would be contraindicated, because it may make the patient more dependent and is consistent with drug tolerance.
There is no indication that the patient should be monitored for signs and symptoms of tolerance, which is different from physical dependence.
The central nervous system drug would not be augmented with another drug, because this indi-cates an addition to the drug regimen, not a replacement.

[Haya94]

Excellent

[cici]

TYSM