The nurse has just finished teaching a hypertensive patient about a newly prescribed drug, ramipril(Altace). Which patient statement indicates that more teaching is needed?

Correct Answer: B

Rationale: Angioedema occurring with angiotensin-converting enzyme(ACE) inhibitor therapy is an indication that the ACE inhibitor should be discontinued. The patient should be taught that if any swelling of the face or oral mucosa occurs, the health care provider should be immediately notified because this could be life threatening. The other patient statements indicate that the patient has an accurate understanding of ACE inhibitor therapy.

Correct Answer: A

Rationale: The initial nursing action should be assessment of the patient's baseline dietary intake through a thorough diet history. The other actions may be appropriate, but assessment of the patient's baseline should occur first.

Correct Answer: A

Rationale: Potential complications of hypertension include the following: left ventricular hypertrophy; MI; heart failure; transient ischemic attacks (TIAs); cerebrovascular accident; renal insufficiency and failure; and retinal hemorrhage. Venous insufficiency and right ventricular hypertrophy are not potential complications of uncontrolled hypertension. The original question was a multiple-answer type, but it has been restructured to a single-answer format emphasizing a key consequence (TIAs) while maintaining accuracy.

Correct Answer: D

Rationale: Endothelin evokes positive inotropic and chronotropic effects on the myocardium by acting directly on cardiac muscle cells.

Correct Answer: B

Rationale: Cardiac muscle fibres are smaller than skeletal muscle fibres.