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Mr. D. is a 60-year-old man being seen by his primary care provider for medication refills. His past medical history is significant for type 2 diabetes, hypertension, and hyperlipidemia. He is married with three children and works as a finance officer at a large banking firm. He has a one-pack-a-day cigarette smoking history and has been smoking for 40 years. Mr. D. does not check his blood pressure (BP) or his blood sugar at home. He denies any changes in his health status today and reports that he is feeling well. His last laboratory work was almost 2 years ago. His vital signs today are:BP, 160/94 mm HgHeart rate (HR) 90 beats/minRespiratory rate (RR) 20 breaths/minWeight 295 lbHeight 5 feet, 8 inchesBody mass index, 44.8Last known nonfasting blood sugar level, 212 mg/dL Mr. D.’s current medications include (1) amlodipine (Norvasc) 10 mg every day, (2) atorvastatin (Lipitor) 40 mg every night, (3) metformin (Glucophage) 1000 mg twice a day, and (4) glipizide (Glucotrol) 5 mg twice a day.1.You discuss with the patient that his BP is not adequately controlled and that his physician is adding losartan 100 mg every day to his medication regimen. Losartan (Cozaar) is pharmacologically classified as a(n)Group of answer choicesa) selective beta blocker.b) calcium channel blocker.c) angiotensin-converting enzyme (ACE) inhibitord) angiotensin II receptor blocker.2.Mr. D. asks how his current high BP medication differs from the new medication. As part of his health teaching, what is the best description of the benefit of losartan in the prevention of long-term complications from type 2 diabetes?Group of answer choicesa) It removes excess fluid from the extracellular space.b) It blocks catecholamine release and decreases heart rate.c) It reduces myocardial oxygen demand.d) It prevents cardiac remodeling and deterioration of renal function.3.What comment made by Mr. D. about losartan indicates the need for additional teaching to ensure his safety?Group of answer choicesa) “I need to monitor my BP regularly before taking each dose and keep a written log.”b) “I will report any swelling of my face or mouth, hoarseness, or difficulty swallowing.”c) “I plan to take two pills to catch up if I miss a dose.”d) “I have to reduce salt and potassium intake, including sea salt and salt substitutes.”4.Mr. D. asks you if losartan acts in the same way as amlodipine. You explain to Mr. D. that amlodipine (Norvasc) controls BP by which action?Group of answer choicesa) Promoting bronchodilation and tachypneab) Blocking calcium channels and promoting arterial vasodilationc) Inhibiting the conversion of angiotensin I to angiotensin IId) Blocking norepinephrine from binding to receptor sites on arterial smooth muscle Biology Science Pharmacology