Certified Medical-Surgical Registered Nurse Practice Exam

What indicates that captopril therapy for heart failure may be ineffective?

1. A skin rash

2. Peripheral edema

3. A dry cough

4. Postural hypotension

The correct answer is: Peripheral edema

The presence of peripheral edema is an important indicator that captopril therapy for heart failure may be ineffective. In heart failure, the heart's ability to pump blood effectively is compromised, which can lead to fluid retention and swelling, especially in the extremities. Captopril, an angiotensin-converting enzyme (ACE) inhibitor, is used to help reduce this fluid retention and improve heart function by lowering blood pressure and decreasing the workload on the heart. If a patient continues to experience peripheral edema despite being on captopril therapy, it suggests that the medication is not effectively managing the underlying fluid overload associated with heart failure. Meanwhile, while a skin rash, dry cough, and postural hypotension can be side effects or responses associated with captopril therapy, they do not directly indicate that the therapy is ineffective in controlling heart failure symptoms. These side effects can happen with medication use but do not necessarily reflect whether the heart failure itself is being managed effectively. Therefore, ongoing peripheral edema specifically points to inadequate response to the heart failure treatment.