American Association of Critical-Care Nurses (AACN) Certification Practice Test

Which medication class is typically indicated for managing hypertension related to renal artery stenosis?

1. Beta blockers

2. ACE inhibitors

3. Calcium channel blockers

4. Diuretics

The correct answer is: ACE inhibitors

ACE inhibitors are typically indicated for managing hypertension related to renal artery stenosis because they work by hindering the action of the enzyme that converts angiotensin I to angiotensin II. This process helps relax blood vessels, reduces blood pressure, and decreases the workload on the heart. In patients with renal artery stenosis, particularly if the stenosis is significant, the kidneys can become reactive to angiotensin II levels because they are not receiving adequate perfusion. By blocking the formation of angiotensin II, ACE inhibitors help mitigate renal ischemia and ultimately improve renal blood flow, while simultaneously controlling blood pressure. Moreover, these medications offer the added benefit of providing renal protection, which is critical in patients with compromised kidney function due to artery stenosis. They also improve outcomes in conditions such as heart failure and proteinuria. With these mechanisms, ACE inhibitors effectively target the underlying pathophysiology of hypertension secondary to renal artery stenosis, making them the preferred choice in such cases.