Emailed Qs Exam 3

The nurse is teaching a client how to take his diltiazem. Which instruction would be most appropriate? "Cut the tablet in half to make it easier to swallow." "Mix the crushed tablet with applesauce to improve the taste." "Swallow the drug whole with a large glass of water." "Chew the tablet thoroughly before swallowing."

"Swallow the drug whole with a large glass of water."

The nurse is caring for a 42-year-old peri-menopausal client recently diagnosed with hypertension and prescribed benazepril. The client also takes over-the-counter ibuprofen for headaches. The nurse would provide which important points when educating the client on taking the new medication? Select all that apply. 1) Use barrier contraceptives while taking benazepril to prevent pregnancy, as it may cause severe birth defects. 2) Take the medication one hour before meals or two hours after meals to enhance absorption of antihypertensives. 3)If swelling of the face, throat, or extremities occurs, hold the next dose and call the primary care provider immediately. 4)Taking ibuprofen can make the drug more potent and decrease your blood pressure more, so take acetaminophen instead. 5)A dry cough may develop when taking benazepril and it is not harmful, but if it is bothersome tell the primary care provider.

1) Use barrier contraceptives while taking benazepril to prevent pregnancy, as it may cause severe birth defects. 3) If swelling of the face, throat, or extremities occurs, hold the next dose and call the primary care provider immediately. 5) A dry cough may develop when taking benazepril and it is not harmful, but if it is bothersome tell the primary care provider. NOTE: The client beginning an ACEI needs to be taught about the symptoms of angioedema and to not take the next dose, but call the primary care provider (PCP) immediately for further instructions. ...Further NOTE: The client taking ACEIs should not take NSAIDs, such as ibuprofen, because they decrease the effectiveness of the ACEI.

The patient has been placed on a nitroprusside drip for the treatment of a hypertensive crisis. Which mechanism of action does the nurse know is true for nitroprusside? 1)It blocks the action of angiotensin II from all the different pathways where it is formed, not just the single substrate altered by ACE inhibitors. 2)It directly relaxes vascular smooth muscle, allowing dilation of peripheral arteries and veins. 3)It binds selectively to the mineralocorticoid receptors. 4)It inhibits the movement of calcium ions across cell membranes.

2) It directly relaxes vascular smooth muscle, allowing dilation of peripheral arteries and veins.

Drugs Affectin During a routine check up of a 45-year-old patient with renal disease, the nurse observes an increase in the patient's blood pressure. Which is the most likely consequence of renal impairment? 1)Essential hypertension 2)Secondary hypertension 3)Rebound hypertension 4)Hypertensive emergency

2)Secondary hypertension

A nurse is educating a patient with hypertension who is prescribed losartan on the mechanism of action of the drug. Which mode of action helps losartan to bring about its antihypertensive effect? 1)By blocking the aldosterone receptors 2)By preventing the conversion of angiotensin I 3)By blocking the angiotensin II receptors 4)By preventing renin secretion

3) By blocking the angiotensin II receptors

A 42-year-old client is seen by the health care provider for follow-up for diabetic nephropathy. The provider prescribed losartan for the treatment of this condition because the medication has been shown to reduce the rate of end-stage renal disease. Which drug class does this drug belong to? Antihyperlipidemic drugs Calcium channel blockers Selective aldosterone blockers Angiotensin II receptor blockers

Angiotensin II receptor blockers

A patient is receiving verapamil. What would be important for the nurse to stress that the patient avoid? Grapefruit juice Milk Apple juice Yogurt

Grapefruit juice

When providing dietary instruction on a low-sodium diet, which dietary choice is most appropriate for a client with hypertension? Hot dog, baked beans, and cole slaw Grilled hamburger, French fries, and cola drink Grilled chicken, green salad, and apple Ham sandwich, potato chips, and cookie

Grilled chicken, green salad, and apple

A community health nurse is facilitating a health promotion session to a group of seniors. Which topic related to hypertension is most important to include in the information? 1)Hypertension will increase the risk of cancer. 2)An increase is sodium is recommended with hypertension. 3)Exercise will increase the risk of hypertension. 4)Hypertension will increase the risk of heart disease.

Hypertension will increase the risk of heart disease.

A group of students are reviewing the various antihypertensive agents. The students demonstrate understanding of the information when they identify what as an example of an angiotensin II receptor blocker? Moexipril Losartan Minoxidil Amlodipine

Losartan

A client, newly diagnosed with hypertension is started on captopril, an ACE inhibitor. The client should be informed of the possibility of what adverse effect? Sedation Persistent cough Sweating Hypokalemia

Persistent cough

A provider chooses to treat an African American client with hypertension with a beta blocker and diuretic instead of an ACE inhibitor. The nurse knows that the provider did this for what reason? 1) Beta blockers and diuretics are less expensive medications than ACE inhibitors. 2) Dark skin increases the reuptake of fluid in the kidneys, so the provider knows the client needs a diuretic. 3) Research has shown beta blockers, in combination with diuretics, treat hypertension in African Americans better than ACE inhibitors. 4) The provider prescribes multiple medications, instead of one for clients with hypertension, to increase compliance.

Research has shown beta blockers, in combination with diuretics, treat hypertension in African Americans better than ACE inhibitors.

A student asks the instructor what the goal of drug therapy is in hypotension and shock. What would the instructor respond? Restore life to the patient. Replace fluids the patient has lost. Restore and maintain adequate tissue perfusion. Resuscitate the client.

Restore and maintain adequate tissue perfusion.

A client is experiencing orthostatic hypotension that is due to antihypertensive therapy. Which nursing diagnosis would be most appropriate? Risk for injury Ineffective airway clearance Impaired peripheral tissue perfusion Fluid volume deficit

Risk for injury