Chapter 26- Drugs for Hypertension

1) Which medical condition should the nurse be concerned about for a client prescribed hydralazine? 1. Asthma 2. Angina 3. Diabetes Hyperthyroidism

2. Angina Pg 366

1) Which changes are sensed by the baroreceptors and relayed to the vasomotor center? 1. Oxygenation 2. Blood pressure 3. Carbon dioxide 4. Blood pH

2. Blood pressure Pg 353

1) Which factors are responsible for blood pressure? 1. Blood volume, heart rate, and stroke volume 2. Cardiac output, blood volume, and peripheral vascular resistance 3. Age, weight, and race 4. Body mass index, diet, and genetics

2. Cardiac output, blood volume, and peripheral vascular resistance Pg 352

1) The nurse is preparing to administer clevidipine (Cleviprex) to a client experiencing a hypertensive crisis. Which interventions should the nurse implement? Select all that apply. 1. Monitor bowel sounds 2. Administer the drug intravenously 3. Continually monitor blood pressure 4. Crush caplets for administration 5. Infuse prescription in normal saline at 125 mL/h

2. Administer the drug intravenously 3. Continually monitor blood pressure Pg 361

1) The nurse is educating a patient whose blood pressure is 140/90 mmHg on ways to lower blood pressure and avoid hypertension. Which lifestyle choices may eliminate the need for pharmacotherapy in this patient? Select all that apply. 1. "I have incorporated yoga into my exercise program." 2. "I will monitor my daily sodium intake." 3. "I will drink a glass of red wine daily to help lower my blood pressure." 4. "I am receiving acupuncture to help me stop smoking."

1. "I have incorporated yoga into my exercise program." 2. "I will monitor my daily sodium intake." 4. "I am receiving acupuncture to help me stop smoking." Pg 355

1) A male client states to the nurse, "I am going to stop taking my metoprolol (Lopressor). I have been experiencing problems having sex." Which responses should the nurse include in the discussion with the client? Select all that apply. 1. "I understand sexual dysfunction can be a common problem with this drug." 2. "Perhaps it would be better if you took atenolol (Tenormin)." 3. "I cannot stop you from discontinuing the drug." 4. "Stopping the prescription abruptly may cause your blood pressure to elevate even higher." 5. "Try taking the drug early in the morning."

1. "I understand sexual dysfunction can be a common problem with this drug." 4. "Stopping the prescription abruptly may cause your blood pressure to elevate even higher." Pg 363-364

1) The nurse has provided education for a client prescribed nifedipine (Adalat CC). Which statement made by the client indicates an understanding of the teaching? Select all that apply. 1. "If I drink alcohol while taking this medication, I will get very sick to my stomach." 2. "I should stop taking my melatonin sleep medication." 3. "I should no longer drink grapefruit juice." 4. "I should no longer drink sports drinks with caffeine in them." "I should stop taking my vitamin C supplement."

1. "If I drink alcohol while taking this medication, I will get very sick to my stomach." Pg 362 Soo thinks also 2. Concurrent use with melatonin may increase blood pressure and heart rate. 3. Grapefruit juice may enhance absorption of nifedipine.

1) Which physiological systems should the nurse recognize are most at risk for a client in a hypertensive crisis? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1. Cardiac 2. Respiratory 3. Integumentary 4. Gastrointestinal 5. Renal

1. Cardiac 5. Renal Pg 366

1) Which prescription should the nurse be concerned about a pregnant client receiving? 1. Enalapril (Vasotec) 2. Potassium supplement 3. Doxazosin (Cardura) 4. Hydrochlorothiazide (HCTZ)

1. Enalapril (Vasotec) Pg 360

1) The nurse is providing education for nonpharmacological interventions to manage hypertension. Which information should the nurse include? Select all that apply. 1. Increase your dietary intake of fruits and vegetables. 2. Decrease the consumption of alcohol. 3. Reduce the dietary intake of potassium. 4. Increase physical activity. 5. Restrict your intake of sodium.

1. Increase your dietary intake of fruits and vegetables. 2. Decrease the consumption of alcohol. 4. Increase physical activity. 5. Restrict your intake of sodium. Pg 355

1) For which conditions is a client with hypertension at risk? Select all that apply. 1. Kidney damage 2. Stroke 3. Liver failure 4. Heart failure 5. Blindness

1. Kidney damage 2. Stroke 4. Heart failure 5. Blindness Pg 354

1) Which electrolytes should the nurse anticipate monitoring for a client prescribed losartan (Cozaar)? Select all that apply. 1. Potassium 2. Sodium 3. Calcium 4. Chloride 5. Magnesium

1. Potassium 2. Sodium Pg 361

1) Which intervention is the highest priority for a 30-year-old female with a BMI of 20 who smokes and has a blood pressure of 137/88? 1. Smoking-cessation program 2. Diuretic therapy 3. Weight-loss program Stress management

1. Smoking-cessation program Pg 355

1) The nurse is preparing to discuss the use of primary hypertensive agents with a client. Which prescriptions should the nurse include? Select all that apply. 1. Thiazide diuretics 2. Angiotensin-II receptor blockers (ARBs) 3. Beta-adrenergic antagonists 4. Direct-acting vasodilators 5. Peripheral adrenergic antagonists

1. Thiazide diuretics 2. Angiotensin-II receptor blockers (ARBs) Pg 358

1) A client receiving hydrochlorothiazide (Microzide) asks the nurse why they are urinating so frequently. Which statement should the nurse provide the client? 1. "Hydrochlorothiazide (Microzide) enhances kidney function causing you to urinate more and that decreases your blood pressure." 2. "Hydrochlorothiazide (Microzide) decreases the fluid in your bloodstream and this lowers your blood pressure." 3. "Hydrochlorothiazide (Microzide) dilates your blood vessels so you urinate more and your blood pressure decreases." 4. "Hydrochlorothiazide (Microzide) increases your heart rate; this pumps blood faster to your kidneys so you urinate more and your blood pressure decreases."

2. "Hydrochlorothiazide (Microzide) decreases the fluid in your bloodstream and this lowers your blood pressure." Pg 358-359

1) Which clients should the nurse anticipate will require a pharmacological intervention to manage their blood pressure? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1. A 30-year-old female whose blood pressure is 138/88 mmHg who is otherwise healthy 2. A 61-year-old man whose blood pressure is 144/90 mmHg who also has type 2 diabetes 3. A 56-year-old woman whose blood pressure is 135/84 mmHg who also has Cushing's disease 4. A 65-year-old man whose blood pressure is 148/88 mmHg who is otherwise healthy 5. A 61-year-old woman whose blood pressure is 153/92 mmHg who is otherwise healthy

2. A 61-year-old man whose blood pressure is 144/90 mmHg who also has type 2 diabetes 5. A 61-year-old woman whose blood pressure is 153/92 mmHg who is otherwise healthy Pg 355

1) he nurse educator is reviewing the physiological regulation blood pressure. Which should the educator identify as initially involved? 1. Production of angiotensin II 2. Action of renin 3. Antidiuretic hormone 4. Production of angiotensin I

2. Action of renin Pg 354

1) The nurse has prescribed dietary education for a client prescribed nifedipine (Procardia XL). Which dietary choice should the nurse recognize requires further education? 1. Whole-wheat pancakes with syrup, and bacon, oatmeal, and orange juice 2. Eggs, whole-wheat toast with butter, cereal, milk, and grapefruit juice 3. Eggs and sausage, a biscuit with margarine, coffee with cream, and cranberry juice 4. Egg and cheese omelet, tea with sugar and lemon, hash brown potatoes, and prune juice

2. Eggs, whole-wheat toast with butter, cereal, milk, and grapefruit juice Pg 362

1) Which statement is accurate in regard to secondary hypertension? 1. There is no known cause. 2. It can result from chronic renal impairment. 3. It is also known as idiopathic. 4. It accounts for 90% of all hypertensive cases.

2. It can result from chronic renal impairment. Pg 354

1) Which is a priority nursing intervention for a client who is newly prescribed enalapril (Vasotec)? 1. Monitor the client for headaches. 2. Take the client's blood pressure. 3. Order a sodium-restricted diet for the client. 4. Review the client's lab results for hypokalemia.

2. Take the client's blood pressure. pg 359

1) should the nurse provide the client? 1. "Doxazosin causes the kidneys to excrete more urine." 2. "Doxazosin helps the heart work more efficiently." 3. "Doxazosin helps dilate the blood vessels." 4. "Doxazosin decreases the release of the stress hormones."

3. "Doxazosin helps dilate the blood vessels." Pg 364

1) The nurse has discussed lifestyle modifications to help manage the client's hypertension. Which statement made by the client indicates an understanding of the information? 1. "I need to get started on my medications right away." 2. "My father had hypertension, did nothing, and lived to be 90 years old." 3. "I know I need to give up my cigarettes and alcohol." "I won't be able to run in the marathon race anymore."

3. "I know I need to give up my cigarettes and alcohol." Pg 355

1) he nurse has completed the education for a client prescribed hydrochlorothiazide (Microzide). Which statement made by the client indicates an understanding of the teaching? 1. "I really need to avoid grapefruit juice when I take this medication." 2. "I need to avoid salt substitutes and potassium-rich foods." 3. "I take my medication early in the morning." 4. "If I develop a cough, I should call my physician."

3. "I take my medication early in the morning." Pg 358

1) Which is the nurse's priority assessment for a client treated with intravenous hydralazine (Apresoline)? 1. Hypotension and bradycardia 2. Hypotension and hyperthermia 3. Hypotension and tachycardia 4. Hypotension and tachypnea

3. Hypotension and tachycardia Pg 366

1) For which assessment findings should the nurse hold enalapril (Vasotec)? Select all that apply. 1. Cough 2. Lightheadedness on ambulation 3. Periorbital edema 4. Sneezing 5. Difficulty swallowing

3. Periorbital edema 5. Difficulty swallowing Pg 360

1) Which statement made by a client newly prescribed a beta-adrenergic blocker should the nurse be concerned about? 1. "I don't handle stress well; I have a lot of diarrhea." 2. "When I have a migraine headache, I need to have the room darkened." 3. "My father died of a heart attack when he was 48 years old." 4. "I have always had problems with my asthma."

4. "I have always had problems with my asthma." Pg 363

1) client experiencing syncope is suspected of taking a losartan (Cozaar) overdose? Which intervention should the nurse anticipate? 1. Administer a calcium infusion 2. Administer a loop diuretic 3. Administer a vasopressor 4. Administer an intravenous solution of normal saline

4. Administer an intravenous solution of normal saline Pg 361

1) The nurse notes that a client experiencing heart failure has been receiving nifedipine (Procardia). Which is a priority assessment for the nurse? 1. Review recent lab results for hypokalemia. 2. Assess urinary output. 3. Assess level of orientation. 4. Auscultate breath sounds for crackles.

4. Auscultate breath sounds for crackles. Pg 362

1) The nurse reviewing the records of a client diagnosed with hypertension notes a weight of 200 lbs, height 5' 4", dietary intake includes primarily starches, an alcohol intake of three beers per week, and stressors include 60-hour workweeks. Based on this information, which should the nurse identify as a priority outcome? 1. Patient will eliminate alcohol from the diet. 2. Patient will decrease stress by limiting work to 40 hours/week. 3. Patient will balance diet according to the food pyramid. 4. Patient will achieve and maintain optimum weight.

4. Patient will achieve and maintain optimum weight. Pg 355

1) Which electrolyte imbalance should the nurse be concerned about for the client who is prescribed a thiazide diuretic? 1. Magnesium 2. Calcium 3. Chloride 4. Potassium

4. Potassium Pg 358