PHARM exam 3, chapter 35 PREP U

A 37-year-old client presents with a blood pressure of 128/78 mm Hg. What lifestyle change should the nurse suggest related to this assessment finding?

"Be aware of your salt intake and limit hidden salt."

The client taking bisoprolol-hydrochlorothiazide (Ziac) states that he is sure the medication is not decreasing his blood pressure. He tells the nurse he is urinating all the time and he does not like this side effect of the medication. What is the nurse's best response?

"Bisoprolol-hydrochlorothiazide (Ziac) works by decreasing the workload of your heart and increasing the excretion of fluid."

The nurse provides drug teaching to the client prescribed captopril. What statement made by the client does the nurse interpret to mean teaching has been effective?

"I will call my doctor if I bruise easily or become extremely tired."

The client has been diagnosed as having hypertension. The nurse is responsible for teaching the client about managing the condition with his newly prescribed medication (lisinopril) and nonpharmacologic methods. What statement by the client suggests that teaching has been effective?

"I will make sure that I rise to a standing position slowly."

A client with primary hypertension asks the nurse why the prescriber added another medication to assist with lowering the blood pressure. What is the nurse's best response

"Many clients require two or more drugs for high blood pressure."

What is the nurse's priority assessment question before giving a female client her prescription for an angiotensin II-receptor blocker (ARB)?

"When was your last menstrual period (LMP)?"

The female client states that her father has had high blood pressure all of his life and he is healthy. She does not understand why the care provider has prescribed medication for her blood pressure. What is the nurse's best response?

"With high blood pressure, blood vessels may be damaged and that can cause heart and kidney disease."

A nurse is educating a group of nursing students on the adverse effects of antihypertensive drugs. The nurse explains that orthostatic hypotension occurs initially in the therapy. Which of the following pressure changes in an upright position would indicate orthostatic hypotension?

A fall in the systolic pressure by 10 mm Hg

A client has been diagnosed with hypertension following several elevated blood pressure readings. The nurse should prepare to educate the client regarding which likely drug regimen?

A thiazide diuretic combined with a beta-blocker

A client who is taking an ACE inhibitor informs the nurse that she is considering having a child. What information should the nurse provide to the client related to this new information?

ACE inhibitors are contraindicated during pregnancy because they are teratogenic.

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?

Angiotensin II receptor blockers

What drug is a safe and effective calcium channel blocker only if the nurse administers it as a sustained-release or extended-release preparation to treat hypertension?

Diltiazem

A client prescribed ramipril earlier in the week states, "Now I have a nagging, dry cough." How should the nurse best follow-up the client's statement?

Drugs like ramipril often cause a cough in clients; we should speak to the health care provider."

A 55-year-old man's hypertension has not responded adequately to his current medication regimen consisting of an ACE inhibitor, a beta-blocker and a thiazide diuretic. As a result, he will soon begin taking hydralazine (Apresoline) in addition to his existing antihypertensives. The addition of this medication to his regimen means that the nurse must prioritize which nursing action?

Frequent assessment of the client's cardiac status

The nurse is providing education regarding lifestyle changes to a client diagnosed with hypertension. When providing dietary instruction on a low-sodium diet, which dietary choice would the nurse identify as most appropriate?

Grilled chicken, green salad, and apple

A client is newly diagnosed with hypertension. When explaining this diagnosis, the nurse would include information that hypertension increases the person's risk for which conditions? Select all that apply.

Heart failure Stroke Blindness Kidney disease

A client with hypertension has not responded adequately to treatment with losartan. What additional medication would the nurse expect the health care provider to prescribe?

Hydrochlorothiazide

A 48-year-old client with a blood pressure of 198/112 mm Hg reports severe headache and drowsiness. The nurse notes that the client is disoriented and has begun to vomit. What is the primary nursing goal for this client experiencing a hypertensive emergency?

Implement interventions to lower blood pressure.

A client, prescribed amlodipine, asks how this drug works. What is the nurse's best response?

It inhibits the influx of calcium ions across cardiac and smooth muscle, dilating the coronary arteries."

A nurse is preparing to administer an antihypertensive drug that lowers the blood pressure primarily via suppression of the renin-angiotensin-aldosterone system. Which drug might this be

Lisinopril

A nursing instructor determines that a class discussion on antihypertensive drugs was successful when the students identify which medication as lowering blood pressure by blocking the binding of angiotensin II at receptor sites in the vascular smooth muscle and adrenal glands? Select all that apply.

Losartan Olmesartan

A client with primary hypertension asks the nurse why the prescriber added another medication to assist with lowering the blood pressure. What is the nurse's best response?

Many clients require two or more drugs for high blood pressure."

When assessing a 50-year-old client during a routine checkup, the nurse observes that the client has a blood pressure of 140/90 mm Hg in his right arm. Which findings would be important for the nurse to assess? Select all that apply.

Measure blood pressure in both the arms. Assess for pitting edema in the extremities. Record the client's body weight.

A patient is receiving a vasodilator that is available only in oral form. Which agent would the nurse most likely identify as being used?

Minoxidil

The nurse is developing the care plan for a client recently diagnosed with hypertension. What outcome would the nurse identify as most important?

Multiple diastolic blood pressure readings less than 90 mm Hg

A client taking diltiazem for hypertension has come to the clinic for a follow-up appointment. What adverse effects should the nurse assess the client for?

Peripheral edema and bradycardia

A client is prescribed aliskiren. The nurse would monitor the laboratory test results of which electrolyte closely?

Potassium

Ms. Tacey, a 65-year-old woman, is treated with eplerenone for hypertension. In addition to monitoring blood pressure, what other important assessment needs to be prioritized in her care?

Potassium levels

A nurse is caring for a client who has been diagnosed with primary hypertension. What nursing interventions should be included in the teaching plan? Select all that appl

Regular aerobic exercise Diet with more fruits and vegetables Decreased alcohol consumption Smoking cessation

A client is experiencing orthostatic hypotension that is due to antihypertensive therapy. Which nursing diagnosis would be most appropriate

Risk for Injury

A client is experiencing orthostatic hypotension that is due to antihypertensive therapy. Which nursing diagnosis would be most appropriate?

Risk for Injury

Which diuretic can be combined with an ACE inhibitor to increase its effectiveness in decreasing blood pressure?

Thiazide diuretics

The client taking antihypertensive medications is taught to notify the healthcare provider when which findings occur?

Weight gain of five pounds over a 2-day period

A 26-year-old white male client has been prescribed captopril for hypertension. A nurse has been assigned to the client to provide education regarding the use of this drug. The nurse will advise the client that:

a persistent, dry cough may occur; however, it is not serious.

A nurse is educating a group of nursing students on the mechanisms of action of angiotensin-converting enzyme inhibitors (ACEI). What should the nurse explain is the hormone produced by the adrenal cortex?

aldosterone

How does captopril contribute to a reduction of a client's blood pressure?

blocking the conversion of angiotensin I to angiotensin II

The nurse is teaching a client who has been prescribed an antihypertensive how to apply the transdermal patch used to administer the medication. What medication is the nurse describing?

clonidine

A client with hypertension has been started on losartan, an angiotensin II receptor blocker (ARB). After 6 weeks of therapy, the health care provider concludes that losartan alone is not controlling the hypertension. What would the health care provider likely add to the regimen to better control the client's hypertension?

diuretic

The nurse is providing education to a client who has been prescribed captopril. What common adverse effect would the nurse mention in the teaching?

dry cough

A client has been prescribed transdermal clonidine therapy. What potential adverse effects should the nurse warn the client about?

dry mouth and dizziness

A client has been prescribed ramipril 5 mg PO daily with the scheduled dose due at 08:00. After reviewing the client's most recent blood work, the nurse should consider withholding the dose because of what laboratory finding?

elevated potassium levels

An older adult who lives in a long-term care facility has recently begun taking losartan (Cozaar) for the treatment of hypertension. The nurse who provides care for this resident should recognize that this change in the resident's medication regimen make create a risk for:

falls

The emergency department nurse is asked to prepare a nitroprusside infusion for a client being brought to the hospital in an ambulance. What is this client's most likely diagnosis?

hypertensive crisis

A client develops primary hypertension and asks the nurse, "How long will I need to receive therapy?" The nurse responds based on the understanding that therapy would be required for how long?

lifelong

When the cardiac workload is increased from secondary hypertension, the client is at risk for developing what associated condition?

myocardial hypertrophy

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?

persistent cough

A client with a long history of hypertension has just been prescribed an alpha1-adrenergic receptor blocker. To reduce this client's risk of orthostatic hypotension and falls, the nurse should encourage the client to implement what intervention?

take meds at bed time

The goal of therapy for a client taking antihypertensive medication is to maintain:

the blood pressure within normal limits.