Pharmacology

A client with diabetes also has hypertension. The nurse would expect that the blood pressure goal for the client would be which of the following?

130/80 mm Hg

A nurse is providing care to a client diagnosed with stage 2 hypertension. The nurse understands that most clients with stage 2 hypertension will require how many antihypertensives to lower blood pressure to goal initially?

2

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

The nurse is providing drug teaching for a client who is prescribed enalapril. What drug-specific adverse effect will the nurse include in the drug teaching?

Persistent cough

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

Potassium

On several occasions, the nurse checks a client's blood pressure. The readings are 130/82 mm Hg, 136/84 mm Hg, and 128/88 mm Hg. The nurse would expect this client to be classified as having which stage of hypertension?

Prehypertension

The client has been taking atenolol for 2 years. The nurse teaches the client to not stop taking his antihypertensives abruptly because what may occur?

Rebound hypertension

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 apply

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

The nurse is preparing to administer losartan to a client with hypertension. The nurse should question this order if which condition is noted in the client's medical record?

pregnancy

An adult client presents with a blood pressure of 128/86 mm Hg. The client exercises regularly, is weight-appropriate for height, and indicates no use of tobacco or alcohol. How would the client's blood pressure be classified?

prehypertension

How is hypertension defined with regard to blood pressure readings?

systolic pressure above 140 mm Hg or diastolic pressure above 90 mm Hg

A client has been admitted to a health care facility for hypertension management. The health care provider has prescribed a transdermal patch of clonidine. The nurse applies the patch to a hairless area at which location?

upper arm

Which antihypertensive medication can be administered by transdermal patch?

clonidine

The nurse is caring for a child who is obese and has hypertension and a slightly elevated serum glucose level. What would the nurse anticipate will be ordered if lifestyle changes do not return blood pressure to an acceptable limit?

Diuretic

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 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?

Explain that drugs like ramipril often cause a cough.

A client prescribed a potassium-sparing diuretic is at a risk for developing which electrolyte imbalance?

hyperkalemia

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

A client receiving medication to treat hypertension is complaining of feeling fatigued and depressed. The nurse knows the client is on which of the following medications?

methyldopa

A nurse is preparing to administer a central acting antiadrenergic. Which medication would the nurse be preparing to administer?

methyldopa

A clinic nurse has been assigned a 49-year-old female client who has a history of diabetes. A recent diagnosis of hypertension has been made, and the client has been prescribed a thiazide diuretic and labetalol. The client will be scheduled to return to the clinic once a month for the next 6 months. A priority action by the nurse will be to:

monitor the client's blood pressure.

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

myocardial hypertrophy

A 37-year-old client presents with a blood pressure of 118/86 mm Hg. What advice should the nurse provide to this client?

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

"It dilates peripheral arteries and relaxes vascular smooth muscle."

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."

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? You Selected:

A fall in the systolic pressure by 10 mm Hg

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 statement should underlie the nurse's response when asked if ACE inhibitor therapy can be continued during pregnancy?

ACE inhibitors are contraindicated during pregnancy because they are teratogenic.

Upon review of the lab findings, the nurse identifies the client's potassium level is 5.9 mEq/L. The nurse recognizes that which antihypertensive may be the cause?

Aliskiren

A client taking a calcium channel blocker (nifedipine) also takes ranitidine for dyspepsia. The nurse assesses the client for which medication interactions?

Bradycardia

A 46-year-old client with a high body-mass index and a sedentary lifestyle has been diagnosed with hypertension after serial blood pressure readings. The clinician has opted to begin the client on captopril (Capoten). The nurse should recognize that the therapeutic effect of this drug is achieved in what way?

By inhibiting the transformation of angiotensin I to angiotensin II

A client is receiving fosinopril. Which adverse effect would the nurse caution the cliient about to help to promote compliance?

Cough

A 71-year-old male client has recently been diagnosed with hypertension. Which measurement is a partial indication of effective treatment and management?

Diastolic blood pressure below 90 mm Hg

The client is diagnosed with primary hypertension. The nurse is educating a client about dietary changes that help decrease blood pressure. Which menu selection indicates the need for further client education?

Ham sandwich with mustard, carrots and cheesy dip

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 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? You Selected:

Lisinopril

The squad brought a 48-year-old man to the ED in the midst of a hypertensive emergency. Blood pressure is 188/112 mm Hg, and the client reports severe headache and drowsiness. He becomes disoriented and vomits. What is the nurse's primary goal in this hypertensive emergency? You Selected:

Lower blood pressure as quickly as possible

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 most 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 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 nurse is caring for a client who has been diagnosed with hypertension and will be taking eplerenone (Inspra). Which would be an appropriate nursing diagnosis for this client?

Risk for Injury related to the adverse effect of dizziness

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

Risk for injury

A nurse is caring for a client who is diabetic and has been diagnosed with hypertension. An angiotensin-converting enzyme inhibitor, captopril, has been prescribed. Which should the nurse assess before beginning drug therapy?

Serum potassium levels

The client has been prescribed amlodipine (Norvasc) for hypertension. His blood pressure upon a revisit remains elevated. The nurse inquires about the use of which alternative therapy? You Selected:

St. John's wort

A client with a blood pressure of 165/95 mm Hg would be classified in which stage of hypertension? You Selected:

Stage 2

The pediatric nurse examines an 11-year-old client with mildly elevated blood pressure who is 15% above the upper age-based weight limits. What is the nurse's priority teaching point? You Selected:

Strategize with the client and family about ways to increase the child's activity level.

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). Which medication should the nurse explain as 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 should inform the client of the possibility of developing what common adverse effect of captopril therapy?

dry cough

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

elevated potassium levels

The client presents to the health care provider with a new onset of a dry cough. The nurse recognizes that which antihypertensive can cause a dry cough?

enalapril

An older adult client who resides in a care facility has been prescribed antihypertensives for the first time following many years of generally good health. When administering the first dose of the prescribed antihypertensive medication to an older adult, the nurse should recognize the related risk to which possible side effect?

falls

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

A client's spouse has brought in a number of healthy snacks to keep at the client's bedside. Knowing that the client's medication regimen includes diltiazem (Cardizem), the nurse would remove which item?

grapefruits

Which dietary choice is most appropriate and should be encouraged by the nurse for a client diagnosed with hypertension?

grilled chicken, green salad, and apple