Deck 22: Antihypertensive Drugs

Question 1

An older adult patient will be taking a vasodilator for hypertension. Which adverse effect is of most concern for the older adult patient taking this class of drug?

A) Dry mouth
B) Restlessness
C) Constipation
D) Hypotension

Answer 1

Hypotension

Question 2

The nurse is reviewing drug therapy for hypertension. According to the JNC-8 guidelines, antihypertensive drug therapy for a newly diagnosed hypertensive African-American patient would most likely include which drug or drug classes?

A) Vasodilators alone
B) ACE inhibitors alone
C) Calcium channel blockers with thiazide diuretics
D) Beta blockers with thiazide diuretics

Answer 2

Calcium channel blockers with thiazide diuretics

Question 3

A patient is to receive enalapril (Vasotec) 5 mg IV every 6 hours. Each dose is given over 5 minutes. The medication is available in an injectable form, 1.25 mg/mL. Identify how many milliliters of medication will the nurse draw up for each dose. _______

Answer 3

4 mL
1.25mg:1 mL :: 5 mg:x mL.
(1.25 × x) = (1 × 5); 1.25x = 5; x = 4.

Question 4

A patient has a new order for the adrenergic drug doxazosin (Cardura). When providing education about this drug, the nurse will include which instructions?

A) "Weigh yourself daily, and report any weight loss to your prescriber."
B) "Increase your potassium intake by eating more bananas and apricots."
C) "The impaired taste associated with this medication usually goes away in 2 to 3 weeks."
D) "Be sure to lie down after taking the first dose, because first-dose hypotension may make you dizzy."

Question 5

A patient's blood pressure elevates to 270/150 mm Hg, and a hypertensive emergency is obvious. He is transferred to the intensive care unit and started on a sodium nitroprusside (Nipride) drip to be titrated per his response. With this medication, the nurse knows that the maximum dose of this drug should be infused for how long?

A) 10 minutes
B) 30 minutes
C) 1 hour
D) 24 hours

Question 6

A patient who has been taking antihypertensive drugs for a few months states that a new, persistent dry cough is very bothersome. The nurse knows that this cough is an adverse effect of which class of antihypertensive drugs?

A) Beta blockers
B) Angiotensin-converting enzyme (ACE) inhibitors
C) Angiotensin II receptor blockers (ARBs)
D) Calcium channel blockers

Question 7

A patient with severe liver disease is receiving the angiotensin-converting enzyme (ACE) inhibitor, captopril (Capoten). The nurse is aware that the advantage of this drug for this patient is which characteristic?

A) Captopril rarely causes first-dose hypotensive effects.
B) Captopril has little effect on electrolyte levels.
C) Captopril is a prodrug and is metabolized by the liver before becoming active.
D) Captopril does not need to be metabolized by the liver before becoming active because it is not a prodrug.

Question 8

During a follow-up visit, the health care provider examines the fundus of the patient's eye. Afterward, the patient asks the nurse, "Why is he looking at my eyes when I have high blood pressure? It does not make sense to me!" What is the best response by the nurse?

A) "We need to monitor for drug toxicity."
B) "We must watch for increased intraocular pressure."
C) "The provider is assessing for visual changes that may occur with drug therapy."
D) "The provider is making sure the treatment is effective over the long term."

Question 9

A patient with type 2 diabetes mellitus has been found to have trace proteinuria. The prescriber writes an order for an angiotensin-converting enzyme (ACE) inhibitor. What is the main reason for prescribing this class of drug for this patient?

A) Cardioprotective effects
B) Renal protective effects
C) Reduces blood pressure
D) Promotes fluid output

Question 10

The nurse is creating a plan of care for a patient with a new diagnosis of hypertension. Which is a potential human needs statement for the patient taking antihypertensive medications?

A) Altered GI elimination (diarrhea)
B) Altered sexual function
C) Altered urinary elimination (urge incontinence)
D) Need for effective perception

Question 11

When counseling a male patient about the possible adverse effects of antihypertensive drugs, the nurse will discuss which potential problem?

A) Impotence
B) Bradycardia
C) Increased libido
D) Weight gain

Question 12

A patient with primary hypertension is prescribed drug therapy for the first time. The patient asks how long drug therapy will be needed. Which answer by the nurse is the correct response?

A) "This therapy will take about 3 months."
B) "This therapy will take about a year."
C) "This therapy will go on until your symptoms disappear."
D) "Therapy for high blood pressure is usually lifelong."

Question 13

The nurse is preparing for a community education program on hypertension. Which of these parameters determine the regulation of arterial blood pressure?

A) Cardiac output and systemic vascular resistance
B) Heart rate and peripheral resistance
C) Blood volume and renal blood flow
D) Myocardial contractility and arteriolar constriction

Question 14

A pregnant woman is experiencing hypertension. The nurse knows that which drug is used for a pregnant patient who is experiencing hypertension?

A) Mannitol (Osmitrol)
B) Enalapril (Vasotec)
C) Hydrochlorothiazide (HydroDIURIL)
D) Methyldopa (Aldomet)

Question 15

The nurse is reviewing the orders for a patient and notes a new order for an angiotensin-converting enzyme (ACE) inhibitor. The nurse checks the current medication orders, knowing that this drug class may have a serious interaction with what other drug class?

A) Calcium channel blockers
B) Diuretics
C) Nonsteroidal anti-inflammatory drugs
D) Nitrates

Question 16

When teaching a patient about antihypertensive drug therapy, which statements by the nurse are correct?

A) "You need to have your blood pressure checked once a week and keep track of the readings."
B) "If you notice that the symptoms have gone away, you should be able to stop taking the drug."
C) "An exercise program may be helpful in treating hypertension, but let's check with your doctor first."
D) "If you experience severe side effects, stop the medicine and let us know at your next office visit."
E) "Most over-the-counter decongestants are compatible with antihypertensive drugs."
F) "Please continue taking the medication, even if you are feeling better."