Question 1

A patient who has been prescribed enalopril (Vasotec)has developed a persistent nonproductive cough.What is the nurse's best action?&#10;A) Ask the prescriber to order something for the patient's cough.&#10;B) Suggest that the family bring the patient some cough drops.&#10;C) Offer the patient sips of water and ice chips.&#10;D) Hold the dose and notify the prescriber.

Accepted Answer

Development of a dry,persistent cough is a side effect of angiotensin-converting enzyme inhibitor drugs such as enalopril.The cough indicates that the patient is having a reaction to the drug.The drug needs to be discontinued and the patient should be started on another drug to control hypertension.

Question 2

A patient's blood pressure is consistently around 138/88 mm Hg.What does this reading represent?&#10;A) Normal blood pressure&#10;B) Prehypertension&#10;C) Stage 1 hypertension&#10;D) Stage 2 hypertension

Accepted Answer

There are four classifications of hypertension (see Table 13-1 in the text).This patient's blood pressure is consistently within the range for pre-hypertension.

Question 3

How does the drug diltiazem (Cardizem)lower blood pressure?&#10;A) Prevents angiotensin from binding to its receptors&#10;B) Blocks nerve stimulation of blood vessels&#10;C) Increases water and sodium loss&#10;D) Widens small arteries

Accepted Answer

Constricted blood vessels increase peripheral resistance and raise blood pressure.Calcium channel blockers work in several ways to lower blood pressure.The main way is by preventing calcium from entering smooth muscle cells in blood vessels,especially small arteries.With less calcium entering these smooth muscle cells,they are more relaxed,dilating (widening)the blood vessels.

Question 4

A 38-year-old patient has been prescribed nadolol (Corgard)80 mg daily for hypertension.The patient tells the nurse that he has stopped taking the drug.What is the nurse's best action at this time?&#10;A) Instruct the patient to begin taking the drug immediately.&#10;B) Ask the patient if he is experiencing side effects of the drug.&#10;C) Document this finding in detail.&#10;D) Immediately notify the prescriber.

Accepted Answer

It is important to address the reason that the patient has stopped taking the drug at this time.Fairly common side effects of beta blockers include decreased sexual ability,dizziness,drowsiness,trouble sleeping,tiredness,and weakness.All of the other actions are important and appropriate,but do not focus on the patient's concerns with regard to why he stopped taking the drug.

Question 5

A patient prescribed a thiazide diuretic for hypertension reports having cramps and feeling like the heart is skipping beats.What side effect of this drug does the nurse suspect?&#10;A) Dizziness&#10;B) Orthostatic hypotension&#10;C) Hypokalemia&#10;D) Dysrhythmia

Accepted Answer

A side effect of both thiazide and loop diuretics is loss of potassium resulting in hypokalemia (low blood potassium).Signs of hypokalemia include cramps,sudden decrease in urination,and irregular heartbeats.

Question 6

When hypertension is not treated,which health problem can result?&#10;A) Kidney damage&#10;B) Prostate enlargement&#10;C) Diabetes mellitus&#10;D) Seizures

Accepted Answer

Health problems that can result from untreated hypertension include arteriosclerosis,heart attack,stroke,enlarged heart,kidney damage,and blindness.High blood pressure can affect the ability of the kidneys to remove waste from the blood by hardening,thickening,and narrowing the arteries to the kidneys.About 25% of patients who are on kidney dialysis have kidney failure that was caused by hypertension.

Question 7

An older patient has been prescribed an angiotensin-converting enzyme (ACE)inhibitor.Which precaution is most important for the nurse to teach the patient about this drug?&#10;A) &#34;Avoid caffeinated drinks that may increase your blood pressure.&#34;&#10;B) &#34;Take this drug at night so that you won't be aware of nausea.&#34;&#10;C) &#34;Change positions slowly when rising up from a sitting position.&#34;&#10;D) &#34;Weigh yourself daily upon first arising in the morning.&#34;

Accepted Answer

Older adults are at greater risk for postural (orthostatic)hypotension when taking ACE inhibitors because of the cardiovascular changes associated with aging.Quickly changing a lying or sitting position to standing can lower blood pressure so rapidly that the patient can get dizzy or faint,leading to a fall.

Question 8

A patient who has been taking lisinopril (Zestril)develops swollen lips and reports that the tongue feels thick.What is the nurse's best action?&#10;A) Document the report and reassure the patient that this is a common drug side effect.&#10;B) Check the patient's pulse for rhythm and take the patient's blood pressure.&#10;C) Ask the patient whether this has ever happened before.&#10;D) Hold the lisinopril dose and notify the prescriber.

Accepted Answer

About 15% of patients taking an angiotensin-converting enzyme (ACE)inhibitor develop allergies to the drug with the first symptom of angioedema (swelling)of the face,lips,tongue,and neck.The swelling can become severe enough to block the patient's airway.Although this reaction is not usually as immediately life-threatening as anaphylaxis,another dose of the drug would worsen the problem.

Question 9

What is the difference between primary hypertension and secondary hypertension?&#10;A) Secondary hypertension is not as severe as primary hypertension.&#10;B) Primary hypertension usually occurs at an earlier age than secondary hypertension.&#10;C) Secondary hypertension is caused by another health problem, whereas primary hypertension does not have a known cause.&#10;D) Primary hypertension can be treated with antihypertensive drugs, whereas secondary hypertension does not respond to drug therapy.

Accepted Answer

Although there are many factors that contribute to the development of primary hypertension (e.g.,obesity,smoking,stress,unhealthy diet),it has no single cause.(Many people with hypertension risk factors do not always develop hypertension.)On the other hand,secondary hypertension results from either another health problem or from the drug treatment of another health problem.

Question 10

Which drug action is most likely to lower blood pressure?&#10;A) Increasing the effectiveness of heart pumping&#10;B) Relaxing (dilating) blood vessel smooth muscle&#10;C) Increasing the excretion of urine from the body&#10;D) Retaining the body's concentration of potassium

Accepted Answer

The most common physiologic change that increases blood pressure is narrowing or constricting of the small arteries.Drugs that cause blood vessels to relax or dilate are most effective at lowering blood pressure.

Question 11

Which precaution is most important for the nurse to teach a patient who has been prescribed a beta blocker for hypertension?&#10;A) &#34;Avoid alcoholic beverages while taking this drug.&#34;&#10;B) &#34;Weigh yourself daily at the same time every morning.&#34;&#10;C) &#34;Wear gloves and other warm clothing during cold weather.&#34;&#10;D) &#34;Do not suddenly stop taking this drug without notifying your prescriber.&#34;

Accepted Answer

The answer of Which precaution is most important for the...

Question 12

The nurse is checking a patient's blood pressure before administering an antihypertensive,and gets a reading of 88/52 mm Hg.What is the nurse's best action?&#10;A) Give the patient a cup of coffee and retake the blood pressure in 30 minutes.&#10;B) Document the finding as the only action and administer the drug as usual.&#10;C) Raise the side rails and apply oxygen by mask or nasal cannula.&#10;D) Hold the dose and notify the prescriber.

Accepted Answer

The answer of The nurse is checking a patient's blood...

Question 13

Which action or precaution is most important for the nurse to perform before giving any type of drug for hypertension?&#10;A) Check the patient's blood pressure.&#10;B) Ensure that the patient is in a sitting position.&#10;C) Check the patient's pulse for regularity.&#10;D) Have the patient drink a full glass of water.

Accepted Answer

The answer of Which action or precaution is most important...

Question 14

A patient taking a thiazide diuretic has the following blood laboratory values for kidney function.Which value does the nurse report to the prescriber immediately?&#10;A) Sodium 124 mEq/L&#10;B) Potassium 3.6 mEq/L&#10;C) Creatinine 0.9 mg/dL&#10;D) Blood urea nitrogen 16 mg/dL

Accepted Answer

The answer of A patient taking a thiazide diuretic has...

Question 15

A patient taking metoprolol (Lopressor)for hypertension reports all of the following side effects.For which side effect does the nurse notify the prescriber?&#10;A) Increased urination during the daytime&#10;B) Heart rate of 68 per minute&#10;C) Chest pain during exercise&#10;D) Decreased sexual ability

Accepted Answer

The answer of A patient taking metoprolol (Lopressor)for hypertension reports...

Question 16

A patient has a dose of labetolol (Normodyne)ordered twice a day and is due to have an exercise stress test this morning.What is the nurse's best action at this time?&#10;A) Give the dose as ordered.&#10;B) Hold the dose and notify the prescriber.&#10;C) Give half the dose now and half after the procedure.&#10;D) Ask the patient about chest pain, dizziness, and light-headedness.

Accepted Answer

The answer of A patient has a dose of labetolol...

Question 17

The nurse is teaching a patient about antihypertensive therapy.Which statement by the patient indicates the need for more teaching?&#10;A) &#34;Now that my blood pressure is normal, I won't need to take my medication anymore.&#34;&#10;B) &#34;When I take my blood pressure at home, I always try to take it at just about the same time every day.&#34;&#10;C) &#34;I check the labels on cans and other food packages to be sure they do not have too much sodium.&#34;&#10;D) &#34;I hope that by continuing to lose weight, I might not have to take medications to manage my high blood pressure.&#34;

Accepted Answer

The answer of The nurse is teaching a patient about...

Question 18

A patient asks the nurse how atenolol (Tenormin)will help reduce hypertension.What is the nurse's best response?&#10;A) &#34;It will help your body rid itself of excess fluids and decrease the work your heart must do to pump blood.&#34;&#10;B) &#34;It will help decrease built-up water and salt in your blood and tissues.&#34;&#10;C) &#34;It will block vasoconstriction as well as salt and water retention.&#34;&#10;D) &#34;It will decrease your heart rate and how hard your heart pumps.&#34;

Accepted Answer

The answer of A patient asks the nurse how atenolol...

Question 19

The nurse gives the first dose of an antihypertensive drug to a patient.Which instruction does the nurse give to the patient next?&#10;A) &#34;Stay in bed and call for help if you need to get up for any reason.&#34;&#10;B) &#34;Urinate in a container so that we can keep track of your urine output.&#34;&#10;C) &#34;If you develop a headache, we can give you some acetaminophen (Tylenol).&#34;&#10;D) &#34;You may get up but only if you need to use the bathroom.&#34;

Accepted Answer

The answer of The nurse gives the first dose of...

Question 20

A patient has been prescribed losartan (Cozaar).Which substance,drug,or activity does the nurse teach the patient to avoid?&#10;A) Oral contraceptives&#10;B) Salt substitutes&#10;C) Caffeine&#10;D) Running

Accepted Answer

The answer of A patient has been prescribed losartan (Cozaar).Which...

Question 21

The nurse is teaching a patient how to administer clonidine (Catapres)using the transdermal patch system.The nurse tells the patient to change the patches how often?&#10;A) Daily&#10;B) Every 3 days&#10;C) Every 7 days&#10;D) Every 14 days

Accepted Answer

The answer of The nurse is teaching a patient how...

Question 22

Which conditions or drugs can cause secondary hypertension?&#10;A) Adrenal gland tumors&#10;B) Estrogen in birth control pills&#10;C) Adenocarcinoma&#10;D) Cortisol&#10;E) Kidney infection

Accepted Answer

The answer of Which conditions or drugs can cause secondary...

Question 23

Which antihypertensive drug is considered safe for use during pregnancy or breastfeeding?&#10;A) clonidine (Catapres)&#10;B) methyldopa (Aldomet)&#10;C) labetalol (Normodyne)&#10;D) carvedilol (Coreg)

Accepted Answer

The answer of Which antihypertensive drug is considered safe for...

Question 24

A patient who is taking nicardipine (Cardene)develops skin lesions,itching,fever,and achy joints.What is the nurse's best first action?&#10;A) Hold the drug and notify the prescriber.&#10;B) Document the finding as expected with this drug.&#10;C) Administer a dose of oral diphenhydramine (Benadryl).&#10;D) Apply a thin coat of hydrocortisone ointment to the lesions.

Accepted Answer

The answer of A patient who is taking nicardipine (Cardene)develops...

Question 25

The nurse is teaching a patient with hypertension about the use of over-the-counter (OTC)drugs.What does the nurse include in the teaching plan?&#10;A) &#34;OTC cold remedies can be safely taken and will not affect your blood pressure.&#34;&#10;B) &#34;Avoid cold remedies that contain phenylephrine or pseudoephedrine because they can increase your blood pressure.&#34;&#10;C) &#34;OTC nonsteroidal anti-inflammatory drugs (NSAIDs) can cause secondary hypertension.&#34;&#10;D) &#34;Avoid taking OTC histamine blockers for reflux or upset stomach.&#34;&#10;E) &#34;Be sure to contact your prescriber before taking any OTC preparations.&#34;

Accepted Answer

The answer of The nurse is teaching a patient with...

Question 26

A patient with hypertension is prescribed terazosin (Hytrin).How does the nurse administer the first dose of this drug to the patient?&#10;A) In the morning to avoid waking the patient at night&#10;B) With meals to avoid GI problems&#10;C) With a full glass of water&#10;D) At bedtime

Accepted Answer

The answer of A patient with hypertension is prescribed terazosin...

Question 27

Which class of antihypertensive drugs has a higher incidence of side effects?&#10;A) Angiotensin converting enzyme (ACE) inhibitors&#10;B) Calcium channel blockers&#10;C) Alpha-beta blockers&#10;D) Direct vasodilators

Accepted Answer

The answer of Which class of antihypertensive drugs has a...

Question 28

The nurse is teaching a patient who has just been prescribed prazosin (Minipres)for hypertension.The nurse immediately notifies the prescriber and questions the order upon discovering that the patient is also taking which drug?

A) aspirin
B) atenolol (Tenormin)
C) chlorothiazide (Diuril)
D) sildenafil (Viagra)

Accepted Answer

The answer of The nurse is teaching a patient who...

Question 29

Which lifestyle changes does the nurse include when teaching a patient who has been prescribed antihypertensive drugs about how to manage hypertension?&#10;A) Establish a regular exercise program.&#10;B) Seek a smoking cessation program.&#10;C) Attain a more challenging career.&#10;D) Consult with a dietitian about a weight loss diet.&#10;E) Choose low-fat, low-salt foods when eating out.

Accepted Answer

The answer of Which lifestyle changes does the nurse include...

Question 30

Which drug acts directly on the peripheral arteries,causing them to dilate and leading to decreased blood pressure?&#10;A) minoxidil (Lonitin)&#10;B) propranolol (Inderal)&#10;C) captopril (Capoten)&#10;D) diltiazem (Cardizem)

Accepted Answer

The answer of Which drug acts directly on the peripheral...

Question 31

Which statements are true about blood pressure?&#10;A) Blood pressure decreases when a person is resting.&#10;B) Blood pressure increases when a person is active.&#10;C) Low blood pressure is called hypotension.&#10;D) Systolic blood pressure is the pressure against artery walls when the heart relaxes.&#10;E) As people get older they are more likely to develop high blood pressure.

Accepted Answer

The answer of Which statements are true about blood pressure?&#10;A)...

Question 32

The nurse is preparing a teaching plan for a patient taking antihypertensive drugs for hypertension.Which symptoms does the nurse include when teaching about the symptoms of hypotension?&#10;A) Increased blood glucose&#10;B) Dizziness&#10;C) GI upset&#10;D) Fainting&#10;E) Light-headedness

Accepted Answer

The answer of The nurse is preparing a teaching plan...

Question 33

A patient with hypertension and type 2 diabetes is taking carvedilol (Coreg).What special precaution does the nurse take when giving this drug?&#10;A) Assesses blood pressure in both arms&#10;B) Monitors strict intake and output&#10;C) Checks blood sugar levels regularly&#10;D) Watches for sacral swelling

Accepted Answer

The answer of A patient with hypertension and type 2...

Question 34

An older adult man who takes verapamil (Calan)reports that his breasts have enlarged.What is the nurse's best action?&#10;A) Ask the patient whether he has had any difficulty getting or maintaining an erection.&#10;B) Document the response and reassure the patient that this is a common side effect.&#10;C) Instruct the patient to use an elastic wrap to bind his breasts during the day.&#10;D) Hold the drug dose and notify the prescriber.

Accepted Answer

The answer of An older adult man who takes verapamil...

Question 35

What are the actions of alpha-beta blocker drugs?&#10;A) Decrease myocardial contractility&#10;B) Work on the central nervous system&#10;C) Slow the heart rate&#10;D) Increase arterial relaxation&#10;E) Decrease venous vasoconstriction

Accepted Answer

The answer of What are the actions of alpha-beta blocker...

Deck 13: Drugs for Hypertension