Question 1

A client is treated in the emergency department for hypertensive emergency.The nurse anticipates treatment with which drug?&#10;A)Metoprolol&#10;B)Lisinopril&#10;C)Clonidine&#10;D)Nitroprusside&#10;

Accepted Answer

Nitroprusside is a vasodilator and is commonly used to treat hypertensive emergencies by rapidly lowering blood pressure. Metoprolol and lisinopril are not suitable for immediate blood pressure reduction in hypertensive emergencies. Clonidine may have a slower onset of action and is not commonly used in the acute management of hypertensive emergencies.

Question 2

The health care provider asks the nurse to monitor a client with hypertension for signs of kidney damage.Which clinical manifestation would indicate kidney damage?&#10;A)Urine output of 30 mL/hr&#10;B)Proteinuria&#10;C)Dysuria&#10;D)Estimated glomerular filtration rate of 105&#10;

Accepted Answer

Proteinuria, or the presence of protein in the urine, is a common sign of kidney damage or dysfunction in clients with hypertension. A decrease in urine output (A) may also indicate kidney damage, but this is not specific to hypertension and can occur with other conditions as well. Dysuria (C) refers to pain or discomfort during urination and is not directly related to kidney damage. An estimated glomerular filtration rate (eGFR) of 105 (D) is actually within the normal range, indicating normal kidney function rather than dysfunction.

Question 3

The nurse is discussing the long-term consequences of uncontrolled hypertension with a group of clients.Place in order the pathological changes that occur as a result of uncontrolled hypertension.Standard Text: Click on the down arrow for each response in the right column and select the correct choice from the list.Response

A)Damage to the blood vessels occurs,particularly the small arteries and arterioles. Response
B)Damage to the blood vessels continues with thickening of the arterial walls. Response
C)The blood vessels become inflamed. Response
D)The lumen of the arteries narrows. Response
E)Blood flow to the vital organs decreases.

Damage to the blood vessels occurs,particularly the small arteries and arterioles. Response
Damage to the blood vessels continues with thickening of the arterial walls. Response
The blood vessels become inflamed. Response
The lumen of the arteries narrows. Response
Blood flow to the vital organs decreases.

Accepted Answer

Uncontrolled hypertension leads to a series of pathological changes in the blood vessels. Initially, damage occurs to small arteries and arterioles, followed by thickening of arterial walls. Inflammation of the blood vessels also occurs, which leads to narrowing of the lumen of the arteries. Eventually, these changes result in decreased blood flow to vital organs, which can cause long-term damage and increase the risk of cardiovascular events.

Question 4

The nurse is educating a client diagnosed with hypertension and explains that which criteria will be used to determine medication management for the client? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

A)Risk factors
B)Comorbid medical conditions
C)Age
D)Degree of blood pressure elevation
E)Occupational status

Accepted Answer

Risk factors, comorbid medical conditions, and degree of blood pressure elevation are all criteria used to determine medication management for clients with hypertension. Age and occupational status may be considered in overall management of hypertension but are not direct criteria for medication management decisions.

Question 5

The nurse is caring for an African American male recently diagnosed with hypertension.The nurse anticipates that this client will be started on which medications? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

A)A thiazide diuretic
B)A calcium channel blocker
C)An ACE inhibitor
D)A beta-adrenergic antagonist
E)An angiotensin II receptor blocker

Accepted Answer

African American patients with hypertension often respond better to initial treatment with a thiazide diuretic or a calcium channel blocker, as these medications have been shown to be more effective in this population for managing hypertension.

Question 6

The nurse is caring for a client with a history of uncontrolled hypertension.The client's family asks the nurse the consequences of this condition.Which conditions will the nurse include in the teaching session regarding the consequences of uncontrolled hypertension? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

A)Stroke
B)Congestive heart failure
C)Myocardial infarction
D)Depression
E)Hyperbilirubinemia

Accepted Answer

Uncontrolled hypertension can lead to serious health consequences including stroke, congestive heart failure, and myocardial infarction. Depression and hyperbilirubinemia are not typically associated with uncontrolled hypertension.

Question 7

The nurse is educating a client whose blood pressure is 140/90 mmHg on ways to lower blood pressure.Which lifestyle choices may eliminate the need for pharmacotherapy in this client? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

A)Increasing intake of wine
B)Restricting salt intake
C)Increasing intake of red meat
D)Increasing activity
E)Stopping smoking

Accepted Answer

Restricting salt intake, increasing physical activity, and stopping smoking are all lifestyle choices that can help lower blood pressure. Increasing intake of red meat is not recommended as it is high in saturated fat which can raise blood pressure. While wine (specifically red wine) has been shown to have some potential benefits for heart health, increasing alcohol intake is not generally recommended as it can raise blood pressure and have negative health effects.

Question 8

A client presents with a blood pressure of 210/124 mmHg.The nurse documents this finding in which way?&#10;A)Prehypertension&#10;B)Stage 1 hypertension&#10;C)Stage 2 hypertension&#10;D)Hypertensive crisis&#10;

Accepted Answer

A blood pressure of 210/124 mmHg is considered a hypertensive crisis, which is a severe and potentially life-threatening condition that requires immediate medical attention. The systolic pressure (top number) is in the hypertensive crisis range, and the diastolic pressure (bottom number) is in the stage 3 hypertension range. Therefore, the best choice is D.

Question 9

The nurse is caring for a client recently diagnosed with hypertension.The client asks what medications may be used to treat the condition.The nurse begins by discussing the primary antihypertensive agents,which include which medications? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

A)Diuretics
B)Angiotensin II receptor blockers (ARBs)
C)Beta-adrenergic antagonists
D)Direct-acting vasodilators
E)Peripheral adrenergic antagonists

Accepted Answer

Diuretics, Angiotensin II receptor blockers (ARBs), and Beta-adrenergic antagonists are primary antihypertensive agents commonly used to treat hypertension. They work by different mechanisms to lower blood pressure.

Question 10

A client comes to the emergency department with a blood pressure of 200/120 mmHg.The health care provider orders hydralazine (Apresoline)IV.What will the nurse's priority assessment include?&#10;A)Hypotension and bradycardia&#10;B)Hypotension and tachypnea&#10;C)Hypotension and hyperthermia&#10;D)Hypotension and tachycardia&#10;

Accepted Answer

Hydralazine is a vasodilator that can cause hypotension and tachycardia as side effects. Therefore, the nurse's priority assessment should include checking for signs of hypotension and tachycardia.

Question 11

A client with a history of heart disease has been diagnosed with hypertension.Which class of drugs is likely to be prescribed?&#10;A)Calcium channel blockers&#10;B)Thiazide diuretics&#10;C)ACE inhibitors&#10;D)Beta blockers&#10;

Accepted Answer

The answer of A client with a history of heart...

Question 12

A client does not want to take hypertension medication,and asks why it is needed,as the client feels fine.Which response by the nurse is the most appropriate?&#10;A)&#34;You're right; there is no need for these medications.&#34;&#10;B)&#34;The medications can prevent worsening of the hypertension.&#34;&#10;C)&#34;If the hypertension is severe,symptoms could arise.&#34;&#10;D)&#34;The medications can prevent complications from hypertension.&#34;&#10;

Accepted Answer

The answer of A client does not want to take...

Question 13

A client with hypertension is also diagnosed with type 2 diabetes mellitus.The client asks why the health care provider has prescribed an ACE inhibitor.Which response by the nurse is the most appropriate?

A)"It protects the kidneys."
B)"It protects the eyes."
C)"It protects the heart."
D)"It protects the nerves."

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Accepted Answer

The answer of A client with hypertension is also diagnosed...

Question 14

The nurse is providing care to a client recently diagnosed with hypertension.The client's sustained blood pressure is 144/90 mmHg and expressed concern about possible effects on the body.When educating this client,which conditions affected by hypertension are appropriate to discuss? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

A)Stroke
B)Kidney damage
C)Heart failure
D)Blindness
E)Liver failure

Accepted Answer

The answer of The nurse is providing care to a...

Question 15

The nurse is teaching a client diagnosed with hypertension about lifestyle modifications.The nurse determines that teaching has been effective when the client makes which statement?&#10;A)&#34;My father had hypertension,did nothing,and lived to be 90 years old.&#34;&#10;B)&#34;I won't be able to run the marathon anymore.&#34;&#10;C)&#34;I need to get started on my medications right away.&#34;&#10;D)&#34;I know I need to give up my cigarettes and alcohol.&#34;&#10;

Accepted Answer

The answer of The nurse is teaching a client diagnosed...

Question 16

The nurse is teaching the client about lifestyle modifications to help manage hypertension.The nurse determines that teaching has been effective when the client makes which statement?&#10;A)&#34;Lifestyle changes always get blood pressure down to normal levels.&#34;&#10;B)&#34;Lifestyle changes are just a way to make you feel like you're doing something.&#34;&#10;C)&#34;As long as I take my medications,I don't need to make any lifestyle changes.&#34;&#10;D)&#34;I will probably need to change my lifestyle and take medications.&#34;&#10;

Accepted Answer

The answer of The nurse is teaching the client about...

Question 17

The client is prescribed doxazosin (Cardura)for hypertension and asks the nurse how the medication works.Which response by the nurse is the most appropriate?&#10;A)&#34;It works by making your blood vessels expand.&#34;&#10;B)&#34;It works by causing your kidneys to excrete more urine.&#34;&#10;C)&#34;It works by decreasing the release of stress hormones.&#34;&#10;D)&#34;It works by making your heart work more efficiently.&#34;&#10;

Accepted Answer

The answer of The client is prescribed doxazosin (Cardura)for hypertension...

Question 18

A client is newly diagnosed with hypertension and diabetes.Which classes of drugs are likely to be prescribed? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

A)ACE inhibitors
B)Beta blockers
C)Thiazide diuretics
D)Calcium channel blockers
E)Angiotensin receptor blockers (ARBs)

Accepted Answer

The answer of A client is newly diagnosed with hypertension...

Question 19

The nurse is caring for a client with a new diagnosis of hypertension and no other conditions.Which medication prescription should the nurse anticipate as the first treatment option?&#10;A)A calcium channel blocker&#10;B)A thiazide-type diuretic&#10;C)An ACE inhibitor&#10;D)A beta blocker&#10;

Accepted Answer

The answer of The nurse is caring for a client...

Question 20

The client recently diagnosed with hypertension presents with the following assessment data: weight,200 lb; height,5'4"; diet,mostly starches; alcohol intake,three beers/week; stressors,works 60 hours/week.In planning care with this client,what is the priority outcome?

A)The client will eliminate alcohol from the diet.
B)The client will decrease stress by limiting work to 40 hours/week.
C)The client will achieve and maintain optimum weight.
D)The client will balance diet according to the food pyramid.

Accepted Answer

The answer of The client recently diagnosed with hypertension presents...

Question 21

The client begins taking enalapril (Vasotec)for hypertension.Which adverse effect should the nurse teach the client to expect while taking this medication?&#10;A)Persistent cough&#10;B)Rebound hypertension&#10;C)Hyperkalemia&#10;D)Hyperglycemia&#10;

Accepted Answer

The answer of The client begins taking enalapril (Vasotec)for hypertension.Which...

Question 22

The nurse completes medication education with a client prescribed hydrochlorothiazide.The nurse determines that teaching has been effective when the client makes which statement?&#10;A)&#34;I take my medication early in the morning.&#34;&#10;B)&#34;I really need to avoid grapefruit juice when I take this medication.&#34;&#10;C)&#34;If I develop a cough,I should call my doctor.&#34;&#10;D)&#34;I need to avoid salt substitutes and potassium-rich foods.&#34;&#10;

Accepted Answer

The answer of The nurse completes medication education with a...

Question 23

Which is a priority nursing intervention for a client who is prescribed enalapril (Vasotec)for antihypertensive treatment?&#10;A)Monitor the client for headaches.&#10;B)Take the client's blood pressure.&#10;C)Review the client's lab results for hypokalemia.&#10;D)Order a sodium-restricted diet for the client.&#10;

Accepted Answer

The answer of Which is a priority nursing intervention for...

Question 24

The nurse is administering nitroprusside sodium in the treatment of a hypertensive crisis.The nurse will assess the client for which signs and symptoms of thiocyanate poisoning? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

A)Hypotension
B)Blurred vision
C)Flushing of the skin
D)Metabolic acidosis
E)Dizziness

Accepted Answer

The answer of The nurse is administering nitroprusside sodium in...

Question 25

The nurse is caring for a client who is prescribed hydralazine for the treatment of high blood pressure.Which medication should the client avoid taking because of the risk of severe hypotension?&#10;A)Beta blockers&#10;B)Monoamine oxidase inhibitors (MAOIs)&#10;C)Acetaminophen&#10;D)Potassium supplements&#10;

Accepted Answer

The answer of The nurse is caring for a client...

Question 26

The nurse is taking the initial history of a client admitted to the hospital for hypertension.The health care provider has ordered a beta-adrenergic blocker.Which statement by the client does the nurse recognize as most significant?

A)"I don't handle stress well; I have a lot of diarrhea."
B)"I have always had problems with my asthma."
C)"When I have a migraine headache,I need to have the room darkened."
D)"My father died of a heart attack when he was 48 years old."

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Accepted Answer

The answer of The nurse is taking the initial history...

Question 27

A client with hypertension has experienced heart failure.The nurse notes that the client is receiving nifedipine (Procardia).Which is a priority assessment for the nurse?&#10;A)Auscultate breath sounds for crackles.&#10;B)Assess level of orientation.&#10;C)Review recent lab results for hypokalemia.&#10;D)Assess urinary output.&#10;

Accepted Answer

The answer of A client with hypertension has experienced heart...

Deck 34: Pharmacotherapy of Hypertension