Deck 36: Pharmacotherapy of Hypertension

Question 1

The client has been recently diagnosed with hypertension.Assessment data includes: Weight: 200 pounds
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?
1)Client will balance diet according to the food pyramid.
2)Client will decrease stress by limiting work to 40 hours/week.
3)Client will eliminate alcohol from the diet.
4)Client will achieve and maintain optimum weight.

Answer 1

4

Question 2

A client with hypertension recently was diagnosed with diabetes.The client asks why the physician has prescribed an ACE inhibitor.The nurse responds:
1)"It protects the heart."
2)"It protects the kidney."
3)"It protects the eye."
4)"It protects the nerves."

Answer 2

2

Question 3

The nurse is counseling a client with prehypertension.Which is the most appropriate statement by the nurse?
1)"You must begin medication."
2)"Let's discuss your lifestyle."
3)"Prehypertension will progress to hypertension."
4)"Prehypertension isn't really serious."

Answer 3

2

Question 4

The client with hypertension has experienced heart failure.The nurse notes that the client is receiving nifedipine (Procardia).What is a priority assessment for the nurse?
1)Auscultate breath sounds for crackles.
2)Review recent lab results for hypokalemia.
3)Assess level of orientation.
4)Assess urinary output.

Question 5

The client is receiving doxazosin (Cardura)for hypertension.He asks the nurse how the medication works.What is the nurse's best response?
1)"It works by causing your kidneys to excrete more urine."
2)"It works by making your blood vessels expand."
3)"It works by making your heart work more efficiently."
4)"It works by decreasing the release of your stress hormones."

Question 6

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

Question 7

A client with a history of heart disease has been diagnosed with hypertension.Which of the following drug classes is likely to be prescribed?
1)Thiazide diuretic
2)ACE inhibitor
3)Angiotensin receptor blocker
4)Calcium channel blocker
5)Beta blocker

Question 8

A client is newly diagnosed with hypertension and diabetes.Which of the following drug classes is likely to be prescribed? Select all that apply.
1)Thiazide diuretic
2)ACE inhibitor
3)Angiotensin receptor blocker
4)Calcium channel blocker
5)Beta blocker

Question 9

A client does not want to take hypertension medication, and asks why it is needed, as the client feels fine.The nurse should reply:
1)"If the hypertension is severe, symptoms could arise."
2)"You're right, there is no need for these medications."
3)"The medications can prevent complications from hypertension."
4)"The medications can prevent worsening of the hypertension."

Question 10

The client comes to the Emergency Department with a blood pressure of 200/120 mm/Hg.The physician orders hydralazine (Apresoline)IV.What will the nurse's priority assessment include?
1)Hypotension and tachycardia
2)Hypotension and bradycardia
3)Hypotension and hyperthermia
4)Hypotension and tachypnea

Question 11

The client recently was diagnosed with hypertension with a sustained blood pressure of 144/90 mm/Hg.The client is concerned about effects on the body.What effects of hypertension on the body will the nurse include in her education of this client? Select all that apply.
1)Heart failure
2)Blindness
3)Liver failure
4)Stroke
5)Kidney damage

Question 12

The nurse is teaching the client about lifestyle modifications to help manage the client's hypertension.The nurse determines that teaching has been effective when the client makes which statement?
1)"I need to get started on my medications right away."
2)"I won't be able to run the marathon anymore."
3)"My father had hypertension, did nothing, and lived to be 90 years old."
4)"I know I need to give up my cigarettes and alcohol."

Question 13

What is a priority nursing intervention for a client who has just begun antihypertensive treatment with enalapril (Vasotec)?
1)Review the client's lab results for hypokalemia.
2)Take the client's blood pressure.
3)Order a sodium-restricted diet for the client.
4)Monitor the client for headaches.

Question 14

The client has a nighttime cough related to taking enalapril (Vasotec).What is the best nursing intervention to promote rest in this client?
1)Contact the physician for an order for a cough suppressant medication.
2)Have the client sleep on two or three pillows at night.
3)Have the client sit up at an 80-degree angle in a comfortable chair at night.
4)Contact the physician for an order for a sedative-hypnotic medication.

Question 15

The physician asks you to monitor a client with stage II hypertension for signs of kidney damage.Which of the following would indicate kidney damage?
1)Urine output of 60 ml/hr
2)Estimated glomerular filtration rate of 105
3)Proteinuria
4)Dysuria

Question 16

The client has a blood pressure reading of 126/84 mm/Hg.She asks the nurse if she has high blood pressure.What is the best response by the nurse?
1)"Your blood pressure is normal."
2)"Your blood pressure is high-normal."
3)"You have prehypertension."
4)"You have stage I hypertension."

Question 17

The client comes to the Emergency Department with a blood pressure of 200/120 mm/Hg.The physician orders hydralazine (Apresoline)IV.What will the nurse's priority assessment include?
1)Hypotension and tachycardia
2)Hypotension and bradycardia
3)Hypotension and hyperthermia
4)Hypotension and tachypnea

Question 18

The nurse is caring for a client with a new diagnosis of hypertension and no other conditions.The nurse should anticipate that the first medication prescribed will most likely be:
1)A thiazide-type diuretic.
2)A beta blocker.
3)An ACE inhibitor.
4)A calcium channel blocker.

Question 19

The nurse completed medication education with the client who receives hydrochlorothiazide (Hydrodiuril).The nurse determines that teaching has been effective when the client makes which statement?
1)"I need to avoid salt substitutes and potassium-rich foods."
2)"If I develop a cough, I should call my doctor."
3)"I take my medication early in the morning."
4)"I really need to avoid grapefruit juice when I take this medication."

Question 20

A client is treated in the Emergency Department for hypertensive emergency.The nurse anticipates treatment with which of the following drugs?
1)Metoprolol
2)Lisinopril
3)Nitroprusside
4)Clonidine

Question 21

The nurse is taking the initial history of a client admitted to the hospital for hypertension.The physician has ordered a beta-adrenergic blocker.Which statement by the client does the nurse recognize as most significant?
1)"When I have a migraine headache, I need to have the room darkened."
2)"My father died of a heart attack when he was 48 years old."
3)"I don't handle stress well; I have a lot of diarrhea."
4)"I have always had problems with my asthma."