Deck 42: Hypertension

Question 1

If not chosen as the first drug in hypertension treatment, which drug class should be added as a second step because it will enhance the effects of most other agents?

A)ACE inhibitors
B)Beta blockers
C)Calcium channel blockers
D)Diuretics

Answer 1

Diuretics

Question 2

Lack of adherence to blood pressure management is very common. Reasons for this lack of adherence include:

A)Lifestyle changes are difficult to achieve and maintain.
B)Adverse drug reactions .
C)Costs of drugs and monitoring with laboratory tests can be expensive.
D)All of the above

Answer 2

All of the above

Question 3

What educational point concerning fluid intake must be covered with diuretic prescriptions?

A)Fluid should be restricted when on a diuretic.
B)Fluids should contain at least one salty item daily.
C)Fluid intake should remain near normal for optimal performance.
D)Avoidance of potassium-rich fluids is encouraged.

Answer 3

Fluid intake should remain near normal for optimal performance.

Question 4

Hypertensive African Americans are typically listed as not being as responsive to which drug groups?

A)ACE inhibitors
B)Calcium channel blockers
C)Diuretics
D)Bidil (hydralazine family of medications)

Question 5

Which of the following disease processes could be made worse by taking a nonselective beta blocker?

A)Asthma
B)Diabetes
C)Both might worsen
D)Beta blockade does not affect these disorders.

Question 6

Because of its action on various body systems, the patient taking a thiazide or loop diuretic may also need to take the following supplement:

A)Potassium
B)Calcium
C)Magnesium
D)Phosphates

Question 7

An ACE inhibitor and what other class of drug may reduce proteinuria in patients with diabetes better than either drug alone?

A)Beta blockers
B)Diuretics
C)Nondihydropyridine calcium channel blockers
D)Angiotensin II receptor blockers

Question 8

Treatment costs are important for patients with hypertension. Which of the following statements about cost is NOT true?

A)Hypertension is a chronic disease where patients may be taking drugs for a long time.
B)Most patients will require more than one drug to treat hypertension.
C)The cost includes the price of any routine or special laboratory tests that a specific drug may require.
D)Few antihypertensive drugs come in generic formulations.

Question 9

Lifestyle modifications for patients with early hypertension include:

A) Diet and increase exercise to achieve a body mass index (BMI) greater than 25.
B) Drink 4 oz of red wine at least once per week.
C) Adopt the dietary approaches to stop hypertension (DASH) diet.
D) Increase potassium intake.

Question 10

Disease states in addition to hypertension in which beta blockade has a compelling indication include:

A)Heart failure
B)Angina
C)Myocardial infarction
D)Dyslipidemia

Question 11

Angiotensin-converting enzyme (ACE) inhibitors treat hypertension because they:

A)Reduce sodium and water retention
B)Decrease vasoconstriction
C)Increase vasodilation
D)All of the above

Question 12

Aldactone family medications are frequently used when the hypertensive patient also has:

A)Hyperkalemia
B)Advancing liver dysfunction
C)The need for birth control
D)Rheumatoid arthritis

Question 13

Which diuretic agents typically do not need potassium supplementation?

A)Loop diuretics
B)Thiazide diuretics
C)Aldosterone inhibitors
D)They all need supplementation.

Question 14

Based on clinical trials, compelling indications for an ACE inhibitor as treatment for hypertension include:

A)Pregnancy
B)Renal parenchymal disease
C)Stable angina
D)Dyslipidemia

Question 15

Caffeine, exercise, and smoking should be avoided for at least how many minutes before blood pressure measurement?

A)15
B)30
C)60
D)90

Question 16

Based on clinical trials, compelling indications for an ACE inhibitor as treatment for hypertension include:

A)Pregnancy
B)Renal parenchymal disease
C)Stable angina
D)Dyslipidemia

Question 17

Blood pressure checks in children:

A)Should occur with their annual physical examinations after six years of age
B)Require a blood pressure cuff that is one-third the diameter of the child's arm
C)Should be done during every health-care visit after three years of age
D)Require additional laboratory tests such as serum creatinine

Question 18

All patients with hypertension benefit from diuretic therapy, but those who benefit the most are:

A)Those with orthostatic hypertension
B)African Americans
C)Those with stable angina
D)Diabetics

Question 19

Beta blockers treat hypertension because they:

A)Reduce peripheral resistance
B)Vasoconstrict coronary arteries
C)Reduce norepinephrine
D)Reduce angiotensin II production

Question 20

Because primary hypertension has no identifiable cause, treatment is based on interfering with the physiological mechanisms that regulate blood pressure. Thiazide diuretics treat hypertension because they:

A)Increase renin secretion
B)Decrease the production of aldosterone
C)Deplete body sodium and reduce fluid volume
D)Decrease blood viscosity

Question 21

Which drug class is recommended for first-line treatment of hypertension in African Americans?

A)Beta blockers
B)Angiotensin II receptor blocker (ARB) medications
C)Calcium channel blockers
D)Alpha blockers

Question 22

Which antihypertensive is safe during pregnancy?

A)ACE
B)Beta blocker
C)Direct renin inhibitor
D)ARB

Question 23

Current guidelines for blood pressure treatment in geriatric patients include:

A)Keep readings close to 120/80.
B)Accept the systolic pressure to be "age + 10."
C)Loosen strict adherence to reduction below 160 systolic.
D)Discontinue medications at age 90.

Question 24

What is a common side-effect concern with hypertensive medications and all individuals, but especially the elderly?

A)Risk of falls
B)Triggering of a hypertensive crisis
C)Erectile priapism
D)Risk for bladder cancer development

Question 25

Potassium excess risk is highest with which combination of medications:

A)Aldactone and a beta blocker
B)An ACE and a loop diuretic
C)An ARB and an aldosterone antagonist
D)A direct renin inhibitor and a thiazide

Question 26

Once-daily diuretics are typically suggested to be taken:

A) At bedtime
B) With every meal
C) Upon awakening
D) Whenever convenient