Deck 16: Drug Therapy for Hypertension

Question 1

Which class of antihypertensive drugs has a higher incidence of side effects?

A) Angiotensin-converting enzyme (ACE)inhibitors
B) Calcium channel blockers
C) Alpha-beta blockers
D) Direct vasodilators

Answer 1

Direct vasodilators

Question 2

Which term means high blood pressure from no known cause?

A) Orthostatic hypertension
B) Orthostatic hypotension
C) Primary hypertension
D) Secondary hypertension

Answer 2

Primary hypertension

Question 3

How do angiotensin-converting enzyme (ACE)inhibitors lower blood pressure?

A) Preventing clots from forming
B) Promoting water and potassium retention
C) Relaxing blood vessel muscles
D) Reversing atherosclerosis

Answer 3

Relaxing blood vessel muscles

Question 4

Which drug is an angiotensin II receptor blocker (ARB)?

A) Lisinopril
B) Bumetanide
C) Ramipril
D) Losartan

Question 5

What types of over-the-counter drugs can worsen high blood pressure?

A) Drugs for asthma
B) Laxatives
C) Cortisone creams
D) Aspirin

Question 6

What side effect is common to calcium channel blockers?

A) Diarrhea
B) Leg and ankle swelling
C) Worsening of glaucoma
D) Dry,hacking cough

Question 7

Which drug acts directly on the peripheral arteries,causing them to dilate and leading to decreased blood pressure?

A) Minoxidil (Loniten)
B) Propranolol (Inderal)
C) Captopril (Capoten)
D) Diltiazem (Cardizem)

Question 8

Which side effect of ACE inhibitors is very common?

A) Hypertension
B) Difficulty sleeping
C) Constipation
D) Dry,hacking cough

Question 9

What is a possible life-threatening adverse effect that can occur when a person is taking an ACE inhibitor?

A) Angioedema
B) Rebound hypertension
C) Loss of taste sensation
D) Rapid development of glaucoma

Question 10

Which condition can be a severe adverse reaction to angiotensin II receptor blockers?

A) Asthma
B) Heart failure
C) Kidney failure
D) Seizure activity

Question 11

What substance should patients taking ACE inhibitors avoid?

A) Alcoholic beverages
B) Salt substitutes
C) Citrus fruits
D) Aspirin

Question 12

How do most diuretics lower blood pressure?

A) Preventing clots from forming
B) Promoting water and sodium loss
C) Constricting blood vessel muscles
D) Reversing atherosclerosis

Question 13

A patient's blood pressure is consistently around 138/88 mm Hg.What does this reading represent?

A) Normal blood pressure
B) Prehypertension
C) Stage 1 hypertension
D) Stage 2 hypertension

Question 14

Which condition is a possible severe adverse effect of beta blockers?

A) Difficulty breathing
B) Blood clots
C) Kidney failure
D) Worsening glaucoma

Question 15

How do alpha blockers work to lower blood pressure?

A) Preventing clots from forming
B) Promoting water and potassium loss
C) Relaxing blood vessel muscles
D) Reversing atherosclerosis

Question 16

What are the most common side effects of alpha blockers?

A) Shakiness and tremors
B) Leg and ankle swelling
C) Constipation and nausea
D) Dizziness and drowsiness

Question 17

How do calcium channel blockers help to lower blood pressure?

A) Relaxing arteries and slowing heart contractions
B) Increasing constriction of muscles in veins
C) Inducing weight loss and reducing obesity
D) Increasing water and sodium loss

Question 18

Which drug for high blood pressure is a beta blocker?

A) Verapamil
B) Telmisartan
C) Captopril
D) Propranolol

Question 19

What condition is a major cause of long-term high blood pressure?

A) Atherosclerosis
B) Bleeding disorders
C) Chronic liver disease
D) Diabetes insipidus

Question 20

What is the difference between primary hypertension and secondary hypertension?

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

Question 21

A patient taking metoprolol (Lopressor)for hypertension reports all of the following side effects.For which side effect will you notify the prescriber?

A) Increased urination during the daytime
B) Heart rate of 68 per minute
C) Chest pain during exercise
D) Decreased sexual ability

Question 22

Which action or precaution is most important for before giving any type of drug for hypertension?

A) Check the patient's blood pressure.
B) Ensure that the patient is in a sitting position.
C) Check the patient's pulse for regularity.
D) Have the patient drink a full glass of water.

Question 23

A patient who has been taking lisinopril (Zestril)develops swollen lips and reports that the tongue feels thick.What is your best action?

A) Document the report and reassure the patient that this is a common drug side effect.
B) Check the patient's pulse for rhythm and take the patient's blood pressure.
C) Ask the patient whether this has ever happened before.
D) Hold the lisinopril dose and notify the prescriber.

Question 24

You are checking a patient's blood pressure before administering an antihypertensive.The reading of 88/52 mm Hg.What is your best action?

A) Give the patient a cup of coffee and retake the blood pressure in 30 minutes.
B) Document the finding as the only action and administer the drug as usual.
C) Raise the side rails and apply oxygen by mask or nasal cannula.
D) Hold the dose and notify the prescriber.

Question 25

An older adult man who takes verapamil (Calan)reports that his breasts have enlarged.What is your best action?

A) Ask the patient whether he has had any difficulty getting or maintaining an erection.
B) Document the response and reassure the patient that this is a common side effect.
C) Instruct the patient to use an elastic wrap to bind his breasts during the day.
D) Hold the drug dose and notify the prescriber.

Question 26

A patient taking a thiazide diuretic has the following blood laboratory values for kidney function.Which value will you report to the prescriber immediately?

A) Sodium 124 mEq/L
B) Potassium 3.6 mEq/L
C) Creatinine 0.9 mg/dL
D) Blood urea nitrogen 16 mg/dL

Question 27

A patient asks you how atenolol (Tenormin)will help reduce hypertension.What is your best response?

A) "It will help your body rid itself of excess fluids and decrease the work your heart must do to pump blood."
B) "It will help decrease built-up water and salt in your blood and tissues."
C) "It will block vasoconstriction as well as salt and water retention."
D) "It will decrease your heart rate and how hard your heart pumps."

Question 28

Which drug action is most likely to lower blood pressure?

A) Increasing the effectiveness of heart pumping
B) Relaxing (dilating)blood vessel smooth muscle
C) Increasing the concentration of urine
D) Retaining the body's concentration of potassium

Question 29

An older patient has been prescribed an angiotensin-converting enzyme (ACE)inhibitor.Which precaution is most important for you to teach the patient about this drug?

A) "Avoid caffeinated drinks that may increase your blood pressure."
B) "Take this drug at night so that you won't be aware of nausea."
C) "Change positions slowly when rising up from a sitting position."
D) "Weigh yourself daily upon first arising in the morning."

Question 30

You give the first dose of an antihypertensive drug to a hospitalized patient.Which instruction should you give to the patient next?

A) "Stay in bed and call for help if you need to get up for any reason."
B) "Urinate in a container so that we can keep track of your urine output."
C) "If you develop a headache,we can give you some acetaminophen (Tylenol)."
D) "You may get up but only if you need to use the bathroom."

Question 31

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 do you suspect?

A) Muscle breakdown
B) Orthostatic hypotension
C) Hypokalemia
D) Dysrhythmia

Question 32

Which precaution is most important for you to teach a patient who has been prescribed a beta blocker drug for hypertension?

A) "Avoid alcoholic beverages while taking this drug."
B) "Weigh yourself daily at the same time every morning."
C) "Wear gloves and other warm clothing during cold weather."
D) "Do not suddenly stop taking this drug without notifying your prescriber."

Question 33

You are teaching a patient about antihypertensive therapy.Which statement by the patient indicates the need for more teaching?

A) "Now that my blood pressure is normal,I won't need to take my medication anymore."
B) "When I take my blood pressure at home,I always try to take it at just about the same time every day."
C) "I check the labels on cans and other food packages to be sure they do not have too much sodium."
D) "I hope that by continuing to lose weight,I might not have to take medications to manage my high blood pressure."

Question 34

You are to give the first dose of enalapril (Vasotec)to a patient whose medication reconciliation indicates he also takes furosemide (Lasix)for hypertension.What action should you take?

A) Administer both drugs as prescribed.
B) Be sure to separate administering the two drugs by at least 6 hours.
C) Notify the prescriber that this patient already takes a drug for hypertension.
D) Suggest to the patient that he take the enalapril in the morning and the furosemide at bedtime.

Question 35

How does the drug diltiazem (Cardizem)lower blood pressure?

A) Prevents angiotensin from binding to its receptors.
B) Blocks nerve stimulation of blood vessels.
C) Increases water and sodium loss.
D) Widens small arteries.

Question 36

A patient has been prescribed losartan (Cozaar).Which substance,drug,or activity do you teach the patient to avoid?

A) Oral contraceptives
B) Salt substitutes
C) Caffeine
D) Running

Question 37

A 38-year-old patient has been prescribed nadolol (Corgard)80 mg daily for hypertension.The patient tells you that he has stopped taking the drug.What is your best first action at this time?

A) Instruct the patient to begin taking the drug immediately.
B) Ask the patient if he is experiencing side effects of the drug.
C) Document this finding in detail.
D) Immediately notify the prescriber.

Question 38

A patient who has been prescribed enalapril (Vasotec)has developed a persistent nonproductive cough.What is your best action?

A) Ask the prescriber to order something for the patient's cough.
B) Suggest that the family bring the patient some cough drops.
C) Offer the patient sips of water and ice chips.
D) Hold the dose and notify the prescriber.

Question 39

For which patient is labetalol (Normodyne)contraindicated as an antihypertensive drug?

A) 48-year-old woman who is going through menopause
B) 72-year-old man who has an enlarged prostate gland
C) 80-year-old woman with severe glaucoma
D) 60-year-old man with severe asthma

Question 40

A patient has a dose of labetalol (Normodyne)ordered twice a day and is due to have an exercise stress test this morning.What is your best action at this time?

A) Give the dose as ordered.
B) Hold the dose and notify the prescriber.
C) Give half the dose now and half after the procedure.
D) Ask the patient about chest pain,dizziness,and light-headedness.

Question 41

Which antihypertensive drug would you teach a patient is considered safe for use during pregnancy or breastfeeding?

A) Clonidine (Catapres)
B) Methyldopa (Aldomet)
C) Labetalol (Normodyne)
D) Carvedilol (Coreg)

Question 42

A patient with hypertension and type 2 diabetes mellitus is taking carvedilol (Coreg).What special precaution should you teach the patient to take when taking this drug?

A) Check blood pressure in both arms.
B) Keep a strict record of intake and output.
C) Check blood sugar levels regularly.
D) Avoid sugar-containing drinks.

Question 43

Which statements are true about blood pressure? (select all that apply)

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

Question 44

A hospitalized patient prescribed nifedipine XL (Procardia)60 mg once a day informs you that at home he was taking nicardipine (Cardene)20 mg three times a day and thinks this is the wrong drug.What is your best action?

A) Give the dose as ordered after informing the patient that this is a new medication the prescriber wants him or her to take.
B) Hold the drug and contact the prescriber to clarify the order because of the patient's concern before administering the dose.
C) Contact the pharmacy to ask what the prescriber ordered and if there was a mistake when the prescription was filled.
D) Administer the dose because nifedipine and nicardipine are from the same class of drugs and may be substituted for each other.

Question 45

Which conditions or drugs can cause secondary hypertension? (select all that apply)

A) Adrenal gland tumors
B) Estrogen in birth control pills
C) Leukemia
D) Cortisol
E) Kidney infection

Question 46

A patient who weighs 220 lb is to receive labetalol 0.25 mg/kg intravenously.The solution of labetalol on hand is 100 mg/20 mL.How many milliliters of labetalol will you prepare for a correct dose?

Question 47

You are teaching a patient who has just been prescribed prazosin (Minipress)for hypertension.You immediately notify the prescriber and question the order upon discovering that the patient is also taking which drug?

A) Aspirin
B) Atenolol (Tenormin)
C) Chlorothiazide (Diuril)
D) Sildenafil (Viagra)

Question 48

A patient who is taking nicardipine (Cardene)develops skin lesions,itching,fever,and achy joints.What is your best first action?

A) Hold the drug and notify the prescriber.
B) Document the finding as expected with this drug.
C) Administer a dose of oral diphenhydramine (Benadryl).
D) Apply a thin coat of hydrocortisone ointment to the lesions.

Question 49

You are teaching a patient how to administer clonidine (Catapres)using the transdermal patch system.How often do you teach the patient to change the patch?

A) Daily
B) Every 3 days
C) Every 7 days
D) Every 14 days

Question 50

Which statement by a patient prescribed enalapril (Vasotec)indicates the need for additional teaching?

A) "I will use a salt substitute instead of table salt when I eat."
B) "I will avoid alcohol while I am taking this medication."
C) "I will wear long sleeves,a hat,and sunscreen when I go outdoors."
D) "I will call my prescriber immediately if I notice any swelling in my face."

Question 51

A patient with hypertension is prescribed terazosin (Hytrin).When should you administer the first dose of this drug to the patient?

A) In the morning to avoid waking the patient at night
B) With meals to avoid GI problems
C) With a full glass of water
D) At bedtime

Question 52

A 33-year-old female patient is currently taking captopril (Capoten)and metoprolol (Lopressor)to control her blood pressure.She tells you that she plans to become pregnant.What should you teach the patient about the use of this drug during pregnancy?

A) ACE inhibitors affect women differently than men.
B) ACE inhibitors have fewer side effects than other hypertension drugs.
C) ACE inhibitors should not be prescribed for women who are pregnant.
D) ACE inhibitors are only safe for use during the third trimester of pregnancy.

Question 53

A child who weighs 68 lb and has very high blood pressure as a result of an adrenal gland tumor is prescribed a STAT dose of oral prazosin (Minipress)at 200 mcg/kg.You have on hand prazosin 2 mg/capsule.How many capsules will you administer to this child?

Question 54

An adult patient is prescribed metoprolol (Lopressor)50 mg orally twice a day.Metoprolol is available in 100 mg tablets.How many tablets will you give for each dose?