Deck 26: Anticoagulants and Coagulants

Question 1

Which of the following is true of sodium nitroprusside (Nipride)?

A) Sodium nitroprusside is administered by slow intravenous infusion.
B) The duration of action of sodium nitroprusside is short, usually 1 to 5 minutes.
C) The normal dose of sodium nitroprusside is approximately 3 mcg per kg per minute.
D) All of these are correct.

Answer 1

All of these are correct.

Question 2

Compare the blood pressure throughout the systemic vasculature,and select the true statement.

A) Pressure is highest in the large veins and lowest in the large arteries.
B) The largest pressure decrease occurs across the capillaries, indicating that they are the site of highest vascular resistance.
C) The largest pressure decrease occurs across the arterioles, indicating that they are the site of highest vascular resistance.
D) Pressure is highest in the arterioles and lowest in the venules.

Answer 2

The largest pressure decrease occurs across the arterioles, indicating that they are the site of highest vascular resistance.

Question 3

Identify the pair of factors that determines cardiac output.

A) Heart rate and peripheral resistance
B) Heart rate and stroke volume
C) Peripheral resistance and stroke volume
D) Heart rate and blood pressure

Answer 3

Heart rate and stroke volume

Question 4

Use the recommended dose (3 mcg/kg/min)to determine the appropriate dose of sodium nitroprusside that would be administered by slow intravenous infusion to a patient who weighs 176 pounds.

A) 240 mcg/kg/min
B) 180 mcg/kg/min
C) 280 mcg/kg/min
D) 320 mcg/kg/min

Question 5

Which of the following angiotensin-converting enzyme inhibitors (ACEIs)possesses the shortest plasma half-life and duration of action and is administered two to three times daily?

A) Quinapril (Accupril)
B) Captopril (Capoten)
C) Losartan (Cozaar)
D) Valsartan (Diovan)

Question 6

Which of the following factors reduces hypertension?

A) Elimination of smoking and regular physical exercise can lead to a reduction in blood pressure.
B) Practicing relaxation techniques aimed at reducing stress can lead to a reduction in blood pressure.
C) Sodium restriction and weight loss can lead to a reduction in blood pressure.
D) All of these are correct.

Question 7

In the context of the mechanism of antihypertensive action,which of the following is the treatment option to be used when the desired effect is to block the beta-1 receptors in the heart to decrease cardiac output and blood pressure?

A) Clonidine (Catapres), guanabenz (Wytensin), and guanfacine (Tenex)
B) Doxazosin (Cardura), prazosin (Minipress), and terazosin (Hytrin)
C) Atenolol (Tenormin), metoprolol (Lopressor), and nadolol (Corgard)
D) None of these

Question 8

Explain the role of the kidneys in the development of hypertension.

A) Activation of the RAA mechanism causes vasoconstriction, and sodium and water release, which leads to an increase in blood pressure.
B) Activation of the RAA mechanism causes vasoconstriction, and sodium and water retention, which leads to an increase in blood pressure.
C) Deactivation of the RAA mechanism causes vasoconstriction, and sodium and water retention, which leads to an increase in blood pressure.
D) None of these are correct.

Question 9

Select the preferred treatment for hypertension for patients with renal disease.

A) Beta-blockers and diuretics
B) ACEIs and ARBs
C) Calcium channel blockers and diuretics
D) Thiazide and loop diuretics

Question 10

In the context of the mechanism of antihypertensive action,which of the following combination of drugs is used when the desired effect is the stimulation of the inhibitory alpha-2 receptors in the vasomotor center of the medulla oblongata,which ultimately reduces the sympathetic stimulation to the heart,kidneys,and blood vessels?

A) Clonidine (Catapres), guanabenz (Wytensin), and guanfacine (Tenex)
B) Doxazosin (Cardura), prazosin (Minipress), and terazosin (Hytrin)
C) Atenolol (Tenormin), metoprolol (Lopressor), and nadolol (Corgard)
D) None of these

Question 11

Which of the following statements is true of the adverse-effects of thiazide and loop diuretics?

A) Thiazide and loop diuretics interfere with the synthesis of renin.
B) Thiazide and loop diuretics interfere with the metabolism of sodium.
C) Thiazide and loop diuretics interfere with the renal excretion of uric acid.
D) None of these are correct.

Question 12

Select the correct statement related to the mechanism of action of aliskiren (Tekturna).

A) Aliskiren interferes with the influx of calcium in cardiac and vascular smooth muscle and thus lowers peripheral resistance and blood pressure.
B) Aliskiren reduces cardiac output by blocking the beta-1 receptors in the heart.
C) Aliskiren inhibits the enzymatic activity of renin and decreases the conversion of angiotensinogen to angiotensin I, thereby reducing the formation of angiotensin II.
D) None of these are correct.

Question 13

Identify the definition of the physiological factor known as cardiac output that determines blood pressure.

A) Cardiac output is the amount of blood that is pumped out of the heart per minute.
B) Cardiac output is the friction that the arterioles have against the flow of blood.
C) Cardiac output is the amount of blood pumped per heartbeat.
D) None of these are correct.

Question 14

Which of the following statements is not true of the vasodilator hydralazine (Apresoline)?

A) Long-term use may produce rheumatoid arthritis or a systemic lupus erythematosus-like syndrome.
B) It is an arteriolar dilator used in moderate to severe hypertension in combination with both diuretics and beta-blockers (triple therapy).
C) The main adverse effects are GI disturbances such as dyspepsia, abdominal pain, and diarrhea.
D) None of these are correct.

Question 15

Identify a true statement about the mechanism of action of the preferred diuretics used in the treatment of hypertension.

A) Thiazide and thiazide-like diuretics cause an increase in the excretion of sodium and water, which reduces the blood volume and cardiac output.
B) Loop diuretics cause an increase in the excretion of sodium and water, which reduces blood volume and cardiac output.
C) Aldosterone antagonists cause an increase in the excretion of sodium and water, which reduces blood volume and cardiac output.
D) None of these are correct.

Question 16

Select the mechanism of action of the angiotensin-converting enzyme inhibitors (ACEIs).

A) ACEIs inhibit the formation of angiotensin II and decrease the release of aldosterone and antidiuretic hormone.
B) ACEIs lower blood pressure by causing a balanced vasodilation of both arteries and veins.
C) ACEIs inhibit inactivation of bradykinin, which produces vasodilation.
D) All of these are correct.

Question 17

Use the recommended dose (3 mcg/kg/min)to determine the appropriate dose of sodium nitroprusside that would be administered by slow intravenous infusion to a patient who weighs 242 pounds.

A) 240 mcg/kg/min
B) 180 mcg/kg/min
C) 280 mcg/kg/min
D) 330 mcg/kg/min

Question 18

Select the primary indication for the use of minoxidil (Loniten).

A) Minoxidil is indicated for patients who do not respond to therapy with calcium antagonists.
B) Minoxidil is indicated for patients who do not respond to triple therapy with other drug combinations.
C) Minoxidil is indicated for patients who do not respond to therapy with beta-blockers.
D) None of these are correct.

Question 19

Select the preferred treatment for hypertension for patients with cardiac arrhythmias or ischemic heart disease.

A) ARBs and diuretics
B) ACEIs
C) Calcium channel blockers or beta-blockers
D) ACEIs and diuretics

Question 20

Implementing a patient education session for a patient suffering from essential hypertension requires:

A) instructing the patient about the importance of taking their medications at proper times.
B) instructing the patient to undergo routine medical checkups to ensure that their blood pressure is under control.
C) instructing the patient that he or she may not have symptoms but will require lifelong treatment.
D) All of these are correct.

Question 21

Kelly conducts a study on the effects of hydralazine,in combination with both diuretics and beta-blockers,as a long-term treatment for severe hypertension.Which of the following would be a valid result of her study?

A) A withdrawal reaction may occur, with patients experiencing rebound sympathetic activity and hypertensive crisis.
B) Patients will experience dry cough and allergic reactions all through the treatment.
C) Patients will experience hallucinations and depression all through the treatment.
D) Rheumatoid arthritis or a systemic lupus erythematosus-like syndrome may develop.

Question 22

Which of the following statements is true of angiotensin receptor blocking drugs?

A) They increase bradykinin concentrations.
B) They are orally active drugs and require multiple doses per day.
C) They cause the dry cough and allergic reactions associated with the ACEIs.
D) They are contraindicated during pregnancy.

Question 23

Which of the following drugs is a calcium channel blocker?

A) Diltiazem
B) Chlorothiazide
C) Propranolol
D) Clonidine

Question 24

Jessica is suffering from hypertension and,therefore,is given clonidine parenterally to treat her condition.If her treatment is discontinued abruptly,she may face withdrawal reactions.Which of the following statements holds true in this case?

A) To avoid withdrawal symptoms of clonidine, her dose should be reduced gradually over a 2-day period.
B) She will develop rheumatoid arthritis or a systemic lupus erythematosus-like syndrome due to the long-term use of clonidine.
C) She may experience rebound sympathetic activity and hypertensive crisis.
D) To avoid withdrawal symptoms of clonidine, she should switch to oral administration of the drug and a weekly transdermal patch.

Question 25

Which of the following statements is true of angiotensin-converting enzyme inhibitors (ACEIs)?

A) It interferes with insulin and blood glucose regulation.
B) Overdosage can cause hypotension and reflex tachycardia.
C) It increases plasma lipids.
D) Increase in the release of aldosterone and antidiuretic hormone.

Question 26

Identify the first drug of the Angiotensin receptor blockers class to be approved.

A) Losartan
B) Captopril
C) Trandolapril
D) Aliskiren

Question 27

Which of the following is a difference between ACEIs and ARBs?

A) Unlike the ACEIs, the ARBs increase bradykinin concentrations.
B) . Unlike the ACEIs, the ARBs bind to the AT1 receptor and competitively antagonize the actions of angiotensin II.
C) Unlike the ACEIs, the ARBs are contraindicated during pregnancy.
D) Unlike the ACEIs, the ARBs block the enzymatic conversion of angiotensin I to angiotensin II.

Question 28

The main concern with the use of potassium-sparing diuretics is the development of _____,especially in patients who are also taking ACEIs,ARBs,or potassium supplements.

A) hirsutism
B) thrombosis
C) hyperkalemia
D) thrombocytopenia

Question 29

Mark suffers from mild hypertension.Which of the following is best suited to treat his condition?

A) Diuretics
B) Diazoxide
C) Sodium Nitroprusside
D) Vasodilators

Question 30

Identify an angiotensin-converting enzyme (ACE)inhibitor.

A) Aliskiren
B) Losartan
C) Chlorthalidone
D) Trandolapril

Question 31

The vasodilator drug Minoxidil differs from Hydralazine in that Minoxidil:

A) is indicated for patients who respond to triple therapy with other drug combinations.
B) is a more potent arteriolar dilator.
C) is given in usual doses of 60 to 100 mg per day in combination with a diuretic and beta-blocker.
D) seldom produces any serious adverse effects.

Question 32

Which of the following is a similarity between angiotensin receptor blocking drugs (ARBs)and angiotensin-converting enzyme inhibitors (ACEIs)?

A) They cause adverse effects such as hypotension and GI disturbances.
B) They increase bradykinin concentrations.
C) They cause dry cough and allergic reactions.
D) They can be used in normal doses during pregnancy.

Question 33

Identify the instrument used to measure blood pressure.

A) Stethoscope
B) Sphygmomanometer
C) Esthesiometer
D) Otoscope

Question 34

Which of the following statements is true of the vasodilator drug diazoxide?

A) Structurally, diazoxide is similar to the thiazide diuretics.
B) Diazoxide is a very potent vasodilator and has significant diuretic activity.
C) Its hypotensive effects last for 1 to 2 hours.
D) Diazoxide is used when the BP needs to be lowered gradually.

Question 35

Essential hypertension differs from secondary hypertension in that:

A) the cause of essential hypertension is unknown.
B) essential hypertension is an acute disease.
C) essential hypertension requires no treatment.
D) the occurrence of essential hypertension is almost negligible.