Deck 26: Drugs for Hypertension

Question 1

A client receiving hydrochlorothiazide (Microzide) asks the nurse why they are urinating so frequently. Which statement should the nurse provide the client?

A) "Hydrochlorothiazide (Microzide) enhances kidney function causing you to urinate more and that decreases your blood pressure."
B) "Hydrochlorothiazide (Microzide) decreases the fluid in your bloodstream and this lowers your blood pressure."
C) "Hydrochlorothiazide (Microzide) dilates your blood vessels so you urinate more and your blood pressure decreases."
D) "Hydrochlorothiazide (Microzide) increases your heart rate; this pumps blood faster to your kidneys so you urinate more and your blood pressure decreases."

Answer 1

"Hydrochlorothiazide (Microzide) decreases the fluid in your bloodstream and this lowers your blood pressure."

Question 2

The nurse notes that a client experiencing heart failure has been receiving nifedipine (Procardia). Which is a priority assessment for the nurse?

A) Review recent lab results for hypokalemia.
B) Assess urinary output.
C) Assess level of orientation.
D) Auscultate breath sounds for crackles.

Answer 2

Auscultate breath sounds for crackles.

Question 3

For which assessment findings should the nurse hold enalapril (Vasotec)? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) Cough
B) Lightheadedness on ambulation
C) Periorbital edema
D) Sneezing
E) Difficulty swallowing

Answer 3

Periorbital edema
Difficulty swallowing

Question 4

A client prescribed doxazosin (Cardura) asks how the medication works. Which information should the nurse provide the client?

A) "Doxazosin causes the kidneys to excrete more urine."
B) "Doxazosin helps the heart work more efficiently."
C) "Doxazosin helps dilate the blood vessels."
D) "Doxazosin decreases the release of the stress hormones."

Question 5

Which factors are responsible for blood pressure?

A) Blood volume, heart rate, and stroke volume
B) Cardiac output, blood volume, and peripheral vascular resistance
C) Age, weight, and race
D) Body mass index, diet, and genetics

Question 6

The nurse reviewing the records of a client diagnosed with hypertension notes a weight of 200 lbs, height 5' 4", dietary intake includes primarily starches, an alcohol intake of three beers per week, and stressors include 60-hour workweeks. Based on this information, which should the nurse identify as a priority outcome?

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

Question 7

Which statement is accurate in regard to secondary hypertension?

A) There is no known cause.
B) It can result from chronic renal impairment.
C) It is also known as idiopathic.
D) It accounts for 90% of all hypertensive cases.

Question 8

Which electrolytes should the nurse anticipate monitoring for a client prescribed losartan (Cozaar)? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) Potassium
B) Sodium
C) Calcium
D) Chloride
E) Magnesium

Question 9

Which is a priority nursing intervention for a client who is newly prescribed enalapril (Vasotec)?

A) Monitor the client for headaches.
B) Take the client's blood pressure.
C) Order a sodium-restricted diet for the client.
D) Review the client's lab results for hypokalemia.

Question 10

The nurse is preparing to administer clevidipine (Cleviprex) to a client experiencing a hypertensive crisis. Which interventions should the nurse implement? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) Monitor bowel sounds
B) Administer the drug intravenously
C) Continually monitor blood pressure
D) Crush caplets for administration
E) Infuse prescription in normal saline at 125 mL/h

Question 11

For which conditions is a client with hypertension at risk? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

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

Question 12

The nurse has completed the education for a client prescribed hydrochlorothiazide (Microzide). Which statement made by the client indicates an understanding of the teaching?

A) "I really need to avoid grapefruit juice when I take this medication."
B) "I need to avoid salt substitutes and potassium-rich foods."
C) "I take my medication early in the morning."
D) "If I develop a cough, I should call my physician."

Question 13

The nurse educator is reviewing the physiological regulation blood pressure. Which should the educator identify as initially involved?

A) Production of angiotensin II
B) Action of renin
C) Antidiuretic hormone
D) Production of angiotensin I

Question 14

Which is the nurse's priority assessment for a client treated with intravenous hydralazine (Apresoline)?

A) Hypotension and bradycardia
B) Hypotension and hyperthermia
C) Hypotension and tachycardia
D) Hypotension and tachypnea

Question 15

Which changes are sensed by the baroreceptors and relayed to the vasomotor center?

A) Oxygenation
B) Blood pressure
C) Carbon dioxide
D) Blood pH

Question 16

Which clients should the nurse anticipate will require a pharmacological intervention to manage their blood pressure? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) A 30-year-old female whose blood pressure is 138/88 mmHg who is otherwise healthy
B) A 61-year-old man whose blood pressure is 144/90 mmHg who also has type 2 diabetes
C) A 56-year-old woman whose blood pressure is 135/84 mmHg who also has Cushing's disease
D) A 65-year-old man whose blood pressure is 148/88 mmHg who is otherwise healthy
E) A 61-year-old woman whose blood pressure is 153/92 mmHg who is otherwise healthy

Question 17

The nurse is providing education for nonpharmacological interventions to manage hypertension. Which information should the nurse include? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) Increase your dietary intake of fruits and vegetables.
B) Decrease the consumption of alcohol.
C) Reduce the dietary intake of potassium.
D) Increase physical activity.
E) Restrict your intake of sodium.

Question 18

The nurse has discussed lifestyle modifications to help manage the client's hypertension. Which statement made by the client indicates an understanding of the information?

A) "I need to get started on my medications right away."
B) "My father had hypertension, did nothing, and lived to be 90 years old."
C) "I know I need to give up my cigarettes and alcohol."
D) "I won't be able to run in the marathon race anymore."

Question 19

The nurse has prescribed dietary education for a client prescribed nifedipine (Procardia XL). Which dietary choice should the nurse recognize requires further education?

A) Whole-wheat pancakes with syrup, and bacon, oatmeal, and orange juice
B) Eggs, whole-wheat toast with butter, cereal, milk, and grapefruit juice
C) Eggs and sausage, a biscuit with margarine, coffee with cream, and cranberry juice
D) Egg and cheese omelet, tea with sugar and lemon, hash brown potatoes, and prune juice

Question 20

Which statement made by a client newly prescribed a beta-adrenergic blocker should the nurse be concerned about?

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

Question 21

Which intervention is the highest priority for a 30-year-old female with a BMI of 20 who smokes and has a blood pressure of 137/88?

A) Smoking-cessation program
B) Diuretic therapy
C) Weight-loss program
D) Stress management

Question 22

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

A) "I have incorporated yoga into my exercise program."
B) "I will monitor my daily sodium intake."
C) "I will drink a glass of red wine daily to help lower my blood pressure."
D) "I am receiving acupuncture to help me stop smoking."

Question 23

The nurse has provided education for a client prescribed nifedipine (Adalat CC). Which statement made by the client indicates an understanding of the teaching? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) "If I drink alcohol while taking this medication, I will get very sick to my stomach."
B) "I should stop taking my melatonin sleep medication."
C) "I should no longer drink grapefruit juice."
D) "I should no longer drink sports drinks with caffeine in them."
E) "I should stop taking my vitamin C supplement."

Question 24

A male client states to the nurse, "I am going to stop taking my metoprolol (Lopressor). I have been experiencing problems having sex." Which responses should the nurse include in the discussion with the client? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) "I understand sexual dysfunction can be a common problem with this drug."
B) "Perhaps it would be better if you took atenolol (Tenormin)."
C) "I cannot stop you from discontinuing the drug."
D) "Stopping the prescription abruptly may cause your blood pressure to elevate even higher."
E) "Try taking the drug early in the morning."

Question 25

Which medical condition should the nurse be concerned about for a client prescribed hydralazine?

A) Asthma
B) Angina
C) Diabetes
D) Hyperthyroidism

Question 26

Which electrolyte imbalance should the nurse be concerned about for the client who is prescribed a thiazide diuretic?

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

Question 27

A client experiencing syncope is suspected of taking a losartan (Cozaar) overdose? Which intervention should the nurse anticipate?

A) Administer a calcium infusion
B) Administer a loop diuretic
C) Administer a vasopressor
D) Administer an intravenous solution of normal saline

Question 28

The nurse is preparing to discuss the use of primary hypertensive agents with a client. Which prescriptions should the nurse include? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

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

Question 29

Which prescription should the nurse be concerned about a pregnant client receiving?

A) Enalapril (Vasotec)
B) Potassium supplement
C) Doxazosin (Cardura)
D) Hydrochlorothiazide (HCTZ)

Question 30

Which physiological systems should the nurse recognize are most at risk for a client in a hypertensive crisis? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) Cardiac
B) Respiratory
C) Integumentary
D) Gastrointestinal
E) Renal