Deck 23: Drugs Used to Treat Hypertension

Question 1

Prior to the administration of a beta-adrenergic blocker, the nurse notes the patient to have a heart rate of 52 beats/min, peripheral edema, crackles in the bases of the lungs, and mottled skin. Which is the priority nursing action?

A) Administer the medication as ordered.
B) Reevaluate the patient in 20 minutes.
C) Obtain a serum blood level.
D) Withhold the medication and notify the health care provider.

Answer 1

Withhold the medication and notify the health care provider.

Question 2

Which common adverse effect of an angiotensin II receptor antagonist will the nurse expect to assess in a patient?

A) Bradycardia
B) Headache
C) Hypokalemia
D) Insomnia

Answer 2

Headache

Question 3

How does propranolol (Inderal) control hypertension?

A) Blocks alpha receptors throughout the body
B) Increases the diuretic response in the renal tubules
C) Reduces the sympathetic stimulation in cardiac muscle
D) Inhibits the conversion of angiotensin I to angiotensin II

Answer 3

Reduces the sympathetic stimulation in cardiac muscle

Question 4

Which is true about postural hypotension during therapy with direct vasodilators?

A) It indicates a therapeutic effect.
B) It gradually resolves with continued medication use.
C) It is a dose-limiting complication of drug therapy.
D) It is a precursor to hypertensive crisis.

Question 5

The nurse is explaining to a patient how ACE inhibitors affect blood pressure. Which statement accurately describes the action of these medications?

A) They increase aldosterone secretion.
B) They inhibit vasoconstriction.
C) They lower heart rate.
D) They promote sodium retention.

Question 6

When displayed by the patient, which symptom would be most indicative to the nurse to withhold a recently prescribed beta-adrenergic blocker?

A) Dizziness
B) Peripheral edema
C) Hyperglycemia
D) Wheezing

Question 7

Which physiological response will the nurse expect to assess in patients taking hydralazine (Apresoline)?

A) Pale skin
B) Tachycardia
C) Increased urinary output
D) Cool extremities

Question 8

Which medication lowers blood pressure by directly inhibiting renin?

A) Aliskiren (Tekturna)
B) Eplerenone (Inspra)
C) Diltiazem (Cardizem)
D) Reserpine

Question 9

The nurse instructs the patient to avoid the sudden discontinuation of beta-adrenergic blockers so as to avoid which symptom?

A) Postural hypotension
B) Edema
C) Increased angina
D) Confusion

Question 10

Which nursing assessment confirms that the angiotensin II receptor blocker (ARB) that a patient is taking is effective?

A) Weight loss of more than 2 pounds/week
B) LDL-cholesterol levels have decreased.
C) Urinary output is increased.
D) Blood pressure has decreased.

Question 11

A patient who has just begun taking an angiotensin-converting enzyme (ACE) inhibitor calls the nurse and reports feeling very dizzy when standing up, and asks if the medication should be discontinued. What is the nurse's best response?

A) "Stop taking the medication immediately."
B) "Rise to a sitting or standing position slowly; your symptoms will resolve."
C) "I will schedule you to visit the health care provider today."
D) "Cut the pill in half and take a reduced dosage."

Question 12

The nurse has provided information to a patient with diabetes who has been prescribed a beta-adrenergic blocker. Which statement by the patient indicates a need for further teaching?

A) "If I get dizzy, I will stop taking the medication."
B) "I may not have my usual symptoms of low blood sugars."
C) "My dosage may need adjustment if I start taking any NSAIDs."
D) "I will need to be evaluated in a few weeks to see if my dosage is effective."

Question 13

The nurse is providing instruction to a patient who was recently prescribed an ACE inhibitor for hypertension. Which is an adverse effect of this medication?

A) Constipation
B) Chronic cough
C) Hypokalemia
D) Nervousness

Question 14

A patient recently prescribed felodipine (Plendil) for treatment of hypertension is experiencing dizziness when rising to a standing position. Which action will the nurse take?

A) Encourage the patient to sit down if feeling faint.
B) Advise the patient to increase dietary sodium.
C) Inform the patient to discontinue the medication.
D) Instruct the patient to monitor weight daily.

Question 15

Which class of antihypertensive agents should be avoided by patients with asthma?

A) ACE inhibitors
B) Diuretics
C) Aldosterone receptor antagonists
D) Beta-adrenergic blocking agents

Question 16

Which medication is often administered with hydralazine to reduce reflex physiological responses to the drug?

A) Beta blockers
B) Renin inhibitor
C) ACE inhibitor
D) Angiotensin II receptor blocker

Question 17

Which agents are preferred for the initial treatment of hypertension?

A) ACE inhibitors and angiotensin receptor antagonists
B) Calcium-ion agonists and central-acting alpha agonists
C) Thiazide diuretics and beta adrenergic blockers
D) Direct vasodilators and peripherally acting adrenergic antagonists

Question 18

A patient asks the nurse how amlodipine (Norvasc) works to reduce the blood pressure. Which response will the nurse provide?

A) "It causes blood vessel dilation."
B) "It helps you get rid of fluid."
C) "It helps your heart beat stronger."
D) "It slows your heart rate."

Question 19

Hydralazine, a direct vasodilator, is used to treat hypertension associated with which condition?

A) Stroke
B) Diabetes mellitus
C) Myocardial infarction
D) Renal disease

Question 20

What is mean arterial pressure (MAP)?

A) The difference between the systolic and diastolic pressures
B) An indicator of the tone of the arterial blood vessel walls
C) The average pressure throughout each cycle of the heartbeat
D) The product of the cardiac output and the peripheral vascular resistance

Question 21

The nurse is finished conducting nutritional education with a patient about the DASH (dietary approaches to stop hypertension) diet. The patient would like to complete the breakfast menu for tomorrow. Which foods offered for breakfast would be most appropriate for the patient to choose? (Select all that apply.)

A) Grapefruit
B) Bacon
C) Whole milk
D) Orange juice
E) Eggs
F) Oatmeal

Question 22

Which statements about diuretics are true? (Select all that apply.)

A) A mechanism of action for the antihypertensive effects of diuretics includes volume depletion.
B) They have been shown to reduce cardiovascular morbidity associated with hypertension.
C) Thiazide diuretics are effective only if renal creatinine clearance is less than 30 mL/min.
D) Diuretics are sodium-sparing.
E) Electrolytes must be evaluated periodically for patients on loop diuretics.

Question 23

Which complications are associated with uncontrolled hypertension? (Select all that apply.)

A) Angina
B) Stroke
C) Hyperglycemia
D) Renal failure
E) Heart failure

Question 24

Which statements are true concerning the use of antihypertensive therapy for the treatment of hypertension? (Select all that apply.)

A) Diuretics are the most commonly prescribed antihypertensive agent.
B) Diuretics are not used for older adult patients.
C) Diuretics are the most expensive of the antihypertensive agents.
D) Diuretics are often prescribed in combination therapy with other antihypertensive agents.
E) Loop diuretics are considered potassium sparing.