Question 1

The nurse would make it a priority to assess the client receiving losartan (Cozaar)for which of the following most common adverse drug effects?&#10;A) Constipation&#10;B) Fatigue and headache&#10;C) Urine discoloration&#10;D) Nonproductive cough&#10;

Accepted Answer

Losartan (Cozaar) is an angiotensin II receptor blocker (ARB) used primarily to treat high blood pressure and heart failure. The most common adverse effects associated with losartan include dizziness, fatigue, and headache, rather than constipation, urine discoloration, or a nonproductive cough, which are not typically associated with this medication.

Question 2

The nurse would contact the prescriber immediately if a client taking lisinopril (Prinivil)developed which of the following manifestations after taking a dose of the drug?&#10;A) Swelling of the face and throat&#10;B) Dry,hacking cough&#10;C) Pulse rate increase of 10 beats/min&#10;D) Blood pressure decline of 8 mm Hg&#10;

Accepted Answer

Swelling of the face and throat can indicate the onset of anaphylaxis, a severe and potentially life-threatening allergic reaction. The nurse should notify the prescriber immediately and take appropriate emergency measures. Dry cough, mild tachycardia, and modest blood pressure reduction are common side effects of lisinopril and do not require immediate intervention unless they are severe or persistent.

Question 3

Based on current evidence,the nurse anticipates that an African American client with hypertension would probably respond best to which combination of medications?&#10;A) Angiotensin-converting enzyme inhibitors and diuretics&#10;B) Diuretics and calcium antagonists&#10;C) Diuretics and $\beta$-blockers&#10;D) Angiotensin-converting enzyme inhibitors and $\beta$-blockers&#10;

Accepted Answer

African American clients with hypertension have been shown to respond better to the combination of diuretics and calcium antagonists. This combination is effective in lowering blood pressure in this population, possibly due to differences in the pathophysiology of hypertension among different racial groups.

Question 4

Client education about clonidine (Catapres)should include which of the following statements?&#10;A) &#34;Your blood pressure should be checked by a physician at least once a year.&#34;&#10;B) &#34;Make sure to take your last dose before bedtime to ensure continuous blood levels.&#34;&#10;C) &#34;You do not need to worry about excessive exercise or prolonged standing while taking clonidine.&#34;&#10;D) &#34;You may find that excessive drooling is a problem,so let your doctor know if this occurs.&#34;&#10;

Accepted Answer

Clonidine can cause drowsiness as a side effect, so taking the last dose before bedtime can help manage this effect and ensure stable blood levels throughout the day.

Question 5

When teaching a client about the drug atenolol (Tenormin)ordered as an antihypertensive,the nurse would inform the client that&#10;A) antihypertensive medications are taken with antacids.&#10;B) Alcohol intake is encouraged to enhance systemic vasodilation.&#10;C) long hot baths and hot tubs are advised to lower diastolic pressure.&#10;D) abrupt withdrawal from the drug is dangerous and may lead to higher pressures.&#10;

Accepted Answer

Abrupt withdrawal from atenolol can lead to rebound hypertension, so it is important for clients to gradually taper off the medication under the guidance of their healthcare provider. Antihypertensive medications are not taken with antacids, alcohol intake should be limited, and hot baths or hot tubs may actually increase blood pressure.

Question 6

Minoxidil (Loniten)should be given concurrently with a $\beta$-adrenergic blocking agent by the nurse as ordered to prevent&#10;A) edema.&#10;B) bradycardia.&#10;C) reflex tachycardia.&#10;D) severe hypertension.&#10;

Accepted Answer

Minoxidil is a potent vasodilator which can cause reflex tachycardia, therefore, it should be given with a beta-blocker to prevent this side effect. A beta-blocker will also help to prevent tachycardia-induced myocardial ischemia. Edema and bradycardia are not side effects of minoxidil, and severe hypertension is not prevented by giving minoxidil with a beta-blocker.

Question 7

The desired effects of diuretics in the reduction of blood pressure are caused by which of the following mechanisms?&#10;A) Vasoconstriction&#10;B) Increased serotonin levels and decreases cardiac workload&#10;C) Volume depletion&#10;D) Correction of an ineffective vasomotor response&#10;

Accepted Answer

Diuretics work by reducing the volume of fluid in the body, leading to a decrease in blood volume and subsequently a reduction in blood pressure. Option A is incorrect because diuretics do not cause vasoconstriction; rather, they can sometimes cause vasodilation. Option B is incorrect because diuretics do not directly affect serotonin levels, and while they may reduce cardiac workload, this is not the primary mechanism by which they reduce blood pressure. Option D is incorrect because diuretics do not correct an ineffective vasomotor response; rather, they may affect vasomotor tone indirectly by decreasing blood volume and reducing pressure on the blood vessels.

Question 8

The nurse would question an order for methyldopa (Aldomet)as an antihypertensive drug for a client with which of the following concurrent health problems?&#10;A) Gastric ulcer&#10;B) Cirrhosis of the liver&#10;C) Irritable bowel syndrome&#10;D) Migraine headaches&#10;

Accepted Answer

Methyldopa is metabolized in the liver and should be used with caution in clients with liver disease or cirrhosis. It may cause hepatotoxicity and worsen liver function.

Question 9

A client with hypertension will be started on a diuretic as first-line drug therapy after lifestyle changes have been ineffective.Which of the following types of diuretics does the nurse anticipate will be used?

A) A thiazide diuretic
B) A loop diuretic
C) A potassium-sparing diuretic
D) An osmotic diuretic

Accepted Answer

Thiazide diuretics, such as hydrochlorothiazide, are commonly used as first-line drug therapy for hypertension because they are effective and well-tolerated. Loop diuretics, potassium-sparing diuretics, and osmotic diuretics may be used in other clinical situations, but are not typically the first choice for hypertension.

Question 10

A nursing student who has an order to give a dose of clonidine (Catapres)to an assigned client asks the nurse about the medication.After referring the student to the drug handbook,the nurse could share that this drug is classified as

A) an angiotensin-converting enzyme inhibitor.
B) a

\beta

-blocker.
C) a centrally acting adrenergic inhibitor.
D) a peripheral adrenergic inhibitor.

Accepted Answer

Clonidine (Catapres) is classified as a centrally acting adrenergic inhibitor. It works by decreasing sympathetic nervous system activity, leading to a decrease in blood pressure and heart rate.

Question 11

A client beginning drug therapy with enalapril (Vasotec)indicates an understanding of drug therapy by stating that which of the following adverse effects may likely occur?&#10;A) Stuffy nose&#10;B) Nonproductive cough&#10;C) Buzzing sound in the ears&#10;D) Numbness and tingling of the fingers or toes&#10;

Accepted Answer

The answer of A client beginning drug therapy with enalapril...

Question 12

The nurse places highest priority on assessing the results of which of the following laboratory studies drawn on a client receiving losartan (Cozaar)?&#10;A) Serum sodium and blood urea nitrogen&#10;B) Serum potassium and creatinine&#10;C) Serum calcium and phosphorus&#10;D) Serum magnesium and uric acid&#10;

Accepted Answer

The answer of The nurse places highest priority on assessing...

Question 13

A client's blood pressure is elevated to 200/120 mm Hg,and a hypertensive emergency is obvious.He is transferred to the intensive care unit and started on a sodium nitroprusside drip (Nipride)to be titrated per orders and client response.With the administration of nitroprusside,the nurse anticipates seeing a decrease in blood pressure

A) immediately.
B) within 10 to 15 minutes.
C) within 3 to 4 doses.
D) after diuresis occurs.

Accepted Answer

The answer of A client's blood pressure is elevated to...

Question 14

The client who is receiving antihypertensive drug therapy is scheduled for elective surgery.What nursing action is the most appropriate for standard practice?&#10;A) Do not give the client any antihypertensive drug dose&#10;B) Give the client a double dose of the antihypertensive drug&#10;C) Give the drug up to the time of surgery and as soon as possible afterward&#10;D) Give the client the antihypertensive drug by the sublingual route&#10;

Accepted Answer

The answer of The client who is receiving antihypertensive drug...

Question 15

A client is taking amlodipine (Norvasc)for control of hypertension.The nurse would give the client which of the following instructions about its use?&#10;A) Take the dose with breakfast,preferably with grapefruit juice&#10;B) Take the dose with a source of protein&#10;C) Take the dose every other day,with a diuretic on the alternate days&#10;D) Take the dose on an empty stomach&#10;

Accepted Answer

The answer of A client is taking amlodipine (Norvasc)for control...

Question 16

Any elevation in blood pressure stretches the baroreceptors and leads to a subsequent&#10;A) sympathetic stimulation.&#10;B) increase in heart contractility.&#10;C) vasoconstriction of peripheral vessels.&#10;D) decrease in heart rate and cardiac output.&#10;

Accepted Answer

The answer of Any elevation in blood pressure stretches the...

Question 17

The nurse would question a new drug order for which of the following medications,which is contraindicated when a client is taking methyldopa (Aldomet)?&#10;A) Diuretics&#10;B) Monoamine oxidase inhibitors&#10;C) Angiotensin-converting enzyme inhibitors&#10;D) $\beta$-blockers

Accepted Answer

The answer of The nurse would question a new drug...

Question 18

Which one of the following is an appropriate nursing intervention for the client who is taking hydrochlorothiazide?&#10;A) Encourage intake of tomatoes and other foods rich in potassium&#10;B) Schedule the dose to be taken in the late afternoon&#10;C) Monitor serum calcium and sodium levels&#10;D) Take the radial pulse for 1 full minute before administering the drug&#10;

Accepted Answer

The answer of Which one of the following is an...

Question 19

One of the most powerful substances in the body that leads to vasoconstriction is&#10;A) epinephrine.&#10;B) dopamine.&#10;C) angiotensin II.&#10;D) serotonin.&#10;

Accepted Answer

The answer of One of the most powerful substances in...

Question 20

A client is beginning drug therapy with lisinopril (Prinivil).The nurse explains to the client that it which of the following laboratory tests must be drawn monthly for the first 3 to 6 months of therapy?

A) White blood cell count with differential
B) Platelet count
C) International normalized ratio
D) Partial thromboplastin time

Accepted Answer

The answer of A client is beginning drug therapy with...

Question 21

Which of the following calcium channel blockers does the nurse anticipate being used primarily for the treatment of cerebral arterial spasms after subarachnoid hemorrhage?&#10;A) Amlodipine (Norvasc)&#10;B) Diltiazem (Cardizem)&#10;C) Nimodipine (Nimotop)&#10;D) Verapamil (Calan)&#10;

Accepted Answer

The answer of Which of the following calcium channel blockers...

Question 22

The mechanism of action of diltiazem (Cardizem)that helps clients with Prinzmetal's angina includes which of the following?&#10;A) Increased conduction through the Purkinje fibers&#10;B) Decreased automaticity of the ventricular tissues&#10;C) Prevention of the influx of calcium ions in vascular smooth muscle&#10;D) Increased oxygen consumption within the myocardial tissue&#10;

Accepted Answer

The answer of The mechanism of action of diltiazem (Cardizem)that...

Question 23

The nurse would question an order for a calcium channel blocker in a client with which of the following health problems?&#10;A) Angina pectoris&#10;B) Subarachnoid hemorrhage&#10;C) Hypotension&#10;D) Dysrhythmia&#10;

Accepted Answer

The answer of The nurse would question an order for...

Question 24

Which of the following drugs should the nurse instruct a client to avoid while taking a calcium channel blocker?&#10;A) Furosemide (Lasix)&#10;B) Digoxin (Lanoxin)&#10;C) Acetaminophen (Tylenol)&#10;D) Ibuprofen (Motrin)&#10;

Accepted Answer

The answer of Which of the following drugs should the...

Question 25

A client is scheduled to receive a first dose of the antihypertensive drug prazosin (Minipress).The nurse provides which instruction to the client before administering the dose?&#10;A) &#34;A transient headache may occur,but it will pass quickly.&#34;&#10;B) &#34;Nausea and vomiting are common but can be helped by eating crackers.&#34;&#10;C) &#34;Do not get out of bed for the first 2 to 3 hours after the dose.&#34;&#10;D) &#34;Some people get a feeling of chills for a few hours after the first dose.&#34;&#10;

Accepted Answer

The answer of A client is scheduled to receive a...

Question 26

Which of the following nursing interventions is the most appropriate to consider when administering nifedipine?&#10;A) Withhold the dose if the pulse is greater than 100 beats/min&#10;B) Withhold the dose if the pulse is less than 80 beats/min&#10;C) Administer an oral dose if the client has an empty stomach&#10;D) Administer an oral dose after a meal&#10;

Accepted Answer

The answer of Which of the following nursing interventions is...

Deck 27: Antihypertensives