Deck 25: Drugs for Hypertension

Question 1

The patient receives hydrochlorothiazide (HydroDIURIL).He tells the nurse he is urinating a lot and s how this drug affects his blood pressure.What is the best response by the nurse?
1)"Hydrochlorothiazide (HydroDIURIL)enhances kidney function causing you to urinate more and that decreases your blood pressure."
2)"Hydrochlorothiazide (HydroDIURIL)decreases the fluid in your bloodstream and this lowers your blood pressure."
3)"Hydrochlorothiazide (HydroDIURIL)dilates your blood vessels so you urinate more and your blood pressure decreases."
4)"Hydrochlorothiazide (HydroDIURIL)increases your heart rate;this pumps blood faster to your kidneys so you urinate more and your blood pressure decreases."

Answer 1

2

Question 2

The nurse completed medication education with the patient who receives hydrochlorothiazide (HydroDIURIL).The nurse determines that teaching has been effective when the patient makes which statement?
1)"I really need to avoid grapefruit juice when I take this medication."
2)"I need to avoid salt substitutes and potassium-rich foods."
3)"I take my medication early in the morning."
4)"If I develop a cough,I should call my doctor."

Answer 2

3

Question 3

The nurse is taking the initial history of a patient admitted to the hospital for hypertension.The physician has ordered a beta-adrenergic blocker.Which statement by the patient does the nurse recognize as most significant?
1)"I don't handle stress well;I have a lot of diarrhea."
2)"When I have a migraine headache,I need to have the room darkened."
3)"My father died of a heart attack when he was 48-years-old."
4)"I have always had problems with my asthma."

Answer 3

4

Question 4

Diuretics are often used to lower blood pressure.Which factor do they affect most?
1)Cardiac output
2)Blood volume
3)Heart rate
4)Peripheral vascular resistance

Question 5

The patient comes to the emergency department with a blood pressure of 200/120 mmHg.The physician orders hydralazine (Apresoline)IV.What will the nurse's priority assessment include?
1)Hypotension and bradycardia
2)Hypotension and hyperthermia
3)Hypotension and tachycardia
4)Hypotension and tachypnea

Question 6

The patient has been recently diagnosed with hypertension.Assessment data includes Wt: 200 pounds
Ht: 5' 4"
Diet: Mostly starches
Alcohol intake: 3 beers/week
Stressors: Works 60 hours/week
In planning care with this patient,what is the priority outcome?
1)Patient will eliminate alcohol from the diet.
2)Patient will decrease stress by limiting work to 40 hours/week.
3)Patient will balance diet according to the food pyramid.
4)Patient will achieve and maintain optimum weight.

Question 7

Which statement is accurate in regard to secondary hypertension?
1)There is no known cause.
2)It can result from chronic renal impairment.
3)It is also known as idiopathic.
4)It accounts for 90% of all hypertensive cases.

Question 8

The patient is receiving doxazosin (Cardura)for hypertension.He asks the nurse how the medication works.What is the nurse's best response?
1)"It works by causing your kidneys to excrete more urine."
2)"It works by making your heart work more efficiently."
3)"It works by making your blood vessels expand."
4)"It works by decreasing the release of your stress hormones."

Question 9

Which of the following lists include the three factors that make up blood pressure?
1)Blood volume,heart rate,and stroke volume
2)Cardiac output,blood volume,and peripheral vascular resistance
3)Age,weight,and race
4)Body mass index,diet,and genetics

Question 10

The patient has a blood pressure reading of 126/84 mmHg.She asks the nurse if she has high blood pressure.What is the best response by the nurse?
1)"You have prehypertension,but it isn't really serious."
2)"You have prehypertension;let's discuss your lifestyle."
3)"You have prehypertension;unfortunately,this will progress to hypertension."
4)"You have prehypertension,and must begin medication."

Question 11

The patient with hypertension is receiving nefedipine (Procardia XL).The nurse determines that the patient needs additional medication education when the patient selects which menu for breakfast?
1)Whole-wheat pancakes with syrup,and bacon,oatmeal,and orange juice
2)Eggs,whole-wheat toast with butter,Lucky Charms cereal,milk,and grapefruit juice
3)Eggs and sausage,a biscuit with margarine,coffee with cream,and cranberry juice
4)Egg and cheese omelet,tea with sugar and lemon,hash brown potatoes,and prune juice

Question 12

What is a priority nursing intervention for a patient who has just begun antihypertensive treatment with enalapril (Vasotec)?
1)Monitor the patient for headaches.
2)Take the patient's blood pressure.
3)Order a sodium-restricted diet for the patient.
4)Review the patient's lab results for hypokalemia.

Question 13

According to the JNC-7,a patient with a blood pressure of 144/82 would be classified as
1)prehypertensive.
2)stage 2 hypertensive.
3)normal.
4)stage 1 hypertensive.

Question 14

The patient has been recently diagnosed with hypertension with a sustained blood pressure of 144/90 mmHg.The patient is concerned about effects on the body.What effects of hypertension on the body will the nurse include in her education of this patient? Credit will be given only if all correct choices and no incorrect choices are selected.
1)Kidney damage
2)Stroke
3)Liver failure
4)Heart failure
5)Blindness

Question 15

The patient with hypertension has experienced heart failure.The nurse notes that the patient is receiving nefedipine (Procardia).What is a priority assessment for the nurse?
1)Review recent lab results for hypokalemia.
2)Assess urinary output.
3)Assess level of orientation.
4)Auscultate breath sounds for crackles.

Question 16

Changes in which of the following would be sensed by baroreceptors and relayed to the vasomotor center?
1)Oxygenation
2)Blood pressure
3)Carbon dioxide
4)Blood pH

Question 17

The nurse is teaching the patient about lifestyle modifications to help manage the patient's hypertension.The nurse determines that teaching has been effective when the patient makes which statement?
1)"I need to get started on my medications right away."
2)"My father had hypertension,did nothing,and lived to be 90-years-old."
3)"I know I need to give up my cigarettes and alcohol."
4)"I won't be able to run in the marathon race anymore."

Question 18

The nurse is conducting the initial group education session for patients who have hypertension.What is the most important information to include? Credit will be given only if all correct choices and no incorrect choices are selected.
1)Blood pressures tend to decrease as people age,due to decreased blood volume.
2)The aorta has sensors that help regulate blood pressure.
3)Anger can result in hypertension.
4)The vasomotor center,located in the limbic system of the brain,helps regulate blood pressure.
5)Hypertension is diagnosed when the blood pressure is greater than 145/95 mmHg.

Question 19

Which of the following interventions would be indicated and take highest priority for a smoking 30-year-old female with a BMI of 20 and a blood pressure of 137/88?
1)Smoking-cessation program
2)Diuretic therapy
3)Weight-loss program
4)Stress management

Question 20

The patient has a nighttime cough related to taking enalapril (Vasotec).What is the best nursing intervention to promote rest in this patient?
1)Have the patient sit up at an 80-degree angle in a comfortable chair at night.
2)Contact the physician for an order for a cough-suppressant medication.
3)Have the patient sleep on two or three pillows at night.
4)Contact the physician for an order for a sedative-hypnotic medication.

Question 21

The nurse is educating a patient who has been diagnosed with hypertension and explains that the criteria that will be used to determine medication management include the patient's Credit will be given only if all correct choices and no incorrect choices are selected.
1)risk factors.
2)comorbid medical conditions.
3)age.
4)degree of blood pressure elevation.
5)occupational status.

Question 22

Which laboratory test would be the priority for a hypertensive patient taking a thiazide diuretic?
1)Magnesium
2)Calcium
3)Chloride
4)Potassium

Question 23

A patient is newly diagnosed with hypertension and diabetes.Which classes of drugs are likely to be prescribed? Credit will be given only if all correct choices and no incorrect choices are selected.
1)ACE inhibitors
2)Beta blockers
3)Thiazide diuretics
4)Calcium channel blockers
5)Angiotensin receptor blockers (ARBs)

Question 24

The nurse is caring for an African American male who has just been diagnosed with hypertension.The nurse anticipates that this patient will be started on which medications? Credit will be given only if all correct choices and no incorrect choices are selected.
1)A thiazide diuretic
2)A calcium channel blocker
3)An ACE inhibitor
4)A beta-adrenergic antagonist
5)An angiotensin-II receptor blocker

Question 25

The nurse is caring for a patient recently diagnosed with hypertension.The patient asks what medications may be used to treat the condition.The nurse begins by discussing the primary antihypertensive agents,which include Credit will be given only if all correct choices and no incorrect choices are selected.
1)diuretics.
2)angiotensin-II receptor blockers (ARBs).
3)beta-adrenergic antagonists.
4)direct-acting vasodilators.
5)peripheral adrenergic antagonists.

Question 26

A hypertensive female patient being treated with which of the following would be of primary concern if she became pregnant?
1)Enalapril (Vasotec)
2)Potassium supplement
3)Doxazosin (Cardura)
4)Hydrochlorothiazide (HCTZ)

Question 27

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? Credit will be given only if all correct choices and no incorrect choices are selected.
1)Increasing intake of wine
2)Restricting salt intake
3)Increasing intake of red meat
4)Increasing activity
5)Stopping smoking