Question 1

An 87-year-old patient is taking furosemide (Lasix)for elevated blood pressure.The nurse knows that older patients are at risk for:

Accepted Answer

Older adults are at greater risk for side effects,especially hypokalemia.

Question 2

A patient is taking hydrochlorothiazide (HydroDIURIL)for hypertension.Dietary teaching would include increasing intake of:

Accepted Answer

Diuretics reduce fluid volume and can cause hypokalemia.Encourage foods high in potassium,such as bananas and orange juice.

Question 3

The nurse understands that when a patient who is taking antihypertensive therapy complains of fatigue and has a pulse of 54 bpm,this side effect is most likely caused by:

Accepted Answer

Calcium channel blockers such as diltiazem and verapamil can cause bradycardia because conduction is slowed in the heart.These drugs also reduce stroke volume and cardiac output,which may result in fatigue.

Question 4

The nurse should instruct the patient who has been started on verapamil (Calan)for his elevated blood pressure to monitor his:

Accepted Answer

Verapamil (Calan)is a calcium channel blocker and most often causes bradycardia.

Question 5

The nurse explains that hypertension in older adults is:

Accepted Answer

Older adults with hypertension have good results with aggressive therapy,although the age-related changes cannot be avoided.

Question 6

The nurse emphasizes that the lifestyle change that has the greatest effect on reducing hypertension is:

Accepted Answer

Weight reduction has the greatest effect on reducing hypertension.

Question 7

An 89-year-old patient is taking an antihypertensive medication.Home care teaching by the nurse would include instructing the patient to:

Accepted Answer

Patients taking antihypertensive medications should get up slowly to prevent falling.They should avoid hot baths because they promote vasodilatation,and never stop the drug abruptly.Sexual dysfunction is a possible side effect,but it does not have to be reported immediately.

Question 8

A patient is prescribed an angiotensin-converting enzyme (ACE)inhibitor,enalapril (Vasotec).The nurse instructs the patient to:

Accepted Answer

ACE inhibitors can cause neutropenia or other blood dyscrasias,and follow-up with blood assessments should be periodically performed.

Question 9

The nurse questions the patient with hypertension about the symptoms of headache because hypertension headaches characteristically occur as:

Accepted Answer

Hypertension occipital headaches occur on awakening.

Question 10

The nurse points out the Dietary Approaches to Stop Hypertension (DASH)diet uses as its source of protein and fat which one of the following?

Accepted Answer

The DASH diet uses whole grains as a source of protein and fat.

Question 11

The patient who is being evaluated every week for possible hypertension is classified as prehypertensive when the blood pressure readings are over:

Accepted Answer

Prehypertension is diagnosed after two readings of over 120/80 mm Hg.The readings of 135/85 mm Hg for 2 months is longer than the diagnostic criteria require.Blood pressures consistently over 140/90 mm Hg are classified as hypertension.

Question 12

The nurse reminds a patient that to be diagnosed with hypertension,the blood pressure is evaluated to confirm consistent blood pressure readings over:

Accepted Answer

The official diagnosis of hypertension is dependent on a period of observation during which the BP is consistently higher than 140/90 mm Hg.

Question 13

An obese 38-year-old African-American patient with diabetes is being evaluated for the use of propranolol (Inderal)in controlling his hypertension.The nurse points out that a contraindication for that drug's use in this patient would be his:

Accepted Answer

Hypoglycemia can occur with this medication and places those with diabetes at high risk for adverse effects.

Question 14

In a teaching plan for a patient with hypertension,the nurse would include:

Accepted Answer

Patients with hypertension should never stop medications without discussing it with their physician.A diet low in saturated and unsaturated fat should be followed.Visits to monitor blood pressure should continue because hypertension is often asymptomatic.Stress can aggravate hypertension; stress management or relaxation strategies should be implemented.

Question 15

The nurse is aware that patients who have chronic obstructive pulmonary disease (COPD)and asthma are not candidates for treatment with the antihypertensive drug:

Accepted Answer

Beta-blocking adrenergic agents block stimulation of catecholamine receptors and cause bronchoconstriction.

Question 16

A patient inquires if his blood pressure is normal.The nurse responds that normal blood pressure is defined as less than:

Accepted Answer

Normal blood pressure is defined as a systolic pressure of less than 120 mm Hg and a diastolic pressure of less than 80 mm Hg.

Question 17

The nurse explains that treatment of secondary hypertension focuses on a:

Accepted Answer

Secondary hypertension has an identifiable cause.Treating the cause is the focus of care for secondary hypertension.

Question 18

The nurse includes in a teaching plan on hypertension that treatment for essential hypertension is focused on:

Accepted Answer

The therapeutic approach to essential hypertension is a nonpharmacologic treatment.The treatment plan is to identify and reduce the modifiable risks,which include weight loss,dietary changes,and increased exercise,for example.

Question 19

To use less sodium in the diet,the nurse recommends the use of spices and:

Accepted Answer

Spices,garlic,and onions are good substitutes for sodium as flavorings.Catsup,soy sauce,and cheese all have large amounts of sodium.

Question 20

An obese African-American man who smokes would have a hypertension staging of grade:

Accepted Answer

Criteria for Grade B are that the patient has more than one risk factor (African American,obese,smoker),with no target organ damage and no clinical cardiovascular problems.Criteria for Grade A indicate that no risks have been assessed,and the criteria for Grade C includes target organ damage and clinical cardiovascular disease or diabetes mellitus.

Quiz 37: Hypertension

An 87-year-old patient is taking furosemide (Lasix) for elevated blood pressure.The nurse knows that older patients are at risk for:

A patient is taking hydrochlorothiazide (HydroDIURIL) for hypertension.Dietary teaching would include increasing intake of: