Cuyahoga Community College - NURSING 1300 Chapter 39: Antihypertensives McCuistion: Pharmacology: A Patient-Centered Nursing Process Approach, 9th Edition MULTIPLE CHOICE 1)A patient is diagnosed with borderline hypertension and states a desire to make lifestyle changes to avoid needing to take medication

Cuyahoga Community College - NURSING 1300

Chapter 39: Antihypertensives

McCuistion: Pharmacology: A Patient-Centered Nursing Process Approach, 9th Edition

MULTIPLE CHOICE

1)A patient is diagnosed with borderline hypertension and states a desire to make lifestyle changes to avoid needing to take medication. The nurse will recommend which changes?

1. 1. Changing from weight bearing exercise to yoga
   2. Decreased fluid intake and increased potassium intake
   3. Stress reduction and increased protein intake
   4. Weight reduction and decreased sodium intake
2. A patient has a blood pressure of 135/85 mm Hg on three separate occasions. The nurse understands that this patient should be treated with
   1. a beta blocker.
   2. a diuretic and a beta blocker.
   3. a diureti
   4. lifestyle changes.
3. A 65-year-old patient has a blood pressure of 155/95 mm Hg. The nurse understands that with treatment, the goal for this patient’s blood pressure is
   1. 120/80  mm Hg
   2. 130/89  mm Hg
   3. 140/90  mm Hg
   4. 150/90  mm Hg
4. The nurse is caring for an African-American patient who has been taking a beta blocker to treat hypertension for several weeks with only slight improvement in blood pressure. The nurse will contact the provider to discuss

1. adding a diuretic medication.
2. changing to an angiotensin-converting enzyme (ACE) inhibitor.
3. decreasing the beta blocker dose.
4. doubling the beta blocker dose.

5. The nurse understands that the dose of a medication such as propranolol may need to be changed for the patient of Asian descent. The nurse expects the provider to
   1. increase the daily dose.
   2. decrease the frequency of the medication to every other day.
   3. decrease the daily dose.
   4. add a second antihypertensive medication.
6. The nurse is preparing to care for a Native American patient who has hypertension. The nurse understands that which antihypertensive medication would be most effective in this patient?
   1. Acebutolol (Sectral)
   2. Captopril (Capoten)
   3. Carteolol HCl (Cartrol)
   4. Metoprolol (Lopressor)
7. The nurse is caring for an 80-year-old patient who has just begun taking a thiazide diuretic to treat hypertension. What is an important aspect of care for this patient?
   1. Encouraging increased fluid intake
   2. Increasing activity and exercise
   3. Initiating a fall risk protocol
   4. Providing a low potassium diet
8. The nurse is performing an assessment on a patient who will begin taking propranolol (Inderal) to treat hypertension. The nurse learns that the patient has a history of asthma and diabetes. The nurse will take which action?
   1. Administer the medication and monitor the patient’s serum glucose.
   2. Contact the provider to discuss another type antihypertensive medication.
   3. Request an order for renal function tests prior to administering this drug.
   4. Teach the patient about the risks of combining herbal medications with this drug.
9. The nurse is admitting a patient who has been taking minoxidil (Loniten) to treat hypertension. Prior to beginning therapy with this medication, the patient had a blood pressure of 170/95 mm Hg and a heart rate of 72 beats per minute. The nurse assesses the patient and notes a blood pressure of 130/72 mm Hg and a heart rate of 78 beats per minute, and also notes a 2.2-kg weight gain since the previous hospitalization and edema of the hands and feet. The nurse will contact the provider to discuss which intervention?
   1. Adding hydrochlorothiazide to help increase urine output
   2. Adding metoprolol (Lopressor) to help decrease the heart rate
   3. Increasing the dose of minoxidil to lower the blood pressure
   4. Restricting fluids to help with weight reduction
10. The nurse is teaching a patient who has hypertension about long-term management of the disease and a beta blocker. The patient reports typically consuming 1 to 2 glasses of wine each evening with meals. How will the nurse respond?
    1. “Beta blockers and wine cause a reflex hypertension.”
    2. “Four to 6 ounces of wine is considered safe with these medications.”
    3. “Wine in moderation helps you relax and get better blood pressure control.”
    4. “Wine increases the hypotensive effects of the beta blocker.”
11. A patient who has recently begun taking captopril (Capoten) to treat hypertension calls a clinic to report a persistent cough. The nurse will perform which action?
    1. Instruct the patient to go to an emergency department because this is a hypersensitivity reaction.
    2. Reassure the patient that this side effect is nothing to worry about and will diminish over time.
    3. Schedule an appointment with the provider to discuss changing to an angiotensin II receptor blocker (ARB).
    4. Tell the patient to stop taking the drug immediately since this is a serious side effect of this drug.
12. The nurse is preparing to administer an ACE inhibitor to a patient who has hypertension. The nurse notes peripheral edema and swelling of the patient’s lips. The patient has a blood pressure of 160/80 mm Hg and a heart rate of 76 beats per minute. What is the nurse’s next action?
    1. Administer the dose and observe carefully for hypotension.
    2. Hold the dose and notify the provider of a hypersensitivity reaction.
    3. Notify the provider and request an order for a diuretic medication.
    4. Request an order for serum electrolytes and renal function tests.
13. The nurse is caring for a patient who will begin taking captopril (Capoten) for hypertension. The nurse reviews the patient’s laboratory test results and notes increased BUN and creatinine. Which action will the nurse take?
    1. Administer the captopril and monitor vital signs.
    2. Contact the provider to discuss changing to fosinopril (Monopril).
    3. Obtain an order for intravenous fluids to improve urine output.
    4. Request an order to add hydrochlorothiazide (HydroDIURIL).
14. The nurse is caring for a patient who experiences a rapid rise in blood pressure. The nurse will contact the provider to discuss administering which medication?
    1. Amlodipine (Norvasc)
    2. Nifedipine (Procardia)
    3. Nifedipine extended release (Procardia XL)
    4. Verapamil (Calan)
15. The nurse is caring for a 70-year-old patient who has recently begun taking amlodipine (Norvasc) 5 mg/day to control hypertension. The nurse notes mild edema of the patient’s ankles, a blood pressure of 130/70 mm Hg, and a heart rate of 80 beats per minute. The patient reports flushing and dizziness. The nurse will notify the provider and
    1. 1. 1. ask to decrease the dose to 2.5 mg/day.
          2. discuss twice daily dosing.
          3. request an order for a diureti
          4. suggest adding propranolol to the regimen.

MULTIPLE RESPONSE

1.   The nurse teaches a patient about antihypertensive medication. Which statements by the patient indicate understanding of the teaching? 

1. 1. 1. 1. “I should be careful when I stand up from a chair.”
         2. “I should not add extra salt to my foods.”
         3. “If I have side effects, I should stop taking the drug immediately.”
         4. “If my blood pressure returns to normal, I can stop taking this drug.”
         5. “I may need to take a combination of drugs, including diuretics.”
         6. “I will not need to make lifestyle changes since I am taking a medication.”

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