Antihypertensives and Cardiovascular Medications > Pharmacology
Exam Review
Medications for hypertension management
Total Questions : 8
Showing 8 questions, Sign in for moreA nurse is teaching a middle-age client about hypertension. Which of the following information should the nurse include in the teaching?
Explanation
Diuretics are drugs that increase urine output and reduce fluid volume in the body. They lower blood pressure by decreasing the amount of sodium and water in the blood vessels, which reduces the pressure on the walls of the arteries. Diuretics are often the first-line therapy for hypertension, especially for older adults and African Americans.
Choice A is wrong because reaching the goal blood pressure depends on many factors, such as the severity of hypertension, the response to medication, and the lifestyle changes of the client. It may take longer than 2 months to achieve optimal blood pressure control.
Choice C is wrong because limiting alcohol consumption to three drinks a day is not enough to prevent or treat hypertension. Alcohol can raise blood pressure by interfering with the effects of medication, stimulating the nervous system, and increasing fluid retention. The recommended limit for alcohol intake is no more than one drink a day for women and two drinks a day for men.
Choice D is wrong because hypertension cannot be cured with medication. Hypertension is a chronic condition that requires lifelong management and monitoring. Medication can help lower blood pressure, but it does not address the underlying causes of hypertension, such as genetics, obesity, stress, or kidney disease. Lifestyle modifications, such as diet, exercise, weight loss, and smoking cessation, are also essential for preventing complications and improving quality of life.
Normal ranges for blood pressure are:
• Systolic: less than 120 mm Hg
• Diastolic: less than 80 mm Hg
Hypertension is defined as:
• Systolic: 130 mm Hg or higher
• Diastolic: 80 mm Hg or higher
A nurse is screening a male client for hypertension. The nurse should identify that which of the following actions by the client increase his risk for hypertension? (Select all that apply.)
Explanation
Drinking 36 oz beer daily and eating a diet high in sodium are actions that increase the risk for hypertension.
Here is why:
• Drinking too much alcohol can raise blood pressure and also damage the liver, brain, and heart.The American Heart Association recommends limiting alcohol intake to no more than one drink per day for women and two drinks per day for men.
• Eating a diet high in sodium can cause the body to retain fluid, which increases blood pressure.The American Heart Association recommends limiting sodium intake to no more than 2,300 mg per day, and ideally no more than 1,500 mg per day.
Choice A, B, and C are wrong because:
• Drinking 8 oz nonfat milk daily is not a risk factor for hypertension.In fact, dairy products may help lower blood pressure by providing calcium, potassium, and protein.
• Eating popcorn at the movie theater is not a risk factor for hypertension, unless the popcorn is heavily salted or buttered.Popcorn is a whole grain that can provide fiber and antioxidants.
• Walking 1 mile daily at 12 min/mile pace is not a risk factor for hypertension.On the contrary, physical activity can help lower blood pressure by strengthening the heart and blood vessels.
Normal blood pressure range is less than 120/80 mm Hg (millimeters of mercury).
Elevated blood pressure range is 120-129/less than 80 mm Hg.
Hypertension stage 1 range is 130-139/80-89 mm Hg.
Hypertension stage 2 range is 140 or higher/90 or higher mm Hg.Hypertensive crisis range is higher than 180/higher than 120 mm Hg.
A nurse is screening a male client for hypertension. The nurse should identify that which of the following actions by the client increase his risk for hypertension? (Select all that apply.)
Explanation
Captopril is a medication used to treat high blood pressure, heart failure, and kidney problems. It belongs to a class of drugs called angiotensin-converting enzyme (ACE) inhibitors, which work by relaxing blood vessels and lowering blood pressure. One of the common side effects of captopril is a dry cough, which may be caused by the accumulation of a substance called bradykinin in the lungs. A persistent cough may indicate that the medication is not well tolerated and may need to be changed.Therefore, the client should report any signs of a cough to their health care provider.
Choice A is wrong because captopril should be taken on an empty stomach, at least one hour before or two hours after meals.Food may decrease the absorption and effectiveness of captopril.
Choice B is wrong because captopril should not be stopped abruptly, even if the blood pressure becomes normal. Stopping captopril suddenly may cause a rebound increase in blood pressure and worsen the condition.Captopril should be taken regularly as prescribed, and only discontinued under the guidance of a health care provider.
Choice D is wrong because captopril should not be taken only when the client has symptoms of high blood pressure. High blood pressure is often asymptomatic, meaning that it does not cause any noticeable signs or symptoms. However, high blood pressure can damage the heart, kidneys, brain, and other organs over time.Therefore, captopril should be taken daily as a preventive measure to lower the risk of complications from high blood pressure.
Normal blood pressure range is less than 120/80 mm Hg (millimeters of mercury).
Elevated blood pressure range is 120-129/less than 80 mm Hg.
Stage 1 high blood pressure range is 130-139/80-89 mm Hg.
Stage 2 high blood pressure range is 140 or higher/90 or higher mm Hg.Hypertensive crisis range is 180 or higher/120 or higher mm Hg.
A client with hypertension is prescribed hydrochlorothiazide (HCTZ). Which of the following statements by the client indicates an understanding of the medication?
Explanation
All of the statements by the client indicate alack of understandingof the medication.
Here is why:
Choice A is wrong because hydrochlorothiazide (HCTZ) is a diuretic (water pill) that increases the amount of urine produced and excreted by the kidneys. Taking this medication at bedtime may cause frequent urination at night and disrupt the sleep cycle.It is recommended to take HCTZ in the morning or early afternoon.
Choice B is wrong because HCTZ is prescribed to treat high blood pressure (hypertension), which is a chronic condition that requires long-term management. Stopping the medication abruptly may cause a rebound increase in blood pressure and increase the risk of complications such as stroke, heart attack, or kidney failure.The client should continue taking HCTZ as directed by the doctor, even if the blood pressure becomes normal.
Choice C is wrong because a persistent cough is not a common side effect of HCTZ. A cough may be a sign of an allergic reaction, a respiratory infection, or another condition that needs medical attention. HCTZ may cause other side effects such as nausea, dizziness, headache, low blood pressure, low potassium levels, high calcium levels, or skin rash.The client should report any unusual or bothersome symptoms to the doctor.
Choice D is wrong because HCTZ is not a medication that can be taken as needed for symptoms of high blood pressure. High blood pressure often has no symptoms and can damage the blood vessels and organs over time. HCTZ works by reducing the fluid volume and pressure in the blood vessels.It needs to be taken regularly and consistently to maintain its effectiveness and prevent fluctuations in blood pressure. The client should be educated about the purpose, benefits, risks, and instructions of taking HCTZ. The client should also be advised to monitor their blood pressure, weight, fluid intake and output, and electrolyte levels while on this medication.The client should also be counseled about lifestyle modifications such as diet, exercise, stress management, and smoking cessation that can help lower blood pressure and improve overall health.
A nurse is caring for a client who is receiving nitroprusside for hypertensive crisis. Which of the following findings should indicate to the nurse that the client is experiencing an adverse effect of this medication?
Explanation
Nitroprusside is a vasodilator that lowers blood pressure by dilating blood vessels.It is used to treat hypertensive crisis, which is a life-threatening condition of very high blood pressure.However, nitroprusside can cause excessive hypotension, which is a serious side effect that can lead to irreversible ischemic injuries or death. Therefore, the nurse should monitor the client’s blood pressure continuously and adjust the infusion rate accordingly.
Choice B is wrong because Bradycardia is wrong because nitroprusside does not affect the heart rate directly.However, bradycardia can occur as a reflex response to hypotension, which is a possible adverse effect of nitroprusside. Therefore, the nurse should also monitor the client’s heart rate and rhythm.
Choice C is wrong because Tachycardia is wrong because nitroprusside does not cause tachycardia directly.However, tachycardia can occur as a compensatory mechanism to hypotension, which is a possible adverse effect of nitroprusside. Therefore, the nurse should also monitor the client’s heart rate and rhythm.
Choice D is wrong because Hypertension is wrong because nitroprusside is used to lower blood pressure, not to raise it.However, hypertension can occur if the infusion is stopped abruptly, which can cause rebound vasoconstriction and increased blood pressure. Therefore, the nurse should taper off the infusion gradually and avoid sudden discontinuation.
Normal ranges for blood pressure are systolic less than 120 mmHg and diastolic less than 80 mmHg.
Normal ranges for heart rate are 60 to 100 beats per minute.
A nurse is teaching a client who has stable angina about the use of sublingual nitroglycerin. Which of the following statements by the client indicates a need for further teaching?
Explanation
This statement indicates a need for further teaching because sublingual nitroglycerin tablets should not be swallowed, but dissolved under the tongue for rapid absorption and onset of action. Swallowing the tablet would reduce its effectiveness and delay its action.
Choice A is wrong because nitroglycerin tablets should be kept in a dark, glass bottle to protect them from light, heat, and moisture, which can degrade the drug.The bottle should be tightly closed and labeled with the date of opening.
Choice B is wrong because nitroglycerin tablets can be taken every 5 minutes for up to three doses if chest pain persists.If the pain is not relieved after three doses, the client should call 911 or seek emergency medical attention.
Choice D is wrong because nitroglycerin tablets have a short shelf life and should be replaced every 6 months or as indicated by the manufacturer.The client should check the expiration date and discard any unused tablets after 6 months.
A nurse is administering aspirin to a client who has angina and is at risk for myocardial infarction. Which of the following statements by the nurse explains the rationale for this medication?
Explanation
Aspirin is an antiplatelet drug that inhibits the aggregation of platelets and prevents the formation of thrombi, which can occlude the coronary arteries and cause angina or myocardial infarction.Aspirin is recommended for clients who have angina and are at risk for myocardial infarction as a secondary prevention measure.
Choice A is wrong because aspirin does not lower blood pressure or reduce cardiac workload.These effects are achieved by other drugs such as beta blockers, calcium channel blockers, or angiotensin-converting enzyme inhibitors.
Choice C is wrong because aspirin does not dilate the coronary arteries or increase blood flow to the heart.These effects are achieved by other drugs such as nitrates or calcium channel blockers.
Choice D is wrong because aspirin does not reduce inflammation or pain in the chest.These effects are achieved by other drugs such as nonsteroidal anti-inflammatory drugs or opioids.
A nurse is monitoring a client who is receiving intravenous heparin for angina and has a history of atrial fibrillation. Which of the following laboratory tests should the nurse use to evaluate the effectiveness of heparin therapy?
Explanation
Activated partial thromboplastin time (aPTT) is the laboratory test that the nurse should use to evaluate the effectiveness of heparin therapy.Heparin is an anticoagulant that works by helping antithrombin inactivate thrombin and factor Xa, reducing the production of fibrin and thus decreasing the formation of clots.The aPTT measures the time it takes for a clot to form in a sample of blood after adding certain substances.The normal range for aPTT is 25 to 35 seconds.A therapeutic level of heparin is 1.5 to 2.5 times the normal value, or 46 to 70 seconds.
Choice A is wrong because prothrombin time (PT) is a test that measures the time it takes for a clot to form in a sample of blood after adding tissue factor.PT is used to monitor warfarin therapy, not heparin therapy.The normal range for PT is 11 to 13 seconds.
Choice B is wrong because international normalized ratio (INR) is a standardized way of reporting the PT results, taking into account the variations in different laboratories and reagents.INR is also used to monitor warfarin therapy, not heparin therapy.The normal range for INR is 0.8 to 1.2.
Choice D is wrong because platelet count is a test that measures the number of platelets in a sample of blood.Platelets are cell fragments that help with blood clotting by sticking together and forming a plug at the site of injury.Platelet count is not directly related to heparin therapy, although heparin can cause a rare but serious adverse effect called heparin-induced thrombocytopenia (HIT), which is a drop in platelet count due to an immune reaction that leads to excessive clotting.The normal range for platelet count is 150,000 to 400,000/mm3.
Sign Up or Login to view all the 8 Questions on this Exam
Join over 100,000+ nursing students using Nursingprepexams’s science-backend flashcards, practice tests and expert solutions to improve their grades and reach their goals.
Sign Up Now
