Chapter 44: Antihypertensives

Chapter 44: Antihypertensives

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

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?

a.	Changing from weight bearing exercise to yoga
b.	Decreased fluid intake and increased potassium intake
c.	Stress reduction and increased protein intake
d.	Weight reduction and decreased sodium intake

 

 

ANS:  D

Weight loss decreases the stress on the heart and the afterload. Decreasing salt intake decreases the amount of retained fluid. Changing to yoga from weight-bearing exercise, limiting fluids, and increasing potassium are not indicated. Stress reduction is recommended, but increasing protein is not.

 

DIF:    COGNITIVE LEVEL: Applying (Application)                  REF:   Page 634

TOP:   NURSING PROCESS: Nursing Intervention: Patient Teaching

MSC:  NCLEX: Health Promotion Model

 

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

a.	a beta blocker.
b.	a diuretic and a beta blocker.
c.	a diuretic.
d.	lifestyle changes.

 

 

ANS:  D

Prehypertension is defined as a systolic pressure of 120 to 139 and a diastolic pressure between 80 and 89. Drug therapy is recommended if the blood pressure is greater than 20/10 over the goal, which would be140/90. Prehypertension is generally treated first with lifestyle changes.

 

DIF:    COGNITIVE LEVEL: Understanding (Comprehension)    REF:   Page 635

TOP:   NURSING PROCESS: Nursing Intervention

MSC:  NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

 

3. A patient has a blood pressure of 155/95 mm Hg. The nurse understands that this patient’s risk of cardiovascular disease is _____ greater than normal.

a.	two times
b.	three times
c.	four times
d.	six times

 

 

ANS:  C

Cardiovascular disease (CVD) risk doubles with each increase of 20/10 mm Hg above normal, starting at 115/75 mm Hg. This patient’s blood pressure is 40/20 above normal, which increases the risk four times. A blood pressure of 135/85 would be two times greater. The patient’s risk would still be four times greater with a blood pressure of 155/70 or 130/95, since systolic and diastolic blood hypertension are each powerful predictors of CVD.

 

DIF:    COGNITIVE LEVEL: Applying (Application)                  REF:   Page 635

TOP:   NURSING PROCESS: Assessment

MSC:  NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

 

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

a.	adding a diuretic medication.
b.	changing to an ACE inhibitor.
c.	decreasing the beta blocker dose.
d.	doubling the beta blocker dose.

 

 

ANS:  A

African Americans do not respond well to beta blockers and ACE inhibitors, but do tend to respond to diuretics and calcium channel blockers. Changing to an ACE inhibitor or altering the beta blocker dose are not indicated. Hypertension in African-American patients can be controlled by combining beta blockers with diuretics.

 

DIF:    COGNITIVE LEVEL: Applying (Application)                  REF:   Page 636

TOP:   NURSING PROCESS: Nursing Intervention/Planning

MSC:  NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies