Chapter 39: Antihypertensives

Chapter 39: 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:    p. 564

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 be 140/90. Prehypertension is generally treated first with lifestyle changes.

 

DIF:    Cognitive Level: Understanding (Comprehension)               REF:    p. 565

TOP:    Nursing Process: Nursing Intervention

MSC:   NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

 

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

a.	120/80 mm Hg
b.	130/89 mm Hg
c.	140/90 mm Hg
d.	150/90 mm Hg

 

 

ANS:   D

According to the Joint National Committee (JNC) 8, a blood pressure of 140/90 is the goal for the population younger than 60 years, with a target of 150/90 for those above 60. The guideline for normal blood pressure is less than 120/80 mm Hg.

 

DIF:    Cognitive Level: Understanding (Comprehension)               REF:    p. 565

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 angiotensin-converting enzyme (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 is not indicated. Hypertension in African-American patients can be controlled by combining beta blockers with diuretics.

 

DIF:    Cognitive Level: Applying (Application)                              REF:    p. 564

TOP:    Nursing Process: Nursing Intervention/Planning

MSC:   NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies