Chapter 46: Drugs for Hypertension

Chapter 46: Drugs for Hypertension

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

1. A patient is being treated with an angiotensin-converting enzyme (ACE) inhibitor. The nurse should advise the patient that ACE inhibitors should not be taken concurrently with which of the following drugs?

a.	Potassium-wasting diuretics
b.	Beta blockers
c.	Potassium-sparing diuretics
d.	Calcium channel blockers

 

 

ANS:   C

ACE inhibitors may cause hyperkalemia and are contraindicated with potassium-sparing diuretics, which also cause hyperkalemia.

ACE inhibitors may be given with potassium-wasting diuretics to help eliminate some of the potassium in the body.

ACE inhibitors may also be given with beta blockers and calcium channel blockers, because these are not contraindicated.

 

DIF:    Cognitive Level: Application             REF:    p. 502

TOP:    Nursing Process: Planning

MSC:   NCLEX Client Needs Category: Physiological Integrity: Reduction of Risk Potential

 

2. When providing education for a patient taking clonidine (Catapres), an alpha₂ agonist, the nurse should inform the patient to anticipate which likely side effect?

a.	Agitation
b.	Restlessness
c.	Dry mouth
d.	Diaphoresis

 

 

ANS:   C

All centrally acting alpha₂ agonists can cause dry mouth and sedation.

Agitation, restlessness, and diaphoresis are not side effects of alpha₂ agonists.

 

DIF:    Cognitive Level: Application             REF:    p. 505

TOP:    Nursing Process: Planning

MSC:   NCLEX Client Needs Category: Safe and Effective Care Environment: Management of Care

 

3. The nurse is teaching a group of patients about hypertension. A patient who has been diagnosed with uncomplicated primary hypertension asks the nurse what the preferred initial antihypertensive drug regimen is. Which of the following is the nurse’s best response?

a.	Direct-acting vasodilators
b.	Thiazide diuretics, as long as renal disease is not a factor
c.	Two diuretics from two different groups
d.	Beta blockers

 

 

ANS:   B

According to The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High BP (JNC 7) guidelines, a thiazide diuretic is appropriate for use for uncomplicated primary hypertension to reduce blood volume and arterial resistance, as long as the patient does not have renal failure.

The use of two direct-acting vasodilators would result in excessive hypotension and would be contraindicated.

Two diuretics from different groups typically are not prescribed together unless potassium loss has been noted, because use of two diuretics may result in hypotension.

Use of a beta blocker no longer is indicated for uncomplicated primary hypertension unless the patient has heart disease.

 

DIF:    Cognitive Level: Application             REF:    p. 494 | p. 501

TOP:    Nursing Process: Implementation

MSC:   NCLEX Client Needs Category: Safe and Effective Care Environment: Management of Care

 

4. A patient is admitted with essential hypertension. Which concurrent health problem would produce the greatest risk of a cardiovascular event?

a.	Obesity
b.	Diabetes
c.	Hyperlipidemia
d.	Peripheral edema

 

 

ANS:   B

Diabetes would pose the greatest risk of a cardiovascular event because of the damage to the endothelium of the vessels

Obesity would also be a risk factor, but not the greatest risk.

Hyperlipidemia would also be considered a risk factor, but not the greatest risk. Diabetes affects multiple systems in the body, including the vessels, heart, and kidneys.

Peripheral edema would not produce the greatest risk for a cardiovascular event.

 

DIF:    Cognitive Level: Analysis                  REF:    p. 497

TOP:    Nursing Process: Planning

MSC:   NCLEX Client Needs Category: Physiological Integrity: Reduction of Risk Potential