Chapter 22: Drugs Used to Treat Hypertension

Chapter 22: Drugs Used to Treat Hypertension

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

MULTIPLE CHOICE

1. A patient who has just begun taking an angiotensin converting enzyme (ACE) inhibitor calls the nurse and reports feeling very dizzy when standing up and asks if the medication should be discontinued. What is the nurse’s best response?

ANS:  B

Dizziness is a common initial adverse effect of this medication, which is usually transient. The patient should be instructed to rise from a lying position slowly to avoid orthostatic hypotension and avoid falling. Medications should not be stopped immediately unless a serious adverse effect occurs. Because this is a common occurrence with ACE inhibitors, there is no need for a visit to the health care provider. A change in dosage will not alter the effect and should not be made without the advice of the primary care provider.

DIF:    Cognitive Level: Application           REF:   Page 348        OBJ:   2

TOP:   Nursing Process Step: Implementation

MSC:  NCLEX Client Needs Category: Physiological Integrity

NOT:  CONCEPT(S): Clinical Judgment; Patient Education; Safety

2. Which nursing assessment confirms that the angiotensin II receptor blocker (ARB) that a patient is taking is effective?

ANS:  D

The primary therapeutic outcome expected from angiotensin II receptor antagonists is reduction of blood pressure to within a normal range. Angiotensin II receptor antagonists bind angiotensin II receptor sites in the vascular smooth muscle, brain, heart, kidneys, and adrenal gland. The blood pressure-elevating (vasoconstricting) and sodium-retaining effects of angiotensin II are thus blocked. Weight loss, although advisable for treatment of hypertension, is not affected by ARBs. ARBs do not affect cholesterol levels. Urine output is not affected by ARBs.

DIF:    Cognitive Level: Application           REF:   Page 349 | Page 350

OBJ:   2 | 5                TOP:   Nursing Process Step: Assessment

MSC:  NCLEX Client Needs Category: Physiological Integrity

NOT:  CONCEPT(S): Clinical Judgment

3. How does propranolol (Inderal) control hypertension?

ANS:  C

The beta-adrenergic blocking agents block beta receptor stimulation in the heart, which then inhibits cardiac response to sympathetic nerve stimulation. This results in a decrease in heart rate, cardiac output, and blood pressure. Beta blockers do not affect alpha receptors. Beta blockers do not have a diuretic effect. ACE inhibitors are in the class of drugs that affects angiotensin conversion.

DIF:    Cognitive Level: Knowledge            REF:   Page 345        OBJ:   5

TOP:   Nursing Process Step: Implementation

MSC:  NCLEX Client Needs Category: Physiological Integrity

NOT:  CONCEPT(S): Clinical Judgment

4. Which class of antihypertensive agents should be avoided by patients with asthma?

ANS:  D

Beta-adrenergic blocking agents can cause bronchoconstriction, which will aggravate asthmatic conditions. ACE inhibitors do not affect respiratory function. Diuretics have the effect of improving respiratory function in cases of congestive heart failure. Aldosterone receptor antagonists do not affect respiratory function.

DIF:    Cognitive Level: Knowledge            REF:   Page 345        OBJ:   5

TOP:   Nursing Process Step: Implementation

MSC:  NCLEX Client Needs Category: Safe, Effective Care Environment

NOT:   CONCEPT(S): Clinical Judgment; Safety; Patient Education