Chapter 26 Pharmacology For Nurses A Pathophysiologic Approach 5th Edition

Chapter 26 Pharmacology For Nurses A Pathophysiologic Approach 5th Edition

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

Question 1

Type: MCSA

The patient receives hydrochlorothiazide (Microzide). He tells the nurse he is urinating a lot and questions how this drug affects his blood pressure. What is the best response by the nurse?

1. “Hydrochlorothiazide (Microzide) enhances kidney function causing you to urinate more and that decreases your blood pressure.”
2. “Hydrochlorothiazide (Microzide) decreases the fluid in your bloodstream and this lowers your blood pressure.”
3. “Hydrochlorothiazide (Microzide) dilates your blood vessels so you urinate more and your blood pressure decreases.”
4. “Hydrochlorothiazide (Microzide) increases your heart rate; this pumps blood faster to your kidneys so you urinate more and your blood pressure decreases.”

Correct Answer: 2

Rationale 1: Hydrochlorothiazide (Microzide) does not enhance kidney function.

Rationale 2: Blood volume is one of the three factors influencing blood pressure. Diuretics like hydrochlorothiazide (Microzide) decrease blood pressure by decreasing total blood volume.

Rationale 3: Hydrochlorothiazide (Microzide) does not dilate blood vessels.

Rationale 4: Hydrochlorothiazide (Microzide) does not increase heart rate.

Global Rationale: Blood volume is one of the three factors influencing blood pressure. Diuretics like hydrochlorothiazide (Microzide) decrease blood pressure by decreasing total blood volume. Hydrochlorothiazide (Microzide) does not increase heart rate. Hydrochlorothiazide (Microzide) does not dilate blood vessels. Hydrochlorothiazide (Microzide) does not enhance kidney function.

 

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Pharmacological and Parenteral Therapies

QSEN Competencies: III.A.1 Demonstrate knowledge of basic scientific methods and processes.

AACN Essentials Competencies: III.1 Explain the interrelationships among theory, practice, and research.

NLN Competencies: Knowledge and Science: Integration of knowledge from nursing and other disciplines.

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 26-6 Differentiate between drug classes used for the primary treatment of hypertension and the agents reserved for persistent hypertension.

MNL Learning Outcome: 4.1.2 Compare the different classes of antihypertensives and their mechanisms of action.

Page Number: 381

 

Question 2

Type: MCMA

The nurse is conducting the initial group education session for patients who have hypertension. What is the most important information to include?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Standard Text: Select all that apply.

1. Blood pressures tend to decrease as people age, due to decreased blood volume.
2. The aorta has sensors that help regulate blood pressure.
3. Anger can result in hypertension.
4. The vasomotor center, located in the limbic system of the brain, helps regulate blood pressure.
5. Hypertension is diagnosed when the blood pressure is greater than 145/95 mmHg.

Correct Answer: 2,3

Rationale 1: Blood pressures tend to rise as people age.

Rationale 2: The aorta and internal carotid artery have baroreceptors that sense changes in pressure in blood vessels and chemoreceptors that detect oxygen, carbon dioxide, and pH levels.

Rationale 3: Anger and stress can cause blood pressure to rise.

Rationale 4: The vasomotor center is located in the medulla oblongata.

Rationale 5: According to JNC-7, a person is considered to have hypertension when sustained blood pressure is 139/89 mmHg.

Global Rationale: Anger and stress can cause blood pressure to rise. The aorta and internal carotid artery have baroreceptors that sense changes in pressure in blood vessels and chemoreceptors that detect oxygen, carbon dioxide, and pH levels. According to JNC-7, a person is considered to have hypertension when sustained blood pressure is 139/89 mmHg. The vasomotor center is located in the medulla oblongata. Blood pressures tend to rise as people age.

 

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

QSEN Competencies: III.A.1 Demonstrate knowledge of basic scientific methods and processes.

AACN Essentials Competencies: III.1 Explain the interrelationships among theory, practice, and research.

NLN Competencies: Knowledge and Science: Integration of knowledge from nursing and other disciplines.

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 26-3 Discuss how the vasomotor center, baroreceptors, chemoreceptors, emotions, and hormones influence blood pressure.

MNL Learning Outcome: 4.1.1 Examine the mechanisms used by the body to regulate blood pressure.

Page Number: 377

 

Question 3

Type: MCMA

For the last 3 months, the nurse has been working with a group of patients who have been using nonpharmacological methods to try to manage their hypertension. The nurse anticipates that which patients will require the addition of a pharmacological intervention?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Standard Text: Select all that apply.

1. A 30-year-old female whose blood pressure is 138/88 mmHg who is otherwise healthy.
2. A 61-year-old man whose blood pressure is 144/90 mmHg who also has type 2 diabetes.
3. A 56-year-old woman whose blood pressure is 135/84 who also has Cushing’s disease.
4. A 65-year-old man whose blood pressure is 148/88 mmHg who is otherwise healthy.
5. A 61-year-old woman whose blood pressure is 153/92 mmHg who is otherwise healthy.

Correct Answer: 2,5

Rationale 1: Hypertension in this age group of healthy adults is considered to be 140/90 mmHg.

Rationale 2: Since this 61-year-old has both hypertension and diabetes, pharmacotherapy is indicated.

Rationale 3: This patient’s blood pressure is no longer in the range of hypertension.

Rationale 4: Since there are no other compelling illnesses, this patient’s hypertension does not need pharmacological intervention.

Rationale 5: Blood pressure over 150/90 mmHg requires treatment in those over age 60.

 

Global Rationale: HTN is defined as blood pressure over 140/90 mmHg. Patients over age 60 who do not have chronic kidney disease or diabetes do not need pharmacotherapy until the 150/90 mmHg threshold has been reached.

 

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

QSEN Competencies: III.A.1 Demonstrate knowledge of basic scientific methods and processes.

AACN Essentials Competencies: III.1 Explain the interrelationships among theory, practice, and research.

NLN Competencies: Knowledge and Science: Integration of knowledge from nursing and other disciplines.

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 26-1 Explain how hypertension is defined and classified.

MNL Learning Outcome: 4.1.1 Examine the mechanisms used by the body to regulate blood pressure.

Page Number: 378

 

 

Question 4

Type: MCMA

The patient has been recently diagnosed with hypertension with a sustained blood pressure of 144/90 mmHg. The patient is concerned about effects on the body. What effects of hypertension on the body will the nurse include in her education of this patient?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Standard Text: Select all that apply.

1. Kidney damage
2. Stroke
3. Liver failure
4. Heart failure
5. Blindness

Correct Answer: 1,2,4,5

Rationale 1: The kidneys are affected by hypertension.

Rationale 2: Stroke is a common effect of hypertension.

Rationale 3: Liver failure is not commonly associated with hypertension.

Rationale 4: The heart is affected by hypertension.

Rationale 5: The retina is affected by hypertension.

Global Rationale: The kidneys, heart, and retina are affected by hypertension. Stroke is a common effect of hypertension. Liver failure is not commonly associated with hypertension.

 

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

QSEN Competencies: III.A.1 Demonstrate knowledge of basic scientific methods and processes.

AACN Essentials Competencies: III.1 Explain the interrelationships among theory, practice, and research.

NLN Competencies: Knowledge and Science: Integration of knowledge from nursing and other disciplines.

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 26-4 Summarize the long-term consequences of untreated hypertension.

MNL Learning Outcome: 4.1.1 Examine the mechanisms used by the body to regulate blood pressure.

Page Number: 377