Antihypertensive NCLEX questions

Antihypertensive NCLEX questions ScienceMedicineNursing catherine_northey Save PHARM Chapter 22 (Antihypertensi...35 terms TrudimaPreview NCLEX Hypertension 136 terms roberto_castrellon Preview CH 25 Hypertension Drugs NCLEX 25 terms njbaderPreview Pharma 120 term lilru The nurse is assessing the patient's knowledge regarding drug therapy prescribed for the treatment of hypertension. Which statement by the patient indicates the need for further teaching by the nurse?

• "I will move slowly from a sitting to standing position."
• "Blood pressure drugs can cause changes in sexual functioning."
• "When my blood pressure is over 140/90, I will take my medication."
• "I will wear a medical alert bracelet."

C.Patients must adhere to prescribed antihypertensive regimen to prevent end-organ damage. Many patients do not adhere to this regimen because hypertension itself does not cause symptoms, but the medication may produce unwanted adverse effects. Patient teaching is essential.

The nurse understands a patient who is treated for hypertension may be switched to an angiotensin receptor blocker (ARB) because of which angiotensin-converting enzyme (ACE) inhibitor adverse effect?

• Dry, nonproductive cough
• Hypokalemia
• Fatigue
• Orthostatic hypotension

A.ACE inhibitors block the breakdown of bradykinins and may cause a dry, nonproductive cough. ARBs do not block this breakdown, thus minimizing this adverse effect. ACE inhibitors and ARBs are equally effective for the treatment of hypertension, but ARBs do not cause cough.Which medication should the nurse question if prescribed together with ACE inhibitors?

• Docusate sodium (Colace)
• Furosemide (Lasix)
• Potassium chloride (K-Dur)
• Morphine

C.ACE inhibitors block the conversion of angiotensin I to angiotensin II, thus also blocking the stimulus for aldosterone production. Aldosterone is responsible for potassium excretion; thus, a decrease in aldosterone production can result in an increase in serum potassium.Before administering eplerenone (Inspra) to a patient, what is the priority nursing action?

• Auscultate heart sounds.
• Obtain serum thiocyanate level.
• Assess level of consciousness.
• Check serum electrolytes.

D.Eplerenone (Inspra) is contraindicated in patients with an elevated serum potassium level (greater than 5.5 mEq/L) or severe renal impairment.Therefore, it is imperative that the nurse assess the patient's most recent serum electrolytes before administering this medication.

To prevent cerebral artery spasms after a subarachnoid hemorrhage, the nurse anticipates administering which calcium channel blocker?

• Amlodipine (Norvasc)
• Nimodipine (Nimotop)
• Diltiazem (Cardizem)
• Verapamil (Calan)

B.Nimodipine crosses the blood-brain barrier and has a greater effect on the cerebral arteries than on other arteries in the body; thus, it is indicated for the treatment of cerebral artery spasm after subarachnoid hemorrhage.The nurse should question a prescription for a calcium channel blocker in a patient with which condition?

• Dysrhythmia
• Hypotension
• Angina pectoris
• Increased intracranial pressure

B.Calcium channel blockers cause smooth muscle vasodilation and thus a drop in blood pressure. They are contraindicated in the presence of hypotension.During discharge teaching, which statement by the nurse would be MOST appropriate for a patient prescribed a transdermal clonidine (Catapres)?

• "Prolonged sitting or standing does not cause hypotension symptoms."
• "Occasional drooling is a common adverse effect of this medication."
• "Your blood pressure should be checked by your health care provider two to three times a week."
• "The patch should be applied to a nonhairy site, and you should not suddenly stop using this drug."

D.Transdermal clonidine patches should be applied to nonhairy areas of the skin, and application sites should be rotated. When the patch dosage form is used, it is important to remove the old patch before applying a new one. It must not be discontinued abruptly because it will lead to severe rebound hypertension (sudden high elevation of blood pressure). Prolonged standing can cause venous pooling and hypotension. Dry mouth, not drooling, is a common adverse effect of clonidine.

The nurse is conducting a community education program. When explaining different medication regimens to treat hypertension, it would be accurate to state that African Americans probably respond best to which combination of medications?

• Diuretics and calcium channel blockers
• ACE inhibitors and diuretics
• Diuretics and beta blockers
• ACE inhibitors and beta blockers

A.Research has demonstrated that African Americans do not typically respond therapeutically to beta blockers or ACE inhibitors. They respond better to diuretics and calcium channel blockers.What is the classification of carvedilol (Coreg)?

• Beta blocker
• ACE inhibitor
• Alpha2 blocker
• Dual-action alpha1 and beta receptor blocker

D.Carvedilol blocks both the alpha1and beta receptors of the adrenergic nervous system.When administering nitroprusside (Nipride) by continuous intravenous infusion, the nurse monitors for which symptom of drug toxicity?

• Wheezing
• Hypotension
• Fever
• Hyperglycemia

B.The main symptom of sodium nitroprusside overdose or toxicity is excessive hypotension.