Chapter 44: Antihypertensives Nursing School Test Banks

Kee: Pharmacology, 7th Edition

Chapter 44: Antihypertensives

Test Bank

MULTIPLE CHOICE

1. The client has been diagnosed as being borderline hypertensive. As part of client teaching, the nurse should emphasize that the client can potentially avoid being placed on medication if he will attempt which changes?

a.

Weight reduction and restricted salt intake

b.

Stress reduction techniques and higher caloric intake

c.

Decreased weight-bearing exercise and decreased fat intake

d.

Decreased fluid intake and increased potassium intake

ANS: A

Weight loss decreases the stress on the heart and the afterload. Decreasing salt intake decreases the amount of retained fluid.

DIF: Cognitive Level: Application REF: p. 653

TOP: Nursing Process: Analysis

MSC: CONTENT CATEGORY: Health Promotion Model

2. The client is a Native American who has been diagnosed as having hypertensive disease. In conferring with the primary health provider, the nurse recognizes that which antihypertensive medication would not be effective with this client?

a.

Furosemide (Lasix)

b.

Metoprolol (Apo-Metoprolol, Toprol SR)

c.

Minoxidil (Loniten, Rogaine)

d.

Prazosin (Minipress)

ANS: B

Native Americans have a reduced or lower response to beta-blockers, such as metoprolol, when compared with Caucasians.

DIF: Cognitive Level: Application REF: pp. 653-654

TOP: Nursing Process: Analysis

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

3. A client is ordered to receive propranolol (Inderal). The nurse notes that the client has a history of asthma. The nurse calls the ordering physician with the knowledge that propranolol may cause:

a.

no change in airway.

b.

bronchial constriction.

c.

bronchial dilation.

d.

bronchial enlargement.

ANS: B

As a beta-blocker, propranolol (Inderal) may cause airway constriction, exacerbating the asthmatic changes.

DIF: Cognitive Level: Application REF: pp. 655-656

TOP: Nursing Process: Intervention

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

4. The client has been ordered treatment with minoxidil (Loniten) to control her hypertension. In designing a client teaching session, the nurse anticipates that the primary health provider will likely order which drug to increase the effectiveness of the minoxidil (Loniten)?

a.

Cardiac glycosides

b.

Diuretics

c.

Glucocorticoids

d.

Antihistamines

ANS: B

Diuretics may be used in conjunction with minoxidil (Loniten) to lower water volume in the body.

DIF: Cognitive Level: Application REF: p. 661

TOP: Nursing Process: Analysis

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

5. The nurse is designing a client teaching session for a hypertensive client who has just been placed on antihypertensive medication. He tells the nurse that he typically drinks two glasses of wine each night. The best reply by the nurse is Alcohol should not be taken with antihypertensives because the combination may:

a.

increase the hypertensive state.

b.

increase the hypotensive state.

c.

lead to renal failure.

d.

lead to a toxic level of the medication.

ANS: B

Both antihypertensives and alcohol decrease BP and may potentiate each other.

DIF: Cognitive Level: Application REF: pp. 659-661

TOP: Nursing Process: Analysis

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

6. A nurse is providing health teaching for clients taking antihypertensives. The highest priority teaching point regarding discontinuation of the drug is that abrupt discontinuation of the drug may result in:

a.

drowsiness.

b.

nasal stuffiness.

c.

rebound hypotension.

d.

rebound hypertension.

ANS: D

When antihypertensives are abruptly discontinued, the body increases the blood pressure in response.

DIF: Cognitive Level: Application REF: p. 657

TOP: Nursing Process: Analysis

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

7. The client has been ordered to be treated with Losartan potassium. What effect should the nurse expect to see in the clients laboratory values?

a.

Decreased liver enzymes

b.

Increased BUN and creatinine

c.

Decreased serum glucose

d.

Increased calcium

ANS: B

Losartan potassium is expected to cause an increase in the clients BUN and creatinine levels.

DIF: Cognitive Level: Application REF: p. 667

TOP: Nursing Process: Planning

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

8. The client has been ordered to be treated with Minipress. She complains to the nurse of experiencing rapid heart rate. The highest priority nursing intervention is to call the physician because a rapid heart rate:

a.

is an expected side effect of the medication.

b.

is evidence of an anaphylactic reaction.

c.

is evidence of an adverse reaction to the medication.

d.

shows that the medication was mixed incorrectly.

ANS: C

Tachycardia is an adverse reaction to treatment with Minipress.

DIF: Cognitive Level: Application REF: p. 661

TOP: Nursing Process: Intervention/Teaching

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

9. The client is being treated with metoprolol. The nurse notes that the client has been experiencing sinus bradycardia. What is the highest priority nursing intervention?

a.

Call the physician; the medication is contraindicated if there is sinus bradycardia.

b.

Teach the client that the medication schedule must be strictly adhered to.

c.

Call the physician; the dosage should be increased when there is sinus bradycardia.

d.

Teach the client that he should notify the physician if he experiences rapid heart rate.

ANS: A

Sinus bradycardia is a contraindication to treatment with metoprolol.

DIF: Cognitive Level: Application REF: p. 656

TOP: Nursing Process: Intervention

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

10. The client is being treated with metoprolol as well as digitalis. The nurse anticipates the interaction of these two drugs will result in an increased incidence of:

a.

tachycardia.

b.

heart block.

c.

bradycardia.

d.

cardiac pauses.

ANS: C

The combination of metoprolol and digitalis will result in an increase incidence of bradycardia.

DIF: Cognitive Level: Application REF: p. 656

TOP: Nursing Process: Planning

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

11. The client is being treated with eplerenone (Inspra). The nurse recognizes that which laboratory value must be monitored most closely while the client is on this medication regimen?

a.

Calcium

b.

Potassium

c.

Sodium

d.

Magnesium

ANS: B

Inspra is contraindicated when serum potassium greater than 5.5 mEq/L.

DIF: Cognitive Level: Application REF: pp. 665-666

TOP: Nursing Process: Planning

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

12. The client is being treated with captopril (Capoten). The nurse teaches the client that while she is on the medication, she should avoid eating a diet that is rich in which:

a.

potassium.

b.

calcium.

c.

iron.

d.

folic acid.

ANS: A

Captopril (Capoten) tends to cause the client to retain potassium; thus the client should not eat a diet rich in potassium.

DIF: Cognitive Level: Application REF: pp. 665-666

TOP: Nursing Process: Intervention/Teaching

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

13. The client has been started on a treatment regimen that includes fosinopril (Monopril). The nurse realizes that the client has also been diagnosed with renal insufficiency. What is the most accurate nursing intervention?

a.

Call the physician; the medication is contraindicated.

b.

Teach the client that the side effects of the drug will be intensified.

c.

Call the physician; the dosage will need to be decreased.

d.

Give the medication as ordered.

ANS: D

The dose of fosinopril (Monopril) will not need to be decreased if the client develops renal insufficiency.

DIF: Cognitive Level: Application REF: pp. 665-666

TOP: Nursing Process: Intervention

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

14. The client is being treated with sodium nitroprusside (Nipride, Nitropress). As the nurse is preparing to administer the medication, the most important thing to verify is that the container is:

a.

wrapped in aluminum foil.

b.

a glass bottle.

c.

a plastic bag.

d.

tinted a dark color.

ANS: A

The container must be wrapped in aluminum foil during administration of the medication.

DIF: Cognitive Level: Application REF: p. 661

TOP: Nursing Process: Planning

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

15. The client is being treated with sodium nitroprusside (Nipride, Nitropress). The nurse notes that the medication is tinted red. What is the highest priority nursing intervention in response to this observation?

a.

Administer the medication as ordered.

b.

Call the pharmacist since the medication should be tinted blue.

c.

Discard the medication; it should not be tinted red.

d.

Call the physician since this indicates that the dosage is wrong.

ANS: C

The medication should be discarded because it should not be tinted red.

DIF: Cognitive Level: Application REF: p. 661

TOP: Nursing Process: Intervention

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

MULTIPLE RESPONSE

1. A client is ordered to receive an antihypertensive medication. Which elements should be included in teaching? (Select all that apply.)

a.

Warn the client to rise slowly to avoid orthostatic hypotension.

b.

Tell the client to limit water intake.

c.

Tell the client to limit potassium intake.

d.

Tell the client to eat a high-sodium diet.

e.

Discuss potential side effects of the medication.

f.

Tell the client to stop the medication if blood pressure is within normal limits.

ANS: A, E

The client receiving an antihypertensive medication should be warned to rise slowly to avoid orthostatic hypotension. The client should also be informed of the possible side effects of the medication.

DIF: Cognitive Level: Application REF: p. 662

TOP: Nursing Process: Intervention/Teaching

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

Copyright 2012, 2009, 2006, 2003 by Saunders, an imprint of Elsevier Inc.

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