Chapter 43 Drugs Affecting Blood Pressure

Chapter 43  Drugs Affecting Blood Pressure

Complete Chapter Questions And Answers
 

Sample Questions

1.
What does the clinic nurse anticipate as initial drug therapy for a 39-year-old African American man who is 25 pounds overweight and newly diagnosed with hypertension?
A)
An angiotensin-converting enzyme (ACE) inhibitor
B)
A beta-blocker
C)
A calcium channel blocker
D)
A diuretic
Ans:
D

Feedback:

African Americans are at highest risk for developing hypertension with men more likely than women to develop the disease. African Americans have documented differences in response to antihypertensive therapy. They are most responsive to single-drug therapy and diuretics. The first line use of a diuretic is in combination with diet and other lifestyle changes. The use of a calcium channel blocker and/or alpha-adrenergic blocker should follow. African Americans are less responsive to ACE inhibitors and beta-blocker.

2.
The clinic nurse assesses a patient taking benazepril (Lotensin) to control hypertension. What is the priority nursing assessment related to this drug?
A)
Mental illness
B)
Hepatic disease
C)
Renal disease
D)
Peptic ulcer disease
Ans:
C

Feedback:

Benazepril is an angiotensin-converting enzyme inhibitor; drugs in this class are contraindicated in the presence of impaired renal function. Mental illness, hepatic disease, or peptic ulcer disease is not a contraindication with this drug.

3.
A patient has been prescribed losartan (Cozaar) for hypertension. What patient teaching points will the nurse include about this drug include?
A)
“Report onset of a cough or fever to health care provider.”
B)
“Limit fluid intake to decrease urinary output.”
C)
“Monitor blood pressure once a week.”
D)
“Take the drug late in the day to prevent sleepiness.”
Ans:
A

Feedback:

Losartan is an angiotensin II–receptor blocker that is associated with a cough, back pain, fever, muscle weakness, and upper respiratory tract infections, so the patient should be taught to report a fever or cough to his health care provider. Fluid intake should be normal and the drug is best taken in the morning. Blood pressure should be monitored daily, especially when first starting the drug when adverse effects are not yet known.

4.
A patient newly diagnosed with hypertension has just been given a prescription for medication. Along with promoting safety, what is the other goal of the nurse’s teaching plan?
A)
A blood pressure of 120/80
B)
Medication compliance
C)
A discussion with his insurance company about the cost of the drug
D)
Verbalization of why drugs should be kept out of the reach of children
Ans:
B

Feedback:

The nurse provides thorough patient teaching, including the name of the drug, dosage prescribed, measures to avoid adverse effects, warning signs of problems, and the need for periodic monitoring and evaluation, to enhance patient knowledge about drug therapy and to promote compliance. All of the options are realistic outcomes for this patient. However, compliance is a great concern for people who are in need of hypertensive agents. It would be most important for his or her health care provider to know that he or she has filled the prescription and is taking his or her medication as prescribed. Keeping the drug out of the reach of children would be a safety measure.

5.
A stepped care management approach to treating hypertension includes weight loss, smoking cessation, decreased use of alcohol, reducing salt in the diet, and increased physical exercise. In which step of a stepped-care management approach will the nurse teach about these changes in lifestyle?
A)
Step 1 only
B)
Steps 1 and 2
C)
Steps 1, 2, and 3
D)
Steps 1, 2, 3, and 4
Ans:
D

Feedback:

Lifestyle changes are encouraged in all four steps and should be advocated for the maintenance of good health. These changes are stressed in steps 1 and 2 in the hope that drug therapy will not be necessary. However, these changes should occur in steps 3 and 4 as well.