NUR 3020 MEDSURG II EXAM 1 2026 CLINICAL
DECISION MAKING WORKBOOK SOLVED
QUESTIONS COMPILATION
◉ increasing activity levels for HTN tx.
Answer: 150min/week!!!!!!!!!!!!!!
-exercising 10 MINUTES at a time 3 TIMES A DAY, 5 DAYS A WEEK
can help lower BP
-or 30 minutes a day, 5 days a week
◉ does lifestyle modification work?.
Answer: yes!!!!! can make a significant difference in pt's BP
◉ goals for individuals w HTN (important).
Answer: <130/80!!!!!!!! (in the elevated BP range)
-may be able to complete w lifestyle modifications alone
-but may also need medications
◉ first-line treatments for HTN.
Answer: need to know
-thiazide-type diuretics
,-calcium channel blockers
-angiotensin converting enzyme (ACE) inhibitors
-angiotensin receptor blockers (ARBs)
◉ thiazide-type diuretics.
Answer: decrease sodium reabsorption which increases fluid loss in
urine, which in turn decreases extracellular fluid and plasma
volume, reducing cardiac output and lowering BP
-also cause potassium loss while retaining calcium.
-initial therapy for african americans
-not given if renal disease!!!!
◉ calcium channel blockers.
Answer: inhibit the entry of calcium ions into heart muscle cells,
causing a slowing of the heart rate, a lessening of the demand for
oxygen and nutrients, and a relaxing of the smooth muscle cells of
the blood vessels to cause dilation
-initial therapy for african americans, not recommended for reduced
ejection fraction
◉ ace inhibitors or ARBS.
Answer: ACE inhibitors interfere w ACE and reduce activity of
angiotensin II; ARBs block action of angiotensin II
-better therapy choice for patients with HTN and CKD
,-SHOULD NOT BE USED SIMULTANEOUSLY bc they have the same
effect
◉ common side effect with ACE?.
Answer: COUGH!! CHRONIC COUGH!
◉ beta blockers.
Answer: decrease heart rate and dilate arteries by blocking beta
receptors
-COMMON SIDE EFFECT: erectile dysfunction
-given if pt has heart disease
◉ hypertension w stable ischemic heart disease.
Answer: first line therapy:
-beta blockers
-ACE inhibitors or ARBs
◉ HF w preserved ejection fraction.
Answer: diuretics prescribed to control fluid overload
-after management of fluid overload, prescribed ACE inhibitors or
ARBS and beta blockers to attain BP goal
, ◉ HF w reduced ejection fraction.
Answer: calcium channel blockers NOT recommended!
◉ stage I HTN initial therapy.
Answer: monotherapy: single antihypertensive drug
-BP goal of <130/80
◉ stage II HTN initial therapy.
Answer: combination drug therapy: 2 first-line antihypertensive
drugs with an average BP more than 20/10 above the BP target
◉ HTN management in older patients.
Answer: ideally dont want to bottom out their BP w drugs
(remember, decr kidney and liver function so drugs have incr
effects)... so tx is different... less
◉ other factors to consider w HTN pharmacotherapy.
Answer: each medication is about equal in effect, but:
-wide variability in response
-some drugs work well w certain pts and some drugs dont... not sure
why
-also need to consider cost, concurrent diagnoses, and drug
interactions
DECISION MAKING WORKBOOK SOLVED
QUESTIONS COMPILATION
◉ increasing activity levels for HTN tx.
Answer: 150min/week!!!!!!!!!!!!!!
-exercising 10 MINUTES at a time 3 TIMES A DAY, 5 DAYS A WEEK
can help lower BP
-or 30 minutes a day, 5 days a week
◉ does lifestyle modification work?.
Answer: yes!!!!! can make a significant difference in pt's BP
◉ goals for individuals w HTN (important).
Answer: <130/80!!!!!!!! (in the elevated BP range)
-may be able to complete w lifestyle modifications alone
-but may also need medications
◉ first-line treatments for HTN.
Answer: need to know
-thiazide-type diuretics
,-calcium channel blockers
-angiotensin converting enzyme (ACE) inhibitors
-angiotensin receptor blockers (ARBs)
◉ thiazide-type diuretics.
Answer: decrease sodium reabsorption which increases fluid loss in
urine, which in turn decreases extracellular fluid and plasma
volume, reducing cardiac output and lowering BP
-also cause potassium loss while retaining calcium.
-initial therapy for african americans
-not given if renal disease!!!!
◉ calcium channel blockers.
Answer: inhibit the entry of calcium ions into heart muscle cells,
causing a slowing of the heart rate, a lessening of the demand for
oxygen and nutrients, and a relaxing of the smooth muscle cells of
the blood vessels to cause dilation
-initial therapy for african americans, not recommended for reduced
ejection fraction
◉ ace inhibitors or ARBS.
Answer: ACE inhibitors interfere w ACE and reduce activity of
angiotensin II; ARBs block action of angiotensin II
-better therapy choice for patients with HTN and CKD
,-SHOULD NOT BE USED SIMULTANEOUSLY bc they have the same
effect
◉ common side effect with ACE?.
Answer: COUGH!! CHRONIC COUGH!
◉ beta blockers.
Answer: decrease heart rate and dilate arteries by blocking beta
receptors
-COMMON SIDE EFFECT: erectile dysfunction
-given if pt has heart disease
◉ hypertension w stable ischemic heart disease.
Answer: first line therapy:
-beta blockers
-ACE inhibitors or ARBs
◉ HF w preserved ejection fraction.
Answer: diuretics prescribed to control fluid overload
-after management of fluid overload, prescribed ACE inhibitors or
ARBS and beta blockers to attain BP goal
, ◉ HF w reduced ejection fraction.
Answer: calcium channel blockers NOT recommended!
◉ stage I HTN initial therapy.
Answer: monotherapy: single antihypertensive drug
-BP goal of <130/80
◉ stage II HTN initial therapy.
Answer: combination drug therapy: 2 first-line antihypertensive
drugs with an average BP more than 20/10 above the BP target
◉ HTN management in older patients.
Answer: ideally dont want to bottom out their BP w drugs
(remember, decr kidney and liver function so drugs have incr
effects)... so tx is different... less
◉ other factors to consider w HTN pharmacotherapy.
Answer: each medication is about equal in effect, but:
-wide variability in response
-some drugs work well w certain pts and some drugs dont... not sure
why
-also need to consider cost, concurrent diagnoses, and drug
interactions
