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Exam (elaborations)

NURS 6521 TEST BANK 2

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NURS 6521 TEST BANK 2 • Question 1 1 out of 1 points A clinic nurse has been assigned a 49-year-old female patient who has a history of diabetes. A recent diagnosis of hypertension has been made, and the patient has been prescribed a thiazide diuretic and labetalol. The patient will be scheduled to return to the clinic once a month for the next 6 months. A priority action by the nurse will be to Response Feedback: Monitoring of blood pressure would be the priority assessment in the care of this patient. Questioning the patient about her dietary intake and weighing her would be appropriate, but secondary in importance. It is unnecessary to monitor the patient's respiratory rate. • Question 2 A 55-year-old man's hypertension has not responded adequately to his 1 out of 1 points current medication regimen consisting or an ACE inhibitor, a beta-blocker and a thiazide diuretic. As a result, he will soon begin taking hydralazine (Apresoline) in addition to his existing antihypertensives. The addition of this medication to his regimen means that the nurse must prioritize which of the following nursing actions? Response Feedback : Hydralazine is associated with an increase in cardiac output that can precipitate palpitations, tachycardia, and angina. As a result, there is a need for astute cardiac assessment. The use of hydralazine does not directly necessitate close monitoring of electrolytes or blood sugars, even though these are prudent assessment measures. There is a risk of dizziness and possibly falls with the use of any antihypertensive, but it is unnecessary to supervise all of the patient's ADLs. • Question 3 A 39-year-old African-American male is 25 pounds overweight and has 1 out of 1 points been diagnosed with hypertension after three consecutive above-normal blood pressure readings. The most likely initial drug therapy for this patient will be Response Feedback : The patient would most likely be prescribed a diuretic in combination with diet and other lifestyle changes. African- American men are at increased risk for developing hypertension and tend to respond differently to antihypertensive therapy. The research shows that African-American men are most responsive to single-drug therapy and diuretics. The use of a calcium channel blocker and/or alpha-adrenergic blocker would follow if he is unresponsive to the diuretic in combination with diet and other lifestyle changes. African Americans tend to be less

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