NUR 3145 Part 4 and 7 Exam 2.
Chapter 22: Antihypertensive Drugs
Lilley: Pharmacology and the Nursing Process, 8th Edition
MULTIPLE CHOICE
1. A patient has a new order for the adrenergic drug doxazosin (Cardura). When providing
education about this drug, the nurse will include which instructions?
a.
“Weigh yourself daily, and report any weight loss to your prescriber.”
b.
“Increase your potassium intake by eating more bananas and apricots.”
c.
“The impaired taste associated with this medication usually goes away in 2 to 3
weeks.”
d.
“Be sure to lie down after taking the first dose, because first-dose hypotension may
make you dizzy.”
ANS: D
A patient who is starting doxazosin should take the first dose while lying down because there
is a first-dose hypotensive effect with this medication. The other options are incorrect.
DIF: COGNITIVE LEVEL: Analyzing (Analysis) REF: p. 354
TOP: NURSING PROCESS: Implementation
MSC: NCLEX: Physiological Integrity: Reduction of Risk Potential
2. A patient with severe liver disease is receiving the angiotensin-converting enzyme (ACE)
inhibitor, captopril (Capoten). The nurse is aware that the advantage of this drug for this
patient is which characteristic?
a.
Captopril rarely causes first-dose hypotensive effects.
b.
Captopril has little effect on electrolyte levels.
c.
Captopril is a prodrug and is metabolized by the liver before becoming active.
d.
Captopril is not a prodrug and does not need to be metabolized by the liver
before becoming active.
ANS: D
A prodrug relies on a functioning liver to be converted to its active form. Captopril is not a
prodrug, and therefore it would be safer for the patient with liver dysfunction.
DIF: COGNITIVE LEVEL: Applying (Application) REF: p. 348
TOP: NURSING PROCESS: Assessment
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
3. During a follow-up visit, the health care provider examines the fundus of the patient’s eye.
Afterward, the patient asks the nurse, “Why is he looking at my eyes when I have high blood
pressure? It does not make sense to me!” What is the best response by the nurse?
a.
“We need to monitor for drug toxicity.”
b.
“We must watch for increased intraocular pressure.”
c.
“The provider is assessing for visual changes that may occur with drug therapy.”
d.
“The provider is making sure the treatment is effective over the long term.”
ANS: D
, The physician would examine the fundus of a patient’s eyes during antihypertensive therapy
because it is a more reliable indicator than blood pressure readings of the long-term
effectiveness of treatment.
DIF: COGNITIVE LEVEL: Applying (Application) REF: p. 358
TOP: NURSING PROCESS: Evaluation
MSC: NCLEX: Physiological Integrity: Physiological Adaptation
4. The nurse is preparing for a community education program on hypertension. Which of
these parameters determine the regulation of arterial blood pressure?
a.
Cardiac output and systemic vascular resistance
b.
Heart rate and peripheral resistance
c.
Blood volume and renal blood flow
d.
Myocardial contractility and arteriolar constriction
ANS: A
Blood pressure is determined by the product of cardiac output and systemic vascular
resistance. The other options are incorrect.
DIF: COGNITIVE LEVEL: Understanding (Comprehension) REF: p. 343
TOP: NURSING PROCESS: General
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
5. When counseling a male patient about the possible adverse effects of antihypertensive
drugs, the nurse will discuss which potential problem?
a.
Impotence
b.
Bradycardia
c.
Increased libido
d.
Weight gain
ANS: A
Sexual dysfunction is a common complication of antihypertensive medications and may be
manifested in men as decreased libido or impotence. The other options are incorrect.
DIF: COGNITIVE LEVEL: Understanding (Comprehension) REF: p. 358
TOP: NURSING PROCESS: Assessment
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
6. The nurse is reviewing drug therapy for hypertension. According to the JNC-8 guidelines,
antihypertensive drug therapy for a newly diagnosed hypertensive African-American patient
would most likely include which drug or drug classes?
a.
Vasodilators alone
b.
ACE inhibitors alone
c.
Calcium channel blockers with thiazide diuretics
d.
Beta blockers with thiazide diuretics
ANS: C
According to the JNC-8 guidelines, calcium channel blockers and diuretics are
recommended as first-line therapy for management of hypertension in African-American
patients. The other drugs are not recommended as first-line drugs for this group.
DIF: COGNITIVE LEVEL: Applying (Application) REF: p. 355
, TOP: NURSING PROCESS: Implementation
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
7. The nurse is creating a plan of care for a patient with a new diagnosis of hypertension. Which
is a potential nursing diagnosis for the patient taking antihypertensive medications?
a.
Diarrhea
b.
Sexual dysfunction
c.
Urge urinary incontinence
d.
Impaired memory
ANS: B
Sexual dysfunction is a potential nursing diagnosis related to possible adverse effects of
antihypertensive drug therapy. The other nursing diagnoses are not appropriate.
DIF: COGNITIVE LEVEL: Applying (Application) REF: p. 355
TOP: NURSING PROCESS: Nursing Diagnosis
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
8. A patient’s blood pressure elevates to 270/150 mm Hg, and a hypertensive emergency is
obvious. He is transferred to the intensive care unit and started on a sodium nitroprusside
(Nipride) drip to be titrated per his response. With this medication, the nurse knows that the
maximum dose of this drug should be infused for how long?
a.
10 minutes
b.
30 minutes
c.
1 hour
d.
24 hours
ANS: A
Sodium nitroprusside is a potent vasodilator and may lead to extreme decreases in the
patient’s blood pressure. For this reason, it is never infused at the maximum dose for more
than 10 minutes. If this drug does not control a patient’s blood pressure after 10 minutes, it
will most likely be ordered to be discontinued. The other times listed are incorrect.
DIF: COGNITIVE LEVEL: Understanding (Comprehension) REF: p. 357
TOP: NURSING PROCESS: Planning
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
9. A patient with primary hypertension is prescribed drug therapy for the first time. The patient
asks how long drug therapy will be needed. Which answer by the nurse is the correct
response?
a.
“This therapy will take about 3 months.”
b.
“This therapy will take about a year.”
c.
“This therapy will go on until your symptoms disappear.”
d.
“Therapy for high blood pressure is usually lifelong.”
ANS: D
There is no cure for the disease, and treatment will be lifelong. The other answers are not
appropriate.
DIF: COGNITIVE LEVEL: Understanding (Comprehension) REF: p. 355
TOP: NURSING PROCESS: Implementation
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
, 10. A patient who has been taking antihypertensive drugs for a few months complains of having a
persistent dry cough. The nurse knows that this cough is an adverse effect of which class of
antihypertensive drugs?
a.
Beta blockers
b.
Angiotensin-converting enzyme (ACE) inhibitors
c.
Angiotensin II receptor blockers (ARBs)
d.
Calcium channel blockers
ANS: B
ACE inhibitors cause a characteristic dry, nonproductive cough that reverses when therapy is
stopped. The other drug classes do not cause this cough.
DIF: COGNITIVE LEVEL: Understanding (Comprehension) REF: p. 349
TOP: NURSING PROCESS: Assessment
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
11. A pregnant woman is experiencing hypertension. The nurse knows that which drug
is commonly used for a pregnant patient who is experiencing hypertension?
a.
Mannitol (Osmitrol)
b.
Enalapril (Vasotec)
c.
Hydrochlorothiazide (HydroDIURIL)
d.
Methyldopa (Aldomet)
ANS: D
Methyldopa is used in the treatment of hypertension during pregnancy. The other options are
incorrect.
DIF: COGNITIVE LEVEL: Understanding (Comprehension) REF: p. 347
TOP: NURSING PROCESS: Planning
MSC: NCLEX: Physiological Integrity: Pharmacological Therapies
12. A patient with type 2 diabetes mellitus has been found to have trace proteinuria. The
prescriber writes an order for an angiotensin-converting enzyme (ACE) inhibitor. What is the
main reason for prescribing this class of drug for this patient?
a.
Cardioprotective effects
b.
Renal protective effects
c.
Reduces blood pressure
d.
Promotes fluid output
ANS: B
ACE inhibitors have been shown to have a protective effect on the kidneys because they
reduce glomerular filtration pressure. This is one reason that they are among the
cardiovascular drugs of choice for diabetic patients. The other drugs do not have this effect.
DIF: COGNITIVE LEVEL: Applying (Application) REF: p. 349
TOP: NURSING PROCESS: Assessment
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
Chapter 22: Antihypertensive Drugs
Lilley: Pharmacology and the Nursing Process, 8th Edition
MULTIPLE CHOICE
1. A patient has a new order for the adrenergic drug doxazosin (Cardura). When providing
education about this drug, the nurse will include which instructions?
a.
“Weigh yourself daily, and report any weight loss to your prescriber.”
b.
“Increase your potassium intake by eating more bananas and apricots.”
c.
“The impaired taste associated with this medication usually goes away in 2 to 3
weeks.”
d.
“Be sure to lie down after taking the first dose, because first-dose hypotension may
make you dizzy.”
ANS: D
A patient who is starting doxazosin should take the first dose while lying down because there
is a first-dose hypotensive effect with this medication. The other options are incorrect.
DIF: COGNITIVE LEVEL: Analyzing (Analysis) REF: p. 354
TOP: NURSING PROCESS: Implementation
MSC: NCLEX: Physiological Integrity: Reduction of Risk Potential
2. A patient with severe liver disease is receiving the angiotensin-converting enzyme (ACE)
inhibitor, captopril (Capoten). The nurse is aware that the advantage of this drug for this
patient is which characteristic?
a.
Captopril rarely causes first-dose hypotensive effects.
b.
Captopril has little effect on electrolyte levels.
c.
Captopril is a prodrug and is metabolized by the liver before becoming active.
d.
Captopril is not a prodrug and does not need to be metabolized by the liver
before becoming active.
ANS: D
A prodrug relies on a functioning liver to be converted to its active form. Captopril is not a
prodrug, and therefore it would be safer for the patient with liver dysfunction.
DIF: COGNITIVE LEVEL: Applying (Application) REF: p. 348
TOP: NURSING PROCESS: Assessment
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
3. During a follow-up visit, the health care provider examines the fundus of the patient’s eye.
Afterward, the patient asks the nurse, “Why is he looking at my eyes when I have high blood
pressure? It does not make sense to me!” What is the best response by the nurse?
a.
“We need to monitor for drug toxicity.”
b.
“We must watch for increased intraocular pressure.”
c.
“The provider is assessing for visual changes that may occur with drug therapy.”
d.
“The provider is making sure the treatment is effective over the long term.”
ANS: D
, The physician would examine the fundus of a patient’s eyes during antihypertensive therapy
because it is a more reliable indicator than blood pressure readings of the long-term
effectiveness of treatment.
DIF: COGNITIVE LEVEL: Applying (Application) REF: p. 358
TOP: NURSING PROCESS: Evaluation
MSC: NCLEX: Physiological Integrity: Physiological Adaptation
4. The nurse is preparing for a community education program on hypertension. Which of
these parameters determine the regulation of arterial blood pressure?
a.
Cardiac output and systemic vascular resistance
b.
Heart rate and peripheral resistance
c.
Blood volume and renal blood flow
d.
Myocardial contractility and arteriolar constriction
ANS: A
Blood pressure is determined by the product of cardiac output and systemic vascular
resistance. The other options are incorrect.
DIF: COGNITIVE LEVEL: Understanding (Comprehension) REF: p. 343
TOP: NURSING PROCESS: General
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
5. When counseling a male patient about the possible adverse effects of antihypertensive
drugs, the nurse will discuss which potential problem?
a.
Impotence
b.
Bradycardia
c.
Increased libido
d.
Weight gain
ANS: A
Sexual dysfunction is a common complication of antihypertensive medications and may be
manifested in men as decreased libido or impotence. The other options are incorrect.
DIF: COGNITIVE LEVEL: Understanding (Comprehension) REF: p. 358
TOP: NURSING PROCESS: Assessment
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
6. The nurse is reviewing drug therapy for hypertension. According to the JNC-8 guidelines,
antihypertensive drug therapy for a newly diagnosed hypertensive African-American patient
would most likely include which drug or drug classes?
a.
Vasodilators alone
b.
ACE inhibitors alone
c.
Calcium channel blockers with thiazide diuretics
d.
Beta blockers with thiazide diuretics
ANS: C
According to the JNC-8 guidelines, calcium channel blockers and diuretics are
recommended as first-line therapy for management of hypertension in African-American
patients. The other drugs are not recommended as first-line drugs for this group.
DIF: COGNITIVE LEVEL: Applying (Application) REF: p. 355
, TOP: NURSING PROCESS: Implementation
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
7. The nurse is creating a plan of care for a patient with a new diagnosis of hypertension. Which
is a potential nursing diagnosis for the patient taking antihypertensive medications?
a.
Diarrhea
b.
Sexual dysfunction
c.
Urge urinary incontinence
d.
Impaired memory
ANS: B
Sexual dysfunction is a potential nursing diagnosis related to possible adverse effects of
antihypertensive drug therapy. The other nursing diagnoses are not appropriate.
DIF: COGNITIVE LEVEL: Applying (Application) REF: p. 355
TOP: NURSING PROCESS: Nursing Diagnosis
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
8. A patient’s blood pressure elevates to 270/150 mm Hg, and a hypertensive emergency is
obvious. He is transferred to the intensive care unit and started on a sodium nitroprusside
(Nipride) drip to be titrated per his response. With this medication, the nurse knows that the
maximum dose of this drug should be infused for how long?
a.
10 minutes
b.
30 minutes
c.
1 hour
d.
24 hours
ANS: A
Sodium nitroprusside is a potent vasodilator and may lead to extreme decreases in the
patient’s blood pressure. For this reason, it is never infused at the maximum dose for more
than 10 minutes. If this drug does not control a patient’s blood pressure after 10 minutes, it
will most likely be ordered to be discontinued. The other times listed are incorrect.
DIF: COGNITIVE LEVEL: Understanding (Comprehension) REF: p. 357
TOP: NURSING PROCESS: Planning
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
9. A patient with primary hypertension is prescribed drug therapy for the first time. The patient
asks how long drug therapy will be needed. Which answer by the nurse is the correct
response?
a.
“This therapy will take about 3 months.”
b.
“This therapy will take about a year.”
c.
“This therapy will go on until your symptoms disappear.”
d.
“Therapy for high blood pressure is usually lifelong.”
ANS: D
There is no cure for the disease, and treatment will be lifelong. The other answers are not
appropriate.
DIF: COGNITIVE LEVEL: Understanding (Comprehension) REF: p. 355
TOP: NURSING PROCESS: Implementation
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
, 10. A patient who has been taking antihypertensive drugs for a few months complains of having a
persistent dry cough. The nurse knows that this cough is an adverse effect of which class of
antihypertensive drugs?
a.
Beta blockers
b.
Angiotensin-converting enzyme (ACE) inhibitors
c.
Angiotensin II receptor blockers (ARBs)
d.
Calcium channel blockers
ANS: B
ACE inhibitors cause a characteristic dry, nonproductive cough that reverses when therapy is
stopped. The other drug classes do not cause this cough.
DIF: COGNITIVE LEVEL: Understanding (Comprehension) REF: p. 349
TOP: NURSING PROCESS: Assessment
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
11. A pregnant woman is experiencing hypertension. The nurse knows that which drug
is commonly used for a pregnant patient who is experiencing hypertension?
a.
Mannitol (Osmitrol)
b.
Enalapril (Vasotec)
c.
Hydrochlorothiazide (HydroDIURIL)
d.
Methyldopa (Aldomet)
ANS: D
Methyldopa is used in the treatment of hypertension during pregnancy. The other options are
incorrect.
DIF: COGNITIVE LEVEL: Understanding (Comprehension) REF: p. 347
TOP: NURSING PROCESS: Planning
MSC: NCLEX: Physiological Integrity: Pharmacological Therapies
12. A patient with type 2 diabetes mellitus has been found to have trace proteinuria. The
prescriber writes an order for an angiotensin-converting enzyme (ACE) inhibitor. What is the
main reason for prescribing this class of drug for this patient?
a.
Cardioprotective effects
b.
Renal protective effects
c.
Reduces blood pressure
d.
Promotes fluid output
ANS: B
ACE inhibitors have been shown to have a protective effect on the kidneys because they
reduce glomerular filtration pressure. This is one reason that they are among the
cardiovascular drugs of choice for diabetic patients. The other drugs do not have this effect.
DIF: COGNITIVE LEVEL: Applying (Application) REF: p. 349
TOP: NURSING PROCESS: Assessment
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
