TEST BANK FOR ROACH’S INTRODUCTORY CLINICAL PHARMACOLOGY

4. While reviewing a client's lab work, the nurse notices the client's potassium is elevated. The nurse checks the client's medication record. Which of the following, if found, would the nurse identify as contributing to the client's elevated potassium level? Select all that apply. A) Atenolol B) Aliskiren C) Clonidine D) Metoprolol E) Eplerenone Ans: B, E Feedback: Direct renin inhibitors such as aliskiren and the drug eplerenone can cause hyperkalemia. Atenolol and metoprolol are beta blockers. Clonidine is a centrally acting adrenergic drug. 5. A nurse is caring for a client experiencing a hypertensive emergency. The nurse understands that if blood pressure is not lowered immediately, damage to which of the following can occur? Select all that apply. A) Heart B) Kidneys C) Gallbladder D) Pancreas E) Eyes Ans: A, B, E Feedback: A hypertensive emergency, if not recognized and treated quickly, can result in damage to target organs including the heart, kidneys, and eyes. 6. Angioedema is a potentially life-threatening medical condition that is associated with some classes of antihypertensive medications. The nurse suspects that a client is experiencing angioedema based on which assessment finding? Select all that apply. A) Heart rate above 100 beats per minute B) Fever greater than 100°F C) Swelling of the face D) Swelling of the throat E) Blood pressure above 170/100 mm Hg Ans: C, D Feedback: w Angioedema presents with swelling of the face, lips, throat, or extremities. 7. Before administering an antihypertensive, the nurse should complete which of the following assessments? Select all that apply. A) Pulse rate on both arms B) Pulse rate on one arm C) Blood pressure in the sitting position D) Blood pressure on both arms E) Blood pressure on one arm Ans: A, C, D Feedback: Pre administration assessment for anti hypertensives should include blood pressure and pulse rate on both arms with the client in standing, sitting, and lying positions. 8. The nurse is providing care to a client being treated for a hypertensive emergency. Which of the following would be appropriate for the nurse to do? A) Take a blood pressure every 30 minutes. B) Alternate the arms for assessing the blood pressure and pulse. C) Continuously monitor the client's status. D) Measure the pulse rate every hour. Ans: C Feedback: When the patient has severe hypertension, does not have the expected response to drug therapy, or is critically ill, continuous monitoring is performed. The blood pressure should be taken in the same arm and same position each time. 9. A client with hypertension comes to the clinic for a follow-up visit. Which of the following would be appropriate for the nurse to do when assisting the client in managing his hypertension? Select all that apply. A) Find local resources in the community for taking blood pressure. B) Teach client how to properly record weight and blood pressure. C) Schedule regular monitoring of weight and blood pressure. D) Schedule an appointment to see a cardiologist. E) Schedule an appointment to see a nephrologist. Ans: A, B, C Feedback: In the ambulatory care setting, the nurse helps plan a schedule of regular monitoring of weight and blood pressure, finds local resources for taking blood pressure in the community, and teaches the client how to record weight and blood pressure readings. 10. The nurse should notify the primary health care provider when which of the following occur while a client is receiving an antihypertensive? Select all that apply. A) Weight gain of 2 lb or more per day B) Headache C) Edema D) Insomnia E) Sedation Ans: A, C Feedback: The nurse should notify the primary health care provider if a client has a weight gain of 2 lb or more per day or edema of the hands, fingers, feet, legs, or sacral area. 11. When teaching a client about the prescribed clonidine transdermal medication, which of the following would the nurse most likely include? Select all that apply. A) A new patch is applied daily. B) If the patch loosens, a new patch should be applied. C) The use of the adhesive overlay is not necessary. D) A different body area should be selected for each application. E) The patch should be applied to a hairless area. Ans: D, E Feedback: The patch is applied to a hairless area of intact skin on the upper arm or torso; the patch is kept in place for 7 days. The adhesive overlay is applied directly over the system to ensure the patch remains in place for the required time. A different body area is selected for each application. If the patch loosens before 7 days, the edges can be reinforced with nonallergenic tape. The date the patch was placed and the date the patch is to be removed can be written on the surface of the patch with a fiber-tipped pen. 12. The nurse should advise the client to do which of the following to reduce the risk of falls due to orthostatic hypotension from antihypertensive drugs? Select all that apply. A) Sit on the bed for 1 or 2 minutes when rising from a lying position. B) Rise quickly from a chair when moving to a standing position. C) Take the antihypertensive less frequently if hypotension occurs. D) Have someone assist the client if dizziness or weakness occurs. E) Increase salt intake to counteract the hypotension. Ans: A, D Feedback: The nurse explains that when rising from a lying position, the client should sit on the edge of the bed for 1 or 2 minutes; the client should rise slowly from a chair and then stand for 1 to 2 minutes; and when symptoms of orthostatic hypotension occur, someone assisting the client in getting out of bed or a chair can decrease the risk of falls due to orthostatic hypotension.