Chapter 8: Antihypertensives
MULTIPLE CHOICE
1. A patient is diagnosed with borderline hypertension and states a desire to make
lifestyle changes to avoid needing to take medication. The nurse will recommend which
changes? a. Changing from weight bearing exercise to yoga
b. Decreased fluid intake and increased potassium intake
c. Stress reduction and increased protein intake
d. Weight reduction and decreased sodium intake
ANS: D
Weight loss decreases the stress on the heart and the afterload. Decreasing salt intake decreases
the amount of retained fluid. Changing to yoga from weight-bearing exercise, limiting fluids,
and increasing potassium are not indicated. Stress reduction is recommended, but increasing
protein is not.
DIF: COGNITIVE LEVEL: Applying (Application) REF: dm 634
TOP: NURSING PROCESS: Nursing Intervention: Patient Teaching
MSC: NCLEX: Health Promotion Model
2. A patient has a blood pressure of 135/85 mm Hg on three separate occasions. The
nurse understands that this patient should be treated with a. a beta blocker.
b. a diuretic and a beta blocker.
c. a diuretic.
d. lifestyle changes.
ANS: D
Prehypertension is defined as a systolic pressure of 120 to 139 and a diastolic pressure
between 80 and 89. Drug therapy is recommended if the blood pressure is greater than 20/10
over the goal, which would be140/90. Prehypertension is generally treated first with lifestyle
changes.
DIF: COGNITIVE LEVEL: Understanding (Comprehension) REF: dm 635
TOP: NURSING PROCESS: Nursing Intervention
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
3. A patient has a blood pressure of 155/95 mm Hg. The nurse understands that this patients
risk of cardiovascular disease is greater than normal. a. two times
b. three times
c. four times
d. six times
ANS: C
Cardiovascular disease (CVD) risk doubles with each increase of 20/10 mm Hg above normal,
starting at 115/75 mm Hg. This patients blood pressure is 40/20 above normal, which increases
the risk four times. A blood pressure of 135/85 would be two times greater. The patients risk
, would still be four times greater with a blood pressure of 155/70 or 130/95, since systolic and
diastolic blood hypertension are each powerful predictors of CVD.
DIF: COGNITIVE LEVEL: Applying (Application) REF: dm 635
TOP: NURSING PROCESS: Assessment
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
4. The nurse is caring for an African-American patient who has been taking a beta blocker to
treat hypertension for several weeks with only slight improvement in blood pressure. The
nurse will contact the provider to discuss
a. adding a diuretic medication.
b. changing to an ACE inhibitor.
c. decreasing the beta blocker dose.
d. doubling the beta blocker dose.
ANS: A
African Americans do not respond well to beta blockers and ACE inhibitors, but do tend to
respond to diuretics and calcium channel blockers. Changing to an ACE inhibitor or altering the
beta blocker dose are not indicated. Hypertension in African-American patients can be
controlled by combining beta blockers with diuretics.
DIF: COGNITIVE LEVEL: Applying (Application) REF: dm 636
TOP: NURSING PROCESS: Nursing Intervention/Planning
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
5. The nurse understands that a medication such as carvedilol (Coreg) may not be effective in
an African-American patient because of its effects on a. cardiac contractility.
b. heart rate.
c. renin release.
d. vascular resistance.
ANS: C
African Americans are more likely to be susceptible to low-renin hypertension. Beta blockers
reduce heart rate, contractility, and renin release, and there is a greater hypotensive response
in patients with higher renin levels. Changes in heart rate, contractility, and vascular
resistance explain why there is some response in this group.
DIF: COGNITIVE LEVEL: Understanding (Comprehension) REF: dm 636
TOP: NURSING PROCESS: Nursing Intervention
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
6. The nurse is preparing to care for a Native-American patient who has hypertension. The
nurse understands that which antihypertensive medication would be most effective in this
patient? a. Acebutolol (Sectral)
b. Captopril (Capoten)
c. Carteolol HCl (Cartrol)
d. Metoprolol (Lopressor)
ANS: B
uytr
Nursedocs Page 2 of 7
MULTIPLE CHOICE
1. A patient is diagnosed with borderline hypertension and states a desire to make
lifestyle changes to avoid needing to take medication. The nurse will recommend which
changes? a. Changing from weight bearing exercise to yoga
b. Decreased fluid intake and increased potassium intake
c. Stress reduction and increased protein intake
d. Weight reduction and decreased sodium intake
ANS: D
Weight loss decreases the stress on the heart and the afterload. Decreasing salt intake decreases
the amount of retained fluid. Changing to yoga from weight-bearing exercise, limiting fluids,
and increasing potassium are not indicated. Stress reduction is recommended, but increasing
protein is not.
DIF: COGNITIVE LEVEL: Applying (Application) REF: dm 634
TOP: NURSING PROCESS: Nursing Intervention: Patient Teaching
MSC: NCLEX: Health Promotion Model
2. A patient has a blood pressure of 135/85 mm Hg on three separate occasions. The
nurse understands that this patient should be treated with a. a beta blocker.
b. a diuretic and a beta blocker.
c. a diuretic.
d. lifestyle changes.
ANS: D
Prehypertension is defined as a systolic pressure of 120 to 139 and a diastolic pressure
between 80 and 89. Drug therapy is recommended if the blood pressure is greater than 20/10
over the goal, which would be140/90. Prehypertension is generally treated first with lifestyle
changes.
DIF: COGNITIVE LEVEL: Understanding (Comprehension) REF: dm 635
TOP: NURSING PROCESS: Nursing Intervention
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
3. A patient has a blood pressure of 155/95 mm Hg. The nurse understands that this patients
risk of cardiovascular disease is greater than normal. a. two times
b. three times
c. four times
d. six times
ANS: C
Cardiovascular disease (CVD) risk doubles with each increase of 20/10 mm Hg above normal,
starting at 115/75 mm Hg. This patients blood pressure is 40/20 above normal, which increases
the risk four times. A blood pressure of 135/85 would be two times greater. The patients risk
, would still be four times greater with a blood pressure of 155/70 or 130/95, since systolic and
diastolic blood hypertension are each powerful predictors of CVD.
DIF: COGNITIVE LEVEL: Applying (Application) REF: dm 635
TOP: NURSING PROCESS: Assessment
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
4. The nurse is caring for an African-American patient who has been taking a beta blocker to
treat hypertension for several weeks with only slight improvement in blood pressure. The
nurse will contact the provider to discuss
a. adding a diuretic medication.
b. changing to an ACE inhibitor.
c. decreasing the beta blocker dose.
d. doubling the beta blocker dose.
ANS: A
African Americans do not respond well to beta blockers and ACE inhibitors, but do tend to
respond to diuretics and calcium channel blockers. Changing to an ACE inhibitor or altering the
beta blocker dose are not indicated. Hypertension in African-American patients can be
controlled by combining beta blockers with diuretics.
DIF: COGNITIVE LEVEL: Applying (Application) REF: dm 636
TOP: NURSING PROCESS: Nursing Intervention/Planning
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
5. The nurse understands that a medication such as carvedilol (Coreg) may not be effective in
an African-American patient because of its effects on a. cardiac contractility.
b. heart rate.
c. renin release.
d. vascular resistance.
ANS: C
African Americans are more likely to be susceptible to low-renin hypertension. Beta blockers
reduce heart rate, contractility, and renin release, and there is a greater hypotensive response
in patients with higher renin levels. Changes in heart rate, contractility, and vascular
resistance explain why there is some response in this group.
DIF: COGNITIVE LEVEL: Understanding (Comprehension) REF: dm 636
TOP: NURSING PROCESS: Nursing Intervention
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
6. The nurse is preparing to care for a Native-American patient who has hypertension. The
nurse understands that which antihypertensive medication would be most effective in this
patient? a. Acebutolol (Sectral)
b. Captopril (Capoten)
c. Carteolol HCl (Cartrol)
d. Metoprolol (Lopressor)
ANS: B
uytr
Nursedocs Page 2 of 7
