CH 25 Hypertension Drugs NCLEX
fully solved & updated (graded
A+)
A client receiving furosemide (Lasix) as an adjunct to treatment of
hypertension returns for follow-up. Which of the following objective data
should the nurse consider when determining the effectiveness of the drug
therapy?
Blood pressure log notes blood pressure 120/70-134/88 since discharge.
Weight loss of six pounds in the past month
Frequency of voiding of at least six times per day
Absence of edema in lower extremities - answer Blood pressure log notes
blood pressure 120/70-134/88 since discharge.
Rationale: Maintenance of blood pressure within normal limits indicates that
treatment goals are achieved. Absence of edema, weight loss, and urinating
all indicate that the diuretic has promoted fluid loss, but are not the best
measure of the drug's effectiveness for hypertension.
A client receiving HCTZ 25 mg q.d. and digoxin 0.125 mg q.d. complains of
nausea and vomiting, and of seeing halos around lights. The client's serum
digoxin level is 2.5 ng. The appropriate nursing intervention is to:
Administer both drugs as ordered.
Document the findings; the lab results are within normal limits.
Hold the digoxin and HCTZ.
Hold the digoxin, and give HCTZ as ordered. - answer Hold the digoxin and
HCTZ.
, Rationale: Thiazide diuretics increase serum digitalis levels by promoting
potassium loss, which increases the risk of digoxin toxicity. A digitalis level
above 2.0 ng is toxic.
Nitroprusside (Nitropress) is prescribed for a client admitted with a blood
pressure of 220/110. What action by a new nurse would require intervention
by the charge nurse?
The nurse inserts a Foley catheter.
The nurse documents the IV rate and status of site every 15 minutes.
The nurse uses electronic monitoring of blood pressure every hour.
The nurse cautions the client to call for assistance before getting out of bed.
- answer The nurse uses electronic monitoring of blood pressure every hour.
Rationale: Nitroprusside decreases blood pressure instantaneously. Vital
signs must be monitored very closely—e.g., every 5-15 minutes.
The nurse is preparing a nitroprusside (Nitropress) IV drip for a client with
severe hypertension. Which of the following actions by the nurse reflect
correct preparation? (Select all that apply.)
Instructs the client to keep the shades in the room closed during the
infusion.
Keeps an opaque cover over the solution and tubing.
Mixes the drug in 250 mL of 5% dextrose and water.
Piggybacks the drug into the client's maintenance IV of normal saline
solution, NSS.
Removes the opaque cover before administering. - answer Keeps an opaque
cover over the solution and tubing.
Mixes the drug in 250 mL of 5% dextrose and water.
fully solved & updated (graded
A+)
A client receiving furosemide (Lasix) as an adjunct to treatment of
hypertension returns for follow-up. Which of the following objective data
should the nurse consider when determining the effectiveness of the drug
therapy?
Blood pressure log notes blood pressure 120/70-134/88 since discharge.
Weight loss of six pounds in the past month
Frequency of voiding of at least six times per day
Absence of edema in lower extremities - answer Blood pressure log notes
blood pressure 120/70-134/88 since discharge.
Rationale: Maintenance of blood pressure within normal limits indicates that
treatment goals are achieved. Absence of edema, weight loss, and urinating
all indicate that the diuretic has promoted fluid loss, but are not the best
measure of the drug's effectiveness for hypertension.
A client receiving HCTZ 25 mg q.d. and digoxin 0.125 mg q.d. complains of
nausea and vomiting, and of seeing halos around lights. The client's serum
digoxin level is 2.5 ng. The appropriate nursing intervention is to:
Administer both drugs as ordered.
Document the findings; the lab results are within normal limits.
Hold the digoxin and HCTZ.
Hold the digoxin, and give HCTZ as ordered. - answer Hold the digoxin and
HCTZ.
, Rationale: Thiazide diuretics increase serum digitalis levels by promoting
potassium loss, which increases the risk of digoxin toxicity. A digitalis level
above 2.0 ng is toxic.
Nitroprusside (Nitropress) is prescribed for a client admitted with a blood
pressure of 220/110. What action by a new nurse would require intervention
by the charge nurse?
The nurse inserts a Foley catheter.
The nurse documents the IV rate and status of site every 15 minutes.
The nurse uses electronic monitoring of blood pressure every hour.
The nurse cautions the client to call for assistance before getting out of bed.
- answer The nurse uses electronic monitoring of blood pressure every hour.
Rationale: Nitroprusside decreases blood pressure instantaneously. Vital
signs must be monitored very closely—e.g., every 5-15 minutes.
The nurse is preparing a nitroprusside (Nitropress) IV drip for a client with
severe hypertension. Which of the following actions by the nurse reflect
correct preparation? (Select all that apply.)
Instructs the client to keep the shades in the room closed during the
infusion.
Keeps an opaque cover over the solution and tubing.
Mixes the drug in 250 mL of 5% dextrose and water.
Piggybacks the drug into the client's maintenance IV of normal saline
solution, NSS.
Removes the opaque cover before administering. - answer Keeps an opaque
cover over the solution and tubing.
Mixes the drug in 250 mL of 5% dextrose and water.
