Question 1

The nurse would make it a priority to assess the client receiving losartan (Cozaar)for which of the following most common adverse drug effects?

Accepted Answer

Losartan (Cozaar) is an angiotensin II receptor blocker (ARB) used primarily to treat high blood pressure and heart failure. The most common adverse effects associated with losartan include dizziness, fatigue, and headache, rather than constipation, urine discoloration, or a nonproductive cough, which are not typically associated with this medication.

Question 2

The nurse would contact the prescriber immediately if a client taking lisinopril (Prinivil)developed which of the following manifestations after taking a dose of the drug?

Accepted Answer

Swelling of the face and throat can indicate the onset of anaphylaxis, a severe and potentially life-threatening allergic reaction. The nurse should notify the prescriber immediately and take appropriate emergency measures. Dry cough, mild tachycardia, and modest blood pressure reduction are common side effects of lisinopril and do not require immediate intervention unless they are severe or persistent.

Question 3

Based on current evidence,the nurse anticipates that an African American client with hypertension would probably respond best to which combination of medications?

Accepted Answer

African American clients with hypertension have been shown to respond better to the combination of diuretics and calcium antagonists. This combination is effective in lowering blood pressure in this population, possibly due to differences in the pathophysiology of hypertension among different racial groups.

Question 4

Client education about clonidine (Catapres)should include which of the following statements?

Accepted Answer

Clonidine can cause drowsiness as a side effect, so taking the last dose before bedtime can help manage this effect and ensure stable blood levels throughout the day.

Question 5

When teaching a client about the drug atenolol (Tenormin)ordered as an antihypertensive,the nurse would inform the client that

Accepted Answer

Abrupt withdrawal from atenolol can lead to rebound hypertension, so it is important for clients to gradually taper off the medication under the guidance of their healthcare provider. Antihypertensive medications are not taken with antacids, alcohol intake should be limited, and hot baths or hot tubs may actually increase blood pressure.

Question 6

Minoxidil (Loniten)should be given concurrently with a $\beta$-adrenergic blocking agent by the nurse as ordered to prevent

Accepted Answer

Minoxidil is a potent vasodilator which can cause reflex tachycardia, therefore, it should be given with a beta-blocker to prevent this side effect. A beta-blocker will also help to prevent tachycardia-induced myocardial ischemia. Edema and bradycardia are not side effects of minoxidil, and severe hypertension is not prevented by giving minoxidil with a beta-blocker.

Question 7

The desired effects of diuretics in the reduction of blood pressure are caused by which of the following mechanisms?

Accepted Answer

Diuretics work by reducing the volume of fluid in the body, leading to a decrease in blood volume and subsequently a reduction in blood pressure. Option A is incorrect because diuretics do not cause vasoconstriction; rather, they can sometimes cause vasodilation. Option B is incorrect because diuretics do not directly affect serotonin levels, and while they may reduce cardiac workload, this is not the primary mechanism by which they reduce blood pressure. Option D is incorrect because diuretics do not correct an ineffective vasomotor response; rather, they may affect vasomotor tone indirectly by decreasing blood volume and reducing pressure on the blood vessels.

Question 8

The nurse would question an order for methyldopa (Aldomet)as an antihypertensive drug for a client with which of the following concurrent health problems?

Accepted Answer

Methyldopa is metabolized in the liver and should be used with caution in clients with liver disease or cirrhosis. It may cause hepatotoxicity and worsen liver function.

Question 9

A client with hypertension will be started on a diuretic as first-line drug therapy after lifestyle changes have been ineffective.Which of the following types of diuretics does the nurse anticipate will be used?

Accepted Answer

Thiazide diuretics, such as hydrochlorothiazide, are commonly used as first-line drug therapy for hypertension because they are effective and well-tolerated. Loop diuretics, potassium-sparing diuretics, and osmotic diuretics may be used in other clinical situations, but are not typically the first choice for hypertension.

Question 10

A nursing student who has an order to give a dose of clonidine (Catapres)to an assigned client asks the nurse about the medication.After referring the student to the drug handbook,the nurse could share that this drug is classified as

Accepted Answer

Clonidine (Catapres) is classified as a centrally acting adrenergic inhibitor. It works by decreasing sympathetic nervous system activity, leading to a decrease in blood pressure and heart rate.

Question 11

A client beginning drug therapy with enalapril (Vasotec)indicates an understanding of drug therapy by stating that which of the following adverse effects may likely occur?

Accepted Answer

Nonproductive cough is a common adverse effect of enalapril and other ACE inhibitors, due to an increase in bradykinin levels. Stuffy nose, buzzing sound in the ears, and numbness and tingling are not typically associated with enalapril use.

Question 12

The nurse places highest priority on assessing the results of which of the following laboratory studies drawn on a client receiving losartan (Cozaar)?

Accepted Answer

Losartan (Cozaar) is an angiotensin II receptor antagonist used to treat hypertension and heart failure. The medication can cause hyperkalemia (elevated serum potassium levels) as a side effect, so it is crucial for the nurse to monitor serum potassium levels of the client receiving losartan. Creatinine levels should also be monitored to assess for any changes in renal function. Serum sodium, calcium, phosphorus, magnesium, and uric acid levels are not directly affected by losartan therapy.

Question 13

A client's blood pressure is elevated to 200/120 mm Hg,and a hypertensive emergency is obvious.He is transferred to the intensive care unit and started on a sodium nitroprusside drip (Nipride)to be titrated per orders and client response.With the administration of nitroprusside,the nurse anticipates seeing a decrease in blood pressure

Accepted Answer

Sodium nitroprusside is a fast-acting vasodilator, and its effects on lowering blood pressure are immediate once the infusion is started.

Question 14

The client who is receiving antihypertensive drug therapy is scheduled for elective surgery.What nursing action is the most appropriate for standard practice?

Accepted Answer

It is important to keep the client's blood pressure under control during surgery, and abruptly stopping antihypertensive medication can cause a sudden increase in blood pressure. Giving a double dose can cause complications such as hypotension. Therefore, giving the drug up to the time of surgery and as soon as possible afterward is the most appropriate action. Giving the drug sublingually is not recommended unless specifically ordered by the healthcare provider.

Question 15

A client is taking amlodipine (Norvasc)for control of hypertension.The nurse would give the client which of the following instructions about its use?

Accepted Answer

Amlodipine is best absorbed on an empty stomach.

Question 16

Any elevation in blood pressure stretches the baroreceptors and leads to a subsequent

Accepted Answer

Baroreceptors, when stretched due to an elevation in blood pressure, initiate a reflex response aimed at lowering the blood pressure. This involves decreasing the heart rate and cardiac output, which are mechanisms to reduce the pressure, rather than increasing it further through sympathetic stimulation, increasing heart contractility, or causing vasoconstriction.

Question 17

The nurse would question a new drug order for which of the following medications,which is contraindicated when a client is taking methyldopa (Aldomet)?

Accepted Answer

Monoamine oxidase inhibitors (MAOIs) are contraindicated with methyldopa because of the risk of hypertensive crisis. MAOIs can cause an increase in norepinephrine, which can lead to a sudden and dangerous increase in blood pressure when combined with methyldopa.

Question 18

Which one of the following is an appropriate nursing intervention for the client who is taking hydrochlorothiazide?

Accepted Answer

Hydrochlorothiazide is a diuretic that can cause potassium depletion, so encouraging intake of potassium-rich foods such as tomatoes can help prevent this. Scheduling the dose for late afternoon is not a specific nursing intervention related to hydrochlorothiazide. Monitoring serum calcium and sodium levels is not directly related to hydrochlorothiazide. Taking the radial pulse is not a specific nursing intervention related to hydrochlorothiazide.

Question 19

One of the most powerful substances in the body that leads to vasoconstriction is

Accepted Answer

Angiotensin II is a potent vasoconstrictor that acts by constricting the smooth muscles of the blood vessels, thereby narrowing the diameter of the vessel and increasing blood pressure. Epinephrine, dopamine, and serotonin also have vasoconstrictive effects, but these are not as strong as the effects of angiotensin II.

Question 20

A client is beginning drug therapy with lisinopril (Prinivil).The nurse explains to the client that it which of the following laboratory tests must be drawn monthly for the first 3 to 6 months of therapy?

Accepted Answer

Lisinopril (Prinivil) can cause neutropenia, so a white blood cell count with differential should be monitored monthly for the first 3 to 6 months of therapy. Platelet count, international normalized ratio, and partial thromboplastin time are not affected by lisinopril therapy.

Quiz 27: Antihypertensives

The nurse would make it a priority to assess the client receiving losartan (Cozaar) for which of the following most common adverse drug effects?

The nurse would contact the prescriber immediately if a client taking lisinopril (Prinivil) developed which of the following manifestations after taking a dose of the drug?

Based on current evidence,the nurse anticipates that an African American client with hypertension would probably respond best to which combination of medications?

Client education about clonidine (Catapres) should include which of the following statements?

When teaching a client about the drug atenolol (Tenormin) ordered as an antihypertensive,the nurse would inform the client that

Minoxidil (Loniten) should be given concurrently with a $\beta$ -adrenergic blocking agent by the nurse as ordered to prevent

The desired effects of diuretics in the reduction of blood pressure are caused by which of the following mechanisms?

The nurse would question an order for methyldopa (Aldomet) as an antihypertensive drug for a client with which of the following concurrent health problems?

A client with hypertension will be started on a diuretic as first-line drug therapy after lifestyle changes have been ineffective.Which of the following types of diuretics does the nurse anticipate will be used?

A nursing student who has an order to give a dose of clonidine (Catapres) to an assigned client asks the nurse about the medication.After referring the student to the drug handbook,the nurse could share that this drug is classified as

A client beginning drug therapy with enalapril (Vasotec) indicates an understanding of drug therapy by stating that which of the following adverse effects may likely occur?

The nurse places highest priority on assessing the results of which of the following laboratory studies drawn on a client receiving losartan (Cozaar) ?

The client who is receiving antihypertensive drug therapy is scheduled for elective surgery.What nursing action is the most appropriate for standard practice?

A client is taking amlodipine (Norvasc) for control of hypertension.The nurse would give the client which of the following instructions about its use?

Any elevation in blood pressure stretches the baroreceptors and leads to a subsequent

The nurse would question a new drug order for which of the following medications,which is contraindicated when a client is taking methyldopa (Aldomet) ?

Which one of the following is an appropriate nursing intervention for the client who is taking hydrochlorothiazide?

One of the most powerful substances in the body that leads to vasoconstriction is

A client is beginning drug therapy with lisinopril (Prinivil) .The nurse explains to the client that it which of the following laboratory tests must be drawn monthly for the first 3 to 6 months of therapy?

Quiz 27: Antihypertensives

The nurse would make it a priority to assess the client receiving losartan (Cozaar) for which of the following most common adverse drug effects?

The nurse would contact the prescriber immediately if a client taking lisinopril (Prinivil) developed which of the following manifestations after taking a dose of the drug?

Based on current evidence,the nurse anticipates that an African American client with hypertension would probably respond best to which combination of medications?

Client education about clonidine (Catapres) should include which of the following statements?

When teaching a client about the drug atenolol (Tenormin) ordered as an antihypertensive,the nurse would inform the client that

Minoxidil (Loniten) should be given concurrently with a β\betaβ -adrenergic blocking agent by the nurse as ordered to prevent

The desired effects of diuretics in the reduction of blood pressure are caused by which of the following mechanisms?

The nurse would question an order for methyldopa (Aldomet) as an antihypertensive drug for a client with which of the following concurrent health problems?

A client with hypertension will be started on a diuretic as first-line drug therapy after lifestyle changes have been ineffective.Which of the following types of diuretics does the nurse anticipate will be used?

A nursing student who has an order to give a dose of clonidine (Catapres) to an assigned client asks the nurse about the medication.After referring the student to the drug handbook,the nurse could share that this drug is classified as

A client beginning drug therapy with enalapril (Vasotec) indicates an understanding of drug therapy by stating that which of the following adverse effects may likely occur?

The nurse places highest priority on assessing the results of which of the following laboratory studies drawn on a client receiving losartan (Cozaar) ?

The client who is receiving antihypertensive drug therapy is scheduled for elective surgery.What nursing action is the most appropriate for standard practice?

A client is taking amlodipine (Norvasc) for control of hypertension.The nurse would give the client which of the following instructions about its use?

Any elevation in blood pressure stretches the baroreceptors and leads to a subsequent

The nurse would question a new drug order for which of the following medications,which is contraindicated when a client is taking methyldopa (Aldomet) ?

Which one of the following is an appropriate nursing intervention for the client who is taking hydrochlorothiazide?

One of the most powerful substances in the body that leads to vasoconstriction is

A client is beginning drug therapy with lisinopril (Prinivil) .The nurse explains to the client that it which of the following laboratory tests must be drawn monthly for the first 3 to 6 months of therapy?

Minoxidil (Loniten) should be given concurrently with a $\beta$ -adrenergic blocking agent by the nurse as ordered to prevent