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MSN Exam for Hypertension (PM)*
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Question 1
According to the JNC Guidelines, what drugs are considered first-line agents for hypertension?
A
Thiazide-type diuretics
B
ACE Inhibitors
C
Beta Blockers
D
All of the above
Question 2
A patient with pregnancy-induced hypertension probably exhibits which of the following symptoms?
A
Proteinuria, headaches, vaginal bleeding
B
Headaches, double vision, vaginal bleeding
C
Proteinuria, headaches, double vision
D
Proteinuria, double vision, uterine contractions
Question 2 Explanation:
A patient with pregnancy-induced hypertension complains of headache, double vision, and sudden weight gain. A urine specimen reveals proteinuria. Vaginal bleeding and uterine contractions are not associated with pregnancy-induces hypertension.
Question 3
Cindy is taking a hypertensive. She has been complaining of feeling light headed and dizzy when she stands up. She has not been tasting food correctly and her UA came back with proteinuria. Further testing showed she has angioedema. What could be causing Cindy's problem?
A
Lasix
B
Aldactone
C
Prinivil
D
Lostran
Question 4
Which individual is at greatest risk for developing hypertension?
A
45 year-old African American attorney
B
60 year-old Asian American shop owner
C
40 year-old Caucasian nurse
D
55 year-old Hispanic teacher
Question 4 Explanation:
45 year-old African American attorney The incidence of hypertension is greater among African Americans than other groups in the US. The incidence among the Hispanic population is rising.
Question 5
K sparing diuretic has been prescribed to Lisa. She has been feeling week, tired, and has numbness. Lisa has been eating extra bananas to increase he K because she knows that K sparing diuretics shed K in urine. The nurse responds by saying:
A
Lisa will need to go on a K supplement.
B
Lisa has become hyperkalemic and needs reeducation on her medication.
C
Lisa is only showing 3 of the 5 indicators for hyperkalemia, so she needs to continue her medication.
D
Lisa needs to be put on a different hypertensive because she is complaining too much.
Question 6
Methyldopa is the drug of choice in pregnancy patients?
A
True
B
False
Question 7
The nurse teaches the patient which of the following guidelines regarding lifestyle modifications for hypertension?
A
Maintain adequate dietary intake of potassium
B
Reduce smoking to no more than four cigarettes per day
C
Limit aerobic physical activity to 15 minutes, three times per week
D
Stop alcohol intake
Question 7 Explanation:
In general, one serving of a potassium-rich food such as banana, kale, broccoli, or orange juice will meet the daily need for potassium.
Question 8
A client is admitted to the hospital. Twelve hours later the nurse observes hand tremors, hyperexicitability, tachycardia, diaphoresis and hypertension. The nurse suspects alcohol withdrawal. The nurse should ask the client:
A
at what time was your last drink taken?
B
Why didn’t you tell us you’re a drinker?
C
Do you drink beer or hard liquor?
D
How long have you been drinking?
Question 8 Explanation:
This question will give the nurse idea WHEN will the withdrawal occur. Withdrawal occurs 5 to 10 hours after the last intake of alcohol. This is a crucial and mortality is very high during this period.
Question 9
Which of the following terms is given to hypertension in which the blood pressure, which is controlled with therapy, becomes uncontrolled (abnormally high) with the discontinuation of therapy?
A
Rebound
B
Essential
C
Primary
D
Secondary
Question 9 Explanation:
Rebound hypertension may precipitate a hypertensive crisis. Essential or primary hypertension denotes high blood pressure from an unidentified source. Essential or primary hypertension denotes high blood pressure from an unidentified source. Secondary hypertension denotes high blood pressure from an identified cause, such as renal disease.
Question 10
The nurse is teaching a client with a history of obesity and hypertension regarding dietary requirements during pregnancy. Which statement indicates that the client needs further teaching?
A
"I need to reduce my daily intake to 1,200 calories a day."
B
"I need to drink at least a quart of milk a day."
C
"I shouldn’t add salt when I am cooking."
D
"I need to eat more protein and fiber each day."
Question 10 Explanation:
The client does not need to drastically reduce her caloric intake during pregnancy. Doing so would not provide adequate nourishment for proper development of the fetus.
Question 11
This hypertension drug is the first choice for diabetic patients?
A
Beta Blockers
B
ACE Inhibitors
C
Calcium Channel Blockers
D
Direct Vasodilators
Question 12
Catapres works by:
A
increasing parasympathetic response
B
keeps the hormone norepinephrine from stimulating the muscle walls of the small arteries/veins.
C
decreases sympathetic response
D
Directly inhibits renin.
Question 13
Check all of the complications that can result from chronic hypertension
A
Retinopathy
B
Kidney disease
C
Depression
D
Alzheimers
Question 14
Hydralazine works on hypertension by:
A
decreases sympathetic response
B
peripheral vasodilation
C
directly inhibits renin
D
blocks Ca from stimulating muscle walls
Question 15
134/85 is considered to be:
A
Pre-hypertension
B
Stage 1 Hypertension
C
Stage 2 Hypertension
D
None of the above
Question 16
How do you prevent from getting high blood pressure
A
Finding a healthy wieght and not smoke
B
eating fruit
C
going outside and eating chicken
Question 17
Nurse Rose is aware that the statement that best explains why furosemide (Lasix) is administered to treat hypertension is:
A
It dilates peripheral blood vessels.
B
It decreases sympathetic cardioacceleration.
C
It inhibits the angiotensin-coverting enzymes
D
It inhibits reabsorption of sodium and water in the loop of Henle.
Question 17 Explanation:
Furosemide is a loop diuretic that inhibits sodium and water reabsorption in the loop Henle, thereby causing a decrease in blood pressure. Vasodilators cause dilation of peripheral blood vessels, directly relaxing vascular smooth muscle and decreasing blood pressure. Adrenergic blockers decrease sympathetic cardioacceleration and decrease blood pressure. Angiotensin-converting enzyme inhibitors decrease blood pressure due to their action on angiotensin.
Question 18
A client with hypertension ask the nurse which factors can cause blood pressure to drop to normal levels?
A
Kidneys’ excretion to sodium only.
B
Kidneys’ retention of sodium and water
C
Kidneys’ excretion of sodium and water
D
Kidneys’ retention of sodium and excretion of water
Question 18 Explanation:
The kidneys respond to rise in blood pressure by excreting sodium and excess water. This response ultimately affects sysmolic blood pressure by regulating blood volume. Sodium or water retention would only further increase blood pressure. Sodium and water travel together across the membrane in the kidneys; one can’t travel without the other.
Question 19
Alpha blockers work by keeping the hormone _________ from simulating the muscle walls of the small arteries/veins.
A
ephinephrine
B
angiotensin 1
C
norepinephrine
D
PTH
Question 20
Which drug inhibits calcium ion influx into vascular smooth muscle?
A
Atenolol
B
Verapamil
C
Hydralazine
D
Hydrochlorothiazide
Question 21
The nurse is assessing a multigravida, 36 weeks gestation for symptoms of pregnancy-induced hypertension and preeclampsia. The nurse should give priority to assessing the client for:
A
Facial swelling
B
Pulse deficits
C
Ankle edema
D
Diminished reflexes
Question 21 Explanation:
The nurse should pay close attention to swelling in the client with preeclampsia. Facial swelling indicates that the client’s condition is worsening and blood pressure will be increased. Answer B is not related to the question; therefore, it is incorrect. Answer C is incorrect because ankle edema is expected in pregnancy. Diminished reflexes are associated with the use of magnesium sulfate, which is the treatment of preeclampsia; therefore, answer D is incorrect.
Question 22
Perry is going on lisinopril. When he asks how it works, the nurse would answer:
A
It releases Ca and HCO3 while holding onto K.
B
It blocks the angiotensin I from turning into angiotensin II, leaving the vessels dilated for better blood flow.
C
It blocks the reabsorbtion of Na.
D
Blocks stimulation of beta .
Question 23
When taking Atenolol, the nurse knows to hold the medication if:
A
HR <50
B
Dry Coughing
C
pt becomes hypotensive
D
if K levels increase
Question 24
What side effects are associated with ACE Inhibitors?
A
Cough
B
Hypotension
C
Angioedema
D
All of the above
Question 25
Norma has started a new drug for hypertension. Thirty minutes after she takes the drug, she develops chest tightness and becomes short of breath and tachypneic. She has a decreased level of consciousness. These signs indicate which of the following conditions?
A
Asthma attack
B
Pulmonary embolism
C
Respiratory failure
D
Rheumatoid arthritis
Question 25 Explanation:
The client was reacting to the drug with respiratory signs of impending anaphylaxis, which could lead to eventually respiratory failure. Although the signs are also related to an asthma attack or a pulmonary embolism, consider the new drug first. Rheumatoid arthritis doesn’t manifest these signs.
Question 26
How does Catapress work?
A
Selectively blocks beta 1 receptors
B
Inhibits the conversion of angiotensin I to angiotensin II
C
Blocks angiotensin II receptors
D
Stimulates alpha 2 receptors
Question 27
Norvasc is a:
A
Loop diuretic
B
Beta Blocker
C
ACE inhibitor
D
Calcium Channel Blocker
Question 28
A patient with a blood pressure of 180/120 and end organ damage is an hypertensive EMERGENCY
A
True
B
False
Question 29
A client with chronic schizophrenia who takes neuroleptic medication is admitted to the psychiatric unit. Nursing assessment reveals rigidity, fever, hypertension, and diaphoresis. These findings suggest which life-threatening reaction:
A
tardive dyskinesia.
B
dystonia.
C
neuroleptic malignant syndrome.
D
akathisia.
Question 29 Explanation:
The client's signs and symptoms suggest neuroleptic malignant syndrome, a life-threatening reaction to neuroleptic medication that requires immediate treatment. Tardive dyskinesia causes involuntary movements of the tongue, mouth, facial muscles, and arm and leg muscles. Dystonia is characterized by cramps and rigidity of the tongue, face, neck, and back muscles. Akathisia causes restlessness, anxiety, and jitteriness.
Question 30
What medications should be avoided in pregnant women, especially in the 2nd-3rd trimester. (check all that apply)
A
ARBs
B
ACE Inhibitors
C
Beta Blockers
D
Tekturna
Question 31
What medication directly dilates the peripheral vesicles?
A
Tekturna
B
Furosemide
C
Hydralazine
D
Valsartan
Question 32
163/112 is considered to be:
A
Pre-hypertension
B
Stage 1 Hypertension
C
Stage 2 Hypertension
D
None of the above
Question 33
Peggy is switching from lisinopril to norvasc. She understands her new medication when she states:
A
I may have headaches
B
It causes vadodilation and decreases SVR and lowers B/P
C
It may cause edema peripherally
D
all the above
Question 34
Direct vasodilators work by peripheral vasodilation. However, the nurse needs to educate their pt by including which of these side effects in their pt education?
A
Increases HR
B
Na retention
C
Drug induced lupus syndrome
D
all the above
E
none of the above
Question 35
Aldactone can cause which of the following side effects?
A
Hypokalemia
B
Hypercalcemia
C
Hyperkalemia
D
Hyperphosphemia
Question 36
How can you prevent high blood pressure?
A
drink water,eat a lot of salt,stay at home
B
drink water,eat healthy,eat a lot of sugar,drink wine
C
Drink a lot of water,exercise,consume less sodium and have a life style change
D
eat healthy,go for a walk once a week,drink 1 bottle of water per day
Question 37
This hypertension drug is the first choice for diabetic and renal failure pts.
A
K sparing diuretics
B
ACE inhibitors
C
Loop diuretics
D
Calcium channel blockers
Question 38
The nurse has been teaching the role of diet in regulating blood pressure to a client with hypertension. Which meal selection indicates that the client understands his new diet?
A
Cornflakes, whole milk, banana, and coffee
B
Scrambled eggs, bacon, toast, and coffee
C
Oatmeal, apple juice, dry toast, and coffee
D
Pancakes, ham, tomato juice, and coffee
Question 38 Explanation:
Oatmeal is low in sodium and high in fiber. Limiting sodium intake and increasing fiber helps to lower cholesterol levels, which reduce blood pressure. Answer A is incorrect because cornflakes and whole milk are higher in sodium and are poor sources of fiber. Answers B and D are incorrect because they contain animal proteins that are high in both cholesterol and sodium.
Question 39
119/80 is considered to be:
A
Pre-hypertension
B
Stage 1 Hypertension
C
Stage 2 Hypertension
D
None of the above
Question 40
Nicole has been taking a central alpha2-agonist. She was doing very well on it and has now ended up in the ED. She reports that she was doing so well that she stopped taking her medication because she felt fine and couldn't afford her medication since being laid off. What could be the reason for Nicole's reaction?
A
Over abundance of K in her system
B
Orthostatic BP problems
C
Drug Induced lupus syndrome
D
Withdrawl phenomenon
Question 41
Steven is taking a anti hypertensive. He takes ibuprofen for knee pain as well. Which ant hypertensive medication should Steven have further education on?
A
Losartan
B
Zestril
C
Atenolol
D
Norvasc
Question 42
A client has been diagnosed with hypertension. The nurse priority nursing diagnosis would be:
A
Ineffective health maintenance
B
Impaired skin integrity
C
Deficient fluid volume
D
Pain
Question 42 Explanation:
Managing hypertension is the priority for the client with hypertension. Clients with hypertension frequently do not experience pain, deficient volume, or impaired skin integrity. It is the asymptomatic nature of hypertension that makes it so difficult to treat.
Question 43
The physician orders lisinopril (Zestril) and furosemide (Lasix) to be administered concomitantly to the client with hypertension. The nurse should:
A
Question the order
B
Administer the medications
C
Administer separately
D
Contact the pharmacy
Question 43 Explanation:
Zestril is an ACE inhibitor and is frequently given with a diuretic such as Lasix for hypertension. Answers A, C, and D are incorrect because the order is accurate. There is no need to question the order, administer the medication separately, or contact the pharmacy.
Question 44
Younger patients are at a higher risk for orthostatic hypotension than Elderly patients
A
True
B
False
Question 45
How does metoprolol work?
A
Selectively blocks beta 1 receptors
B
Inhibits the conversion of angiotensin I to angiotensin II
C
Blocks angiotensin II receptors
D
Stimulate alpha 2 receptors
Question 46
Glenn comes into the ED with olguria. Upon his assessment he says that he is on an antihypertensive. Glenn was outside in the hot sun working in his garden when he became dizzy. His wife found him soaked in sweat. What could have caused Glenn's problem?
A
ACE inhibitor
B
Calcium Channel Blocker
C
K sparing diruretic
D
Loop Diuretic
Question 47
African Americans have an increased need for combination therapy to attain and maintain blood pressure goals
A
True
B
False
Question 48
Sodium intake is good to prevent high blood pressure?
A
True
B
False
Question 49
Officially, hypertension is diagnosed when the patient demonstrates a systolic blood pressure greater than ______ mm Hg and a diastolic blood pressure greater than _____ mm Hg over a sustained period.
A
140, 90
B
130, 80
C
110, 60
D
120, 70
Question 49 Explanation:
According to the categories of blood pressure levels established by the JNC VI, stage 1 hypertension is demonstrated by a systolic pressure of 140–159 or a diastolic pressure of 90–99.
Question 50
A client with hypertension has begun an aerobic exercise program. The nurse should tell the client that the recommended exercise regimen should begin slowly and build up to:
A
20–30 minutes three times a week
B
45 minutes two times a week
C
1 hour four times a week
D
1 hour two times a week
Question 50 Explanation:
The client’s aerobic workout should be 20–30 minutes long three times a week.
Question 51
The immediate objective of nursing care for an overweight, mildly hypertensive male client with ureteral colic and hematuria is to decrease:
A
Pain
B
Weight
C
Hematuria
D
Hypertension
Question 51 Explanation:
Sharp, severe pain (renal colic) radiating toward the genitalia and thigh is caused by uretheral distention and smooth muscle spasm; relief form pain is the priority.
Question 52
An agitated, confused female client arrives in the emergency department. Her history includes type 1 diabetes mellitus, hypertension, and angina pectoris. Assessment reveals pallor, diaphoresis, headache, and intense hunger. A stat blood glucose sample measures 42 mg/dl, and the client is treated for an acute hypoglycemic reaction. After recovery, nurse Lily teaches the client to treat hypoglycemia by ingesting:
A
2 to 5 g of a simple carbohydrate.
B
10 to 15 g of a simple carbohydrate.
C
18 to 20 g of a simple carbohydrate.
D
25 to 30 g of a simple carbohydrate.
Question 52 Explanation:
To reverse hypoglycemia, the American Diabetes Association recommends ingesting 10 to 15 g of a simple carbohydrate, such as three to five pieces of hard candy, two to three packets of sugar (4 to 6 tsp), or 4 oz of fruit juice. If necessary, this treatment can be repeated in 15 minutes. Ingesting only 2 to 5 g of a simple carbohydrate may not raise the blood glucose level sufficiently. Ingesting more than 15 g may raise it above normal, causing hyperglycemia.
Question 53
Which class of drugs can cause lupus-like syndrome?
A
Direct Vasodilators
B
Beta Blockers
C
Calcium Channel Blockers
D
Alpha-2 Agonists
Question 54
Kids between the ages of 1 and 10 are the only ones prone to hypertension
A
True
B
False
Question 55
While a client with hypertension is being assessed, he says to the nurse, “I really don’t know why I am here. I feel fine and haven’t had any symptoms.” The nurse would explain to the client that symptoms of hypertension:
A
Are often not present
B
Signify a high risk of stroke
C
Occur only with malignant hypertension
D
Appear after irreversible kidney damage has occurred
Question 56
Primary focus should be reaching systolic blood pressure goal.
A
True
B
False
Question 57
Which drug is used to treat hypertensive emergencies?
A
Zyprexa
B
Lasix
C
Sodium Chloride
D
Nitroprusside
Question 58
The client is admitted to the hospital with hypertensive crises. Diazoxide (Hyperstat) is ordered. During administration, the nurse should:
A
Utilize an infusion pump
B
Check the blood glucose level
C
Place the client in Trendelenburg position
D
Cover the solution with foil
Question 58 Explanation:
Hyperstat is given IV push for hypertensive crises, but it often causes hyperglycemia. The glucose level will drop rapidly when stopped. Answer A is incorrect because the hyperstat is given by IV push. The client should be placed in dorsal recumbent position, not a Trendelenburg position, as stated in answer C. Answer D is incorrect because the medication does not have to be covered with foil.
Question 59
The client admitted for alcohol detoxification develops increased tremors, irritability, hypertension and fever. The nurse should be alert for impending:
A
delirium tremens
B
Korsakoff’s syndrome
C
esophageal varices
D
Wernicke’s syndrome
Question 59 Explanation:
Delirium Tremens is the most extreme central nervous system irritability due to withdrawal from alcohol B. This refers to an amnestic syndrome associated with chronic alcoholism due to a deficiency in Vit. B C. This is a complication of liver cirrhosis which may be secondary to alcoholism . D. This is a complication of alcoholism characterized by irregularities of eye movements and lack of coordination.
Question 60
A female client with a history of pheochromocytoma is admitted to the hospital in an acute hypertensive crisis. To reverse hypertensive crisis caused by pheochromocytoma, nurse Lyka expects to administer:
A
phentolamine (Regitine).
B
methyldopa (Aldomet).
C
mannitol (Osmitrol).
D
felodipine (Plendil).
Question 60 Explanation:
Pheochromocytoma causes excessive production of epinephrine and norepinephrine, natural catecholamines that raise the blood pressure. Phentolamine, an alpha-adrenergic blocking agent given by I.V. bolus or drip, antagonizes the body’s response to circulating epinephrine and norepinephrine, reducing blood pressure quickly and effectively. Although methyldopa is an antihypertensive agent available in parenteral form, it isn’t effective in treating hypertensive emergencies. Mannitol, a diuretic, isn’t used to treat hypertensive emergencies. Felodipine, an antihypertensive agent, is available only in extended-release tablets and therefore doesn’t reduce blood pressure quickly enough to correct hypertensive crisis.
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MSN Exam for Hypertension (EM)*
Choose the letter of the correct answer. You got 60 minutes to finish the exam .Good luck!
Start
Congratulations - you have completed MSN Exam for Hypertension (EM)*.
You scored %%SCORE%% out of %%TOTAL%%.
Your performance has been rated as %%RATING%%
Your answers are highlighted below.
Question 1
Norvasc is a:
A
Loop diuretic
B
Beta Blocker
C
ACE inhibitor
D
Calcium Channel Blocker
Question 2
A client with hypertension has begun an aerobic exercise program. The nurse should tell the client that the recommended exercise regimen should begin slowly and build up to:
A
20–30 minutes three times a week
B
45 minutes two times a week
C
1 hour four times a week
D
1 hour two times a week
Question 2 Explanation:
The client’s aerobic workout should be 20–30 minutes long three times a week.
Question 3
Sodium intake is good to prevent high blood pressure?
A
True
B
False
Question 4
A client with chronic schizophrenia who takes neuroleptic medication is admitted to the psychiatric unit. Nursing assessment reveals rigidity, fever, hypertension, and diaphoresis. These findings suggest which life-threatening reaction:
A
tardive dyskinesia.
B
dystonia.
C
neuroleptic malignant syndrome.
D
akathisia.
Question 4 Explanation:
The client's signs and symptoms suggest neuroleptic malignant syndrome, a life-threatening reaction to neuroleptic medication that requires immediate treatment. Tardive dyskinesia causes involuntary movements of the tongue, mouth, facial muscles, and arm and leg muscles. Dystonia is characterized by cramps and rigidity of the tongue, face, neck, and back muscles. Akathisia causes restlessness, anxiety, and jitteriness.
Question 5
The nurse teaches the patient which of the following guidelines regarding lifestyle modifications for hypertension?
A
Maintain adequate dietary intake of potassium
B
Reduce smoking to no more than four cigarettes per day
C
Limit aerobic physical activity to 15 minutes, three times per week
D
Stop alcohol intake
Question 5 Explanation:
In general, one serving of a potassium-rich food such as banana, kale, broccoli, or orange juice will meet the daily need for potassium.
Question 6
African Americans have an increased need for combination therapy to attain and maintain blood pressure goals
A
True
B
False
Question 7
Aldactone can cause which of the following side effects?
A
Hypokalemia
B
Hypercalcemia
C
Hyperkalemia
D
Hyperphosphemia
Question 8
When taking Atenolol, the nurse knows to hold the medication if:
A
HR <50
B
Dry Coughing
C
pt becomes hypotensive
D
if K levels increase
Question 9
This hypertension drug is the first choice for diabetic patients?
A
Beta Blockers
B
ACE Inhibitors
C
Calcium Channel Blockers
D
Direct Vasodilators
Question 10
What side effects are associated with ACE Inhibitors?
A
Cough
B
Hypotension
C
Angioedema
D
All of the above
Question 11
How do you prevent from getting high blood pressure
A
Finding a healthy wieght and not smoke
B
eating fruit
C
going outside and eating chicken
Question 12
K sparing diuretic has been prescribed to Lisa. She has been feeling week, tired, and has numbness. Lisa has been eating extra bananas to increase he K because she knows that K sparing diuretics shed K in urine. The nurse responds by saying:
A
Lisa will need to go on a K supplement.
B
Lisa has become hyperkalemic and needs reeducation on her medication.
C
Lisa is only showing 3 of the 5 indicators for hyperkalemia, so she needs to continue her medication.
D
Lisa needs to be put on a different hypertensive because she is complaining too much.
Question 13
Primary focus should be reaching systolic blood pressure goal.
A
True
B
False
Question 14
Methyldopa is the drug of choice in pregnancy patients?
A
True
B
False
Question 15
How does Catapress work?
A
Selectively blocks beta 1 receptors
B
Inhibits the conversion of angiotensin I to angiotensin II
C
Blocks angiotensin II receptors
D
Stimulates alpha 2 receptors
Question 16
Check all of the complications that can result from chronic hypertension
A
Retinopathy
B
Kidney disease
C
Depression
D
Alzheimers
Question 17
Which drug inhibits calcium ion influx into vascular smooth muscle?
A
Atenolol
B
Verapamil
C
Hydralazine
D
Hydrochlorothiazide
Question 18
This hypertension drug is the first choice for diabetic and renal failure pts.
A
K sparing diuretics
B
ACE inhibitors
C
Loop diuretics
D
Calcium channel blockers
Question 19
Officially, hypertension is diagnosed when the patient demonstrates a systolic blood pressure greater than ______ mm Hg and a diastolic blood pressure greater than _____ mm Hg over a sustained period.
A
140, 90
B
130, 80
C
110, 60
D
120, 70
Question 19 Explanation:
According to the categories of blood pressure levels established by the JNC VI, stage 1 hypertension is demonstrated by a systolic pressure of 140–159 or a diastolic pressure of 90–99.
Question 20
A patient with a blood pressure of 180/120 and end organ damage is an hypertensive EMERGENCY
A
True
B
False
Question 21
Younger patients are at a higher risk for orthostatic hypotension than Elderly patients
A
True
B
False
Question 22
A client with hypertension ask the nurse which factors can cause blood pressure to drop to normal levels?
A
Kidneys’ excretion to sodium only.
B
Kidneys’ retention of sodium and water
C
Kidneys’ excretion of sodium and water
D
Kidneys’ retention of sodium and excretion of water
Question 22 Explanation:
The kidneys respond to rise in blood pressure by excreting sodium and excess water. This response ultimately affects sysmolic blood pressure by regulating blood volume. Sodium or water retention would only further increase blood pressure. Sodium and water travel together across the membrane in the kidneys; one can’t travel without the other.
Question 23
What medication directly dilates the peripheral vesicles?
A
Tekturna
B
Furosemide
C
Hydralazine
D
Valsartan
Question 24
A patient with pregnancy-induced hypertension probably exhibits which of the following symptoms?
A
Proteinuria, headaches, vaginal bleeding
B
Headaches, double vision, vaginal bleeding
C
Proteinuria, headaches, double vision
D
Proteinuria, double vision, uterine contractions
Question 24 Explanation:
A patient with pregnancy-induced hypertension complains of headache, double vision, and sudden weight gain. A urine specimen reveals proteinuria. Vaginal bleeding and uterine contractions are not associated with pregnancy-induces hypertension.
Question 25
An agitated, confused female client arrives in the emergency department. Her history includes type 1 diabetes mellitus, hypertension, and angina pectoris. Assessment reveals pallor, diaphoresis, headache, and intense hunger. A stat blood glucose sample measures 42 mg/dl, and the client is treated for an acute hypoglycemic reaction. After recovery, nurse Lily teaches the client to treat hypoglycemia by ingesting:
A
2 to 5 g of a simple carbohydrate.
B
10 to 15 g of a simple carbohydrate.
C
18 to 20 g of a simple carbohydrate.
D
25 to 30 g of a simple carbohydrate.
Question 25 Explanation:
To reverse hypoglycemia, the American Diabetes Association recommends ingesting 10 to 15 g of a simple carbohydrate, such as three to five pieces of hard candy, two to three packets of sugar (4 to 6 tsp), or 4 oz of fruit juice. If necessary, this treatment can be repeated in 15 minutes. Ingesting only 2 to 5 g of a simple carbohydrate may not raise the blood glucose level sufficiently. Ingesting more than 15 g may raise it above normal, causing hyperglycemia.
Question 26
How does metoprolol work?
A
Selectively blocks beta 1 receptors
B
Inhibits the conversion of angiotensin I to angiotensin II
C
Blocks angiotensin II receptors
D
Stimulate alpha 2 receptors
Question 27
Glenn comes into the ED with olguria. Upon his assessment he says that he is on an antihypertensive. Glenn was outside in the hot sun working in his garden when he became dizzy. His wife found him soaked in sweat. What could have caused Glenn's problem?
A
ACE inhibitor
B
Calcium Channel Blocker
C
K sparing diruretic
D
Loop Diuretic
Question 28
The physician orders lisinopril (Zestril) and furosemide (Lasix) to be administered concomitantly to the client with hypertension. The nurse should:
A
Question the order
B
Administer the medications
C
Administer separately
D
Contact the pharmacy
Question 28 Explanation:
Zestril is an ACE inhibitor and is frequently given with a diuretic such as Lasix for hypertension. Answers A, C, and D are incorrect because the order is accurate. There is no need to question the order, administer the medication separately, or contact the pharmacy.
Question 29
The nurse is teaching a client with a history of obesity and hypertension regarding dietary requirements during pregnancy. Which statement indicates that the client needs further teaching?
A
"I need to reduce my daily intake to 1,200 calories a day."
B
"I need to drink at least a quart of milk a day."
C
"I shouldn’t add salt when I am cooking."
D
"I need to eat more protein and fiber each day."
Question 29 Explanation:
The client does not need to drastically reduce her caloric intake during pregnancy. Doing so would not provide adequate nourishment for proper development of the fetus.
Question 30
Hydralazine works on hypertension by:
A
decreases sympathetic response
B
peripheral vasodilation
C
directly inhibits renin
D
blocks Ca from stimulating muscle walls
Question 31
The immediate objective of nursing care for an overweight, mildly hypertensive male client with ureteral colic and hematuria is to decrease:
A
Pain
B
Weight
C
Hematuria
D
Hypertension
Question 31 Explanation:
Sharp, severe pain (renal colic) radiating toward the genitalia and thigh is caused by uretheral distention and smooth muscle spasm; relief form pain is the priority.
Question 32
Direct vasodilators work by peripheral vasodilation. However, the nurse needs to educate their pt by including which of these side effects in their pt education?
A
Increases HR
B
Na retention
C
Drug induced lupus syndrome
D
all the above
E
none of the above
Question 33
The client is admitted to the hospital with hypertensive crises. Diazoxide (Hyperstat) is ordered. During administration, the nurse should:
A
Utilize an infusion pump
B
Check the blood glucose level
C
Place the client in Trendelenburg position
D
Cover the solution with foil
Question 33 Explanation:
Hyperstat is given IV push for hypertensive crises, but it often causes hyperglycemia. The glucose level will drop rapidly when stopped. Answer A is incorrect because the hyperstat is given by IV push. The client should be placed in dorsal recumbent position, not a Trendelenburg position, as stated in answer C. Answer D is incorrect because the medication does not have to be covered with foil.
Question 34
While a client with hypertension is being assessed, he says to the nurse, “I really don’t know why I am here. I feel fine and haven’t had any symptoms.” The nurse would explain to the client that symptoms of hypertension:
A
Are often not present
B
Signify a high risk of stroke
C
Occur only with malignant hypertension
D
Appear after irreversible kidney damage has occurred
Question 35
Which drug is used to treat hypertensive emergencies?
A
Zyprexa
B
Lasix
C
Sodium Chloride
D
Nitroprusside
Question 36
Alpha blockers work by keeping the hormone _________ from simulating the muscle walls of the small arteries/veins.
A
ephinephrine
B
angiotensin 1
C
norepinephrine
D
PTH
Question 37
The client admitted for alcohol detoxification develops increased tremors, irritability, hypertension and fever. The nurse should be alert for impending:
A
delirium tremens
B
Korsakoff’s syndrome
C
esophageal varices
D
Wernicke’s syndrome
Question 37 Explanation:
Delirium Tremens is the most extreme central nervous system irritability due to withdrawal from alcohol B. This refers to an amnestic syndrome associated with chronic alcoholism due to a deficiency in Vit. B C. This is a complication of liver cirrhosis which may be secondary to alcoholism . D. This is a complication of alcoholism characterized by irregularities of eye movements and lack of coordination.
Question 38
Peggy is switching from lisinopril to norvasc. She understands her new medication when she states:
A
I may have headaches
B
It causes vadodilation and decreases SVR and lowers B/P
C
It may cause edema peripherally
D
all the above
Question 39
Nurse Rose is aware that the statement that best explains why furosemide (Lasix) is administered to treat hypertension is:
A
It dilates peripheral blood vessels.
B
It decreases sympathetic cardioacceleration.
C
It inhibits the angiotensin-coverting enzymes
D
It inhibits reabsorption of sodium and water in the loop of Henle.
Question 39 Explanation:
Furosemide is a loop diuretic that inhibits sodium and water reabsorption in the loop Henle, thereby causing a decrease in blood pressure. Vasodilators cause dilation of peripheral blood vessels, directly relaxing vascular smooth muscle and decreasing blood pressure. Adrenergic blockers decrease sympathetic cardioacceleration and decrease blood pressure. Angiotensin-converting enzyme inhibitors decrease blood pressure due to their action on angiotensin.
Question 40
Cindy is taking a hypertensive. She has been complaining of feeling light headed and dizzy when she stands up. She has not been tasting food correctly and her UA came back with proteinuria. Further testing showed she has angioedema. What could be causing Cindy's problem?
A
Lasix
B
Aldactone
C
Prinivil
D
Lostran
Question 41
How can you prevent high blood pressure?
A
drink water,eat a lot of salt,stay at home
B
drink water,eat healthy,eat a lot of sugar,drink wine
C
Drink a lot of water,exercise,consume less sodium and have a life style change
D
eat healthy,go for a walk once a week,drink 1 bottle of water per day
Question 42
According to the JNC Guidelines, what drugs are considered first-line agents for hypertension?
A
Thiazide-type diuretics
B
ACE Inhibitors
C
Beta Blockers
D
All of the above
Question 43
The nurse is assessing a multigravida, 36 weeks gestation for symptoms of pregnancy-induced hypertension and preeclampsia. The nurse should give priority to assessing the client for:
A
Facial swelling
B
Pulse deficits
C
Ankle edema
D
Diminished reflexes
Question 43 Explanation:
The nurse should pay close attention to swelling in the client with preeclampsia. Facial swelling indicates that the client’s condition is worsening and blood pressure will be increased. Answer B is not related to the question; therefore, it is incorrect. Answer C is incorrect because ankle edema is expected in pregnancy. Diminished reflexes are associated with the use of magnesium sulfate, which is the treatment of preeclampsia; therefore, answer D is incorrect.
Question 44
The nurse has been teaching the role of diet in regulating blood pressure to a client with hypertension. Which meal selection indicates that the client understands his new diet?
A
Cornflakes, whole milk, banana, and coffee
B
Scrambled eggs, bacon, toast, and coffee
C
Oatmeal, apple juice, dry toast, and coffee
D
Pancakes, ham, tomato juice, and coffee
Question 44 Explanation:
Oatmeal is low in sodium and high in fiber. Limiting sodium intake and increasing fiber helps to lower cholesterol levels, which reduce blood pressure. Answer A is incorrect because cornflakes and whole milk are higher in sodium and are poor sources of fiber. Answers B and D are incorrect because they contain animal proteins that are high in both cholesterol and sodium.
Question 45
134/85 is considered to be:
A
Pre-hypertension
B
Stage 1 Hypertension
C
Stage 2 Hypertension
D
None of the above
Question 46
A female client with a history of pheochromocytoma is admitted to the hospital in an acute hypertensive crisis. To reverse hypertensive crisis caused by pheochromocytoma, nurse Lyka expects to administer:
A
phentolamine (Regitine).
B
methyldopa (Aldomet).
C
mannitol (Osmitrol).
D
felodipine (Plendil).
Question 46 Explanation:
Pheochromocytoma causes excessive production of epinephrine and norepinephrine, natural catecholamines that raise the blood pressure. Phentolamine, an alpha-adrenergic blocking agent given by I.V. bolus or drip, antagonizes the body’s response to circulating epinephrine and norepinephrine, reducing blood pressure quickly and effectively. Although methyldopa is an antihypertensive agent available in parenteral form, it isn’t effective in treating hypertensive emergencies. Mannitol, a diuretic, isn’t used to treat hypertensive emergencies. Felodipine, an antihypertensive agent, is available only in extended-release tablets and therefore doesn’t reduce blood pressure quickly enough to correct hypertensive crisis.
Question 47
Which individual is at greatest risk for developing hypertension?
A
45 year-old African American attorney
B
60 year-old Asian American shop owner
C
40 year-old Caucasian nurse
D
55 year-old Hispanic teacher
Question 47 Explanation:
45 year-old African American attorney The incidence of hypertension is greater among African Americans than other groups in the US. The incidence among the Hispanic population is rising.
Question 48
Nicole has been taking a central alpha2-agonist. She was doing very well on it and has now ended up in the ED. She reports that she was doing so well that she stopped taking her medication because she felt fine and couldn't afford her medication since being laid off. What could be the reason for Nicole's reaction?
A
Over abundance of K in her system
B
Orthostatic BP problems
C
Drug Induced lupus syndrome
D
Withdrawl phenomenon
Question 49
Norma has started a new drug for hypertension. Thirty minutes after she takes the drug, she develops chest tightness and becomes short of breath and tachypneic. She has a decreased level of consciousness. These signs indicate which of the following conditions?
A
Asthma attack
B
Pulmonary embolism
C
Respiratory failure
D
Rheumatoid arthritis
Question 49 Explanation:
The client was reacting to the drug with respiratory signs of impending anaphylaxis, which could lead to eventually respiratory failure. Although the signs are also related to an asthma attack or a pulmonary embolism, consider the new drug first. Rheumatoid arthritis doesn’t manifest these signs.
Question 50
Which class of drugs can cause lupus-like syndrome?
A
Direct Vasodilators
B
Beta Blockers
C
Calcium Channel Blockers
D
Alpha-2 Agonists
Question 51
A client is admitted to the hospital. Twelve hours later the nurse observes hand tremors, hyperexicitability, tachycardia, diaphoresis and hypertension. The nurse suspects alcohol withdrawal. The nurse should ask the client:
A
at what time was your last drink taken?
B
Why didn’t you tell us you’re a drinker?
C
Do you drink beer or hard liquor?
D
How long have you been drinking?
Question 51 Explanation:
This question will give the nurse idea WHEN will the withdrawal occur. Withdrawal occurs 5 to 10 hours after the last intake of alcohol. This is a crucial and mortality is very high during this period.
Question 52
A client has been diagnosed with hypertension. The nurse priority nursing diagnosis would be:
A
Ineffective health maintenance
B
Impaired skin integrity
C
Deficient fluid volume
D
Pain
Question 52 Explanation:
Managing hypertension is the priority for the client with hypertension. Clients with hypertension frequently do not experience pain, deficient volume, or impaired skin integrity. It is the asymptomatic nature of hypertension that makes it so difficult to treat.
Question 53
Steven is taking a anti hypertensive. He takes ibuprofen for knee pain as well. Which ant hypertensive medication should Steven have further education on?
A
Losartan
B
Zestril
C
Atenolol
D
Norvasc
Question 54
Perry is going on lisinopril. When he asks how it works, the nurse would answer:
A
It releases Ca and HCO3 while holding onto K.
B
It blocks the angiotensin I from turning into angiotensin II, leaving the vessels dilated for better blood flow.
C
It blocks the reabsorbtion of Na.
D
Blocks stimulation of beta .
Question 55
Which of the following terms is given to hypertension in which the blood pressure, which is controlled with therapy, becomes uncontrolled (abnormally high) with the discontinuation of therapy?
A
Rebound
B
Essential
C
Primary
D
Secondary
Question 55 Explanation:
Rebound hypertension may precipitate a hypertensive crisis. Essential or primary hypertension denotes high blood pressure from an unidentified source. Essential or primary hypertension denotes high blood pressure from an unidentified source. Secondary hypertension denotes high blood pressure from an identified cause, such as renal disease.
Question 56
163/112 is considered to be:
A
Pre-hypertension
B
Stage 1 Hypertension
C
Stage 2 Hypertension
D
None of the above
Question 57
119/80 is considered to be:
A
Pre-hypertension
B
Stage 1 Hypertension
C
Stage 2 Hypertension
D
None of the above
Question 58
Catapres works by:
A
increasing parasympathetic response
B
keeps the hormone norepinephrine from stimulating the muscle walls of the small arteries/veins.
C
decreases sympathetic response
D
Directly inhibits renin.
Question 59
Kids between the ages of 1 and 10 are the only ones prone to hypertension
A
True
B
False
Question 60
What medications should be avoided in pregnant women, especially in the 2nd-3rd trimester. (check all that apply)
A
ARBs
B
ACE Inhibitors
C
Beta Blockers
D
Tekturna
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1) This hypertension drug is the first choice for diabetic and renal failure pts.
K sparing diuretics
ACE inhibitors
Loop diuretics
Calcium channel blockers
2) While a client with hypertension is being assessed, he says to the nurse, “I really don’t know why I am here. I feel fine and haven’t had any symptoms.” The nurse would explain to the client that symptoms of hypertension:
Are often not present
Signify a high risk of stroke
Occur only with malignant hypertension
Appear after irreversible kidney damage has occurred
3) A client is admitted to the hospital. Twelve hours later the nurse observes hand tremors, hyperexicitability, tachycardia, diaphoresis and hypertension. The nurse suspects alcohol withdrawal. The nurse should ask the client:
at what time was your last drink taken?
Why didn’t you tell us you’re a drinker?
Do you drink beer or hard liquor?
How long have you been drinking?
4) How does metoprolol work?
Selectively blocks beta 1 receptors
Inhibits the conversion of angiotensin I to angiotensin II
Blocks angiotensin II receptors
Stimulate alpha 2 receptors
5) Sodium intake is good to prevent high blood pressure?
True
False
6) A female client with a history of pheochromocytoma is admitted to the hospital in an acute hypertensive crisis. To reverse hypertensive crisis caused by pheochromocytoma, nurse Lyka expects to administer:
phentolamine (Regitine).
methyldopa (Aldomet).
mannitol (Osmitrol).
felodipine (Plendil).
7) Norvasc is a:
Loop diuretic
Beta Blocker
ACE inhibitor
Calcium Channel Blocker
8) Alpha blockers work by keeping the hormone _________ from simulating the muscle walls of the small arteries/veins.
ephinephrine
angiotensin 1
norepinephrine
PTH
9) Which drug inhibits calcium ion influx into vascular smooth muscle?
Atenolol
Verapamil
Hydralazine
Hydrochlorothiazide
10) The nurse teaches the patient which of the following guidelines regarding lifestyle modifications for hypertension?
Maintain adequate dietary intake of potassium
Reduce smoking to no more than four cigarettes per day
Limit aerobic physical activity to 15 minutes, three times per week
Stop alcohol intake
11) Methyldopa is the drug of choice in pregnancy patients?
True
False
12) According to the JNC Guidelines, what drugs are considered first-line agents for hypertension?
Thiazide-type diuretics
ACE Inhibitors
Beta Blockers
All of the above
13) The client is admitted to the hospital with hypertensive crises. Diazoxide (Hyperstat) is ordered. During administration, the nurse should:
Utilize an infusion pump
Check the blood glucose level
Place the client in Trendelenburg position
Cover the solution with foil
14) Glenn comes into the ED with olguria. Upon his assessment he says that he is on an antihypertensive. Glenn was outside in the hot sun working in his garden when he became dizzy. His wife found him soaked in sweat. What could have caused Glenn’s problem?
ACE inhibitor
Calcium Channel Blocker
K sparing diruretic
Loop Diuretic
15) Nurse Rose is aware that the statement that best explains why furosemide (Lasix) is administered to treat hypertension is:
It dilates peripheral blood vessels.
It decreases sympathetic cardioacceleration.
It inhibits the angiotensin-coverting enzymes
It inhibits reabsorption of sodium and water in the loop of Henle.
16) The nurse is teaching a client with a history of obesity and hypertension regarding dietary requirements during pregnancy. Which statement indicates that the client needs further teaching?
“I need to reduce my daily intake to 1,200 calories a day.”
“I need to drink at least a quart of milk a day.”
“I shouldn’t add salt when I am cooking.”
“I need to eat more protein and fiber each day.”
17) How do you prevent from getting high blood pressure
Finding a healthy wieght and not smoke
eating fruit
going outside and eating chicken
18) A client with hypertension has begun an aerobic exercise program. The nurse should tell the client that the recommended exercise regimen should begin slowly and build up to:
20–30 minutes three times a week
45 minutes two times a week
1 hour four times a week
1 hour two times a week
19) The client admitted for alcohol detoxification develops increased tremors, irritability, hypertension and fever. The nurse should be alert for impending:
delirium tremens
Korsakoff’s syndrome
esophageal varices
Wernicke’s syndrome
20) Carapres works by:
increasing parasympathetic response
keeps the hormone norepinephrine from stimulating the muscle walls of the small arteries/veins.
decreases sympathetic response
Directly inhibits renin.
21) Which of the following terms is given to hypertension in which the blood pressure, which is controlled with therapy, becomes uncontrolled (abnormally high) with the discontinuation of therapy?
Rebound
Essential
Primary
Secondary
22) The nurse has been teaching the role of diet in regulating blood pressure to a client with hypertension. Which meal selection indicates that the client understands his new diet?
Cornflakes, whole milk, banana, and coffee
Scrambled eggs, bacon, toast, and coffee
Oatmeal, apple juice, dry toast, and coffee
Pancakes, ham, tomato juice, and coffee
23) A patient with a blood pressure of 180/120 and end organ damage is an hypertensive EMERGENCY
True
False
24) Which class of drugs can cause lupus-like syndrome?
Direct Vasodilators
Beta Blockers
Calcium Channel Blockers
Alpha-2 Agonists
25) A client has been diagnosed with hypertension. The nurse priority nursing diagnosis would be:
Ineffective health maintenance
Impaired skin integrity
Deficient fluid volume
Pain
26) Steven is taking a anti hypertensive. He takes ibuprofen for knee pain as well. Which ant hypertensive medication should Steven have further education on?
Losartan
Zestril
Atenolol
Norvasc
27) Peggy is switching from lisinopril to norvasc. She understands her new medication when she states:
I may have headaches
It causes vadodilation and decreases SVR and lowers B/P
It may cause edema peripherally
all the above
28) An agitated, confused female client arrives in the emergency department. Her history includes type 1 diabetes mellitus, hypertension, and angina pectoris. Assessment reveals pallor, diaphoresis, headache, and intense hunger. A stat blood glucose sample measures 42 mg/dl, and the client is treated for an acute hypoglycemic reaction. After recovery, nurse Lily teaches the client to treat hypoglycemia by ingesting:
2 to 5 g of a simple carbohydrate.
10 to 15 g of a simple carbohydrate.
18 to 20 g of a simple carbohydrate.
25 to 30 g of a simple carbohydrate.
29) How does Catapress work?
Selectively blocks beta 1 receptors
Inhibits the conversion of angiotensin I to angiotensin II
Blocks angiotensin II receptors
Stimulates alpha 2 receptors
30) What side effects are associated with ACE Inhibitors?
Cough
Hypotension
Angioedema
All of the above
31) Which individual is at greatest risk for developing hypertension?
45 year-old African American attorney
60 year-old Asian American shop owner
40 year-old Caucasian nurse
55 year-old Hispanic teacher
32) Nicole has been taking a central alpha2-agonist. She was doing very well on it and has now ended up in the ED. She reports that she was doing so well that she stopped taking her medication because she felt fine and couldn’t afford her medication since being laid off. What could be the reason for Nicole’s reaction?
Over abundance of K in her system
Orthostatic BP problems
Drug Induced lupus syndrome
Withdrawl phenomenon
33) Cindy is taking a hypertensive. She has been complaining of feeling light headed and dizzy when she stands up. She has not been tasting food correctly and her UA came back with proteinuria. Further testing showed she has angioedema. What could be causing Cindy’s problem?
Lasix
Aldactone
Prinivil
Lostran
34) What medications should be avoided in pregnant women, especially in the 2nd-3rd trimester. (check all that apply)
ARBs
ACE Inhibitors
Beta Blockers
Tekturna
35) Officially, hypertension is diagnosed when the patient demonstrates a systolic blood pressure greater than ______ mm Hg and a diastolic blood pressure greater than _____ mm Hg over a sustained period.
140, 90
130, 80
110, 60
120, 70
36) Primary focus should be reaching systolic blood pressure goal.
True
False
37) Norma has started a new drug for hypertension. Thirty minutes after she takes the drug, she develops chest tightness and becomes short of breath and tachypneic. She has a decreased level of consciousness. These signs indicate which of the following conditions?
Asthma attack
Pulmonary embolism
Respiratory failure
Rheumatoid arthritis
38) The nurse is assessing a multigravida, 36 weeks gestation for symptoms of pregnancy-induced hypertension and preeclampsia. The nurse should give priority to assessing the client for:
Facial swelling
Pulse deficits
Ankle edema
Diminished reflexes
39) Kids,Between the ages of 1 and 10 are the only ones prone to hypertension
True
False
40) Aldactone can cause which of the following side effects?
Hypokalemia
Hypercalcemia
Hyperkalemia
Hyperphosphemia
41) When taking Atenolol, the nurse knows to hold the medication if:
HR <50
Dry Coughing
pt becomes hypotensive
if K levels increase
42) Direct vasodilators work by peripheral vasodilation. However, the nurse needs to educate their pt by including which of these side effects in their pt education?
Increases HR
Na retention
Drug induced lupus syndrome
all the above
none of the above
43) A client with hypertension ask the nurse which factors can cause blood pressure to drop to normal levels?
Kidneys’ excretion to sodium only.
Kidneys’ retention of sodium and water
Kidneys’ excretion of sodium and water
Kidneys’ retention of sodium and excretion of water
44) Hydralazine works on hypertension by:
decreases sympathetic response
peripheral vasodilation
directly inhibits renin
blocks Ca from stimulating muscle walls
45) Younger patients are at a higher risk for orthostatic hypotension than Elderly patients
True
False
46) 134/85 is considered to be:
Pre-hypertension
Stage 1 Hypertension
Stage 2 Hypertension
None of the above
47) K sparing diuretic has been prescribed to Lisa. She has been feeling week, tired, and has numbness. Lisa has been eating extra bananas to increase he K because she knows that K sparing diuretics shed K in urine. The nurse responds by saying:
Lisa will need to go on a K supplement.
Lisa has become hyperkalemic and needs reeducation on her medication.
Lisa is only showing 3 of the 5 indicators for hyperkalemia, so she needs to continue her medication.
Lisa needs to be put on a different hypertensive because she is complaining too much.
48) Perry is going on lisinopril. When he asks how it works, the nurse would answer:
It releases Ca and HCO3 while holding onto K.
It blocks the angiotensin I from turning into angiotensin II, leaving the vessels dilated for better blood flow.
It blocks the reabsorbtion of Na.
Blocks stimulation of beta .
49) Which drug is used to treat hypertensive emergencies?
Zyprexa
Lasix
Sodium Chloride
Nitroprusside
50) The immediate objective of nursing care for an overweight, mildly hypertensive male client with ureteral colic and hematuria is to decrease:
Pain
Weight
Hematuria
Hypertension
51) A client with chronic schizophrenia who takes neuroleptic medication is admitted to the psychiatric unit. Nursing assessment reveals rigidity, fever, hypertension, and diaphoresis. These findings suggest which life-threatening reaction:
tardive dyskinesia.
dystonia.
neuroleptic malignant syndrome.
akathisia.
52) 119/80 is considered to be:
Pre-hypertension
Stage 1 Hypertension
Stage 2 Hypertension
None of the above
53) What medication directly dilates the peripheral vesicles?
Tekturna
Furosemide
Hydralazine
Valsartan
54) How can you prevent high blood pressure?
drink water,eat a lot of salt,stay at home
drink water,eat healthy,eat a lot of sugar,drink wine
Drink a lot of water,exercise,consume less sodium and have a life style change
eat healthy,go for a walk once a week,drink 1 bottle of water per day
55) The physician orders lisinopril (Zestril) and furosemide (Lasix) to be administered concomitantly to the client with hypertension. The nurse should:
Question the order
Administer the medications
Administer separately
Contact the pharmacy
56) Check all of the complications that can result from chronic hypertension
Retinopathy
Kidney disease
Depression
Alzheimers
57) African Americans have an increased need for combination therapy to attain and maintain blood pressure goals
True
False
58) 163/112 is considered to be:
Pre-hypertension
Stage 1 Hypertension
Stage 2 Hypertension
None of the above
59) A patient with pregnancy-induced hypertension probably exhibits which of the following symptoms?
Proteinuria, headaches, vaginal bleeding
Headaches, double vision, vaginal bleeding
Proteinuria, headaches, double vision
Proteinuria, double vision, uterine contractions
60) This hypertension drug is the first choice for diabetic patients?
Beta Blockers
ACE Inhibitors
Calcium Channel Blockers
Direct Vasodilators
Answers and Rationales
C. Loop diuretics
A. Are often not present
A. at what time was your last drink taken?. This question will give the nurse idea WHEN will the withdrawal occur. Withdrawal occurs 5 to 10 hours after the last intake of alcohol. This is a crucial and mortality is very high during this period.
A. Selectively blocks beta 1 receptors
B. False
A. phentolamine (Regitine). Pheochromocytoma causes excessive production of epinephrine and norepinephrine, natural catecholamines that raise the blood pressure. Phentolamine, an alpha-adrenergic blocking agent given by I.V. bolus or drip, antagonizes the body’s response to circulating epinephrine and norepinephrine, reducing blood pressure quickly and effectively. Although methyldopa is an antihypertensive agent available in parenteral form, it isn’t effective in treating hypertensive emergencies. Mannitol, a diuretic, isn’t used to treat hypertensive emergencies. Felodipine, an antihypertensive agent, is available only in extended-release tablets and therefore doesn’t reduce blood pressure quickly enough to correct hypertensive crisis.
D. Calcium Channel Blocker
C. norepinephrine
B. Verapamil
A. Maintain adequate dietary intake of potassium . In general, one serving of a potassium-rich food such as banana, kale, broccoli, or orange juice will meet the daily need for potassium.
A. True
D. All of the above
B. Check the blood glucose level . Hyperstat is given IV push for hypertensive crises, but it often causes hyperglycemia. The glucose level will drop rapidly when stopped. Answer A is incorrect because the hyperstat is given by IV push. The client should be placed in dorsal recumbent position, not a Trendelenburg position, as stated in answer C. Answer D is incorrect because the medication does not have to be covered with foil.
D. Loop Diuretic
D. It inhibits reabsorption of sodium and water in the loop of Henle. Furosemide is a loop diuretic that inhibits sodium and water reabsorption in the loop Henle, thereby causing a decrease in blood pressure. Vasodilators cause dilation of peripheral blood vessels, directly relaxing vascular smooth muscle and decreasing blood pressure. Adrenergic blockers decrease sympathetic cardioacceleration and decrease blood pressure. Angiotensin-converting enzyme inhibitors decrease blood pressure due to their action on angiotensin.
A. “I need to reduce my daily intake to 1,200 calories a day.” The client does not need to drastically reduce her caloric intake during pregnancy. Doing so would not provide adequate nourishment for proper development of the fetus.
A. Finding a healthy wieght and not smoke
A. 20–30 minutes three times a week. The client’s aerobic workout should be 20–30 minutes long three times a week.
A. delirium tremens. Delirium Tremens is the most extreme central nervous system irritability due to withdrawal from alcohol B. This refers to an amnestic syndrome associated with chronic alcoholism due to a deficiency in Vit. B C. This is a complication of liver cirrhosis which may be secondary to alcoholism . D. This is a complication of alcoholism characterized by irregularities of eye movements and lack of coordination.
C. decreases sympathetic response
A. Rebound . Rebound hypertension may precipitate a hypertensive crisis. Essential or primary hypertension denotes high blood pressure from an unidentified source. Essential or primary hypertension denotes high blood pressure from an unidentified source. Secondary hypertension denotes high blood pressure from an identified cause, such as renal disease.
C. Oatmeal, apple juice, dry toast, and coffee. Oatmeal is low in sodium and high in fiber. Limiting sodium intake and increasing fiber helps to lower cholesterol levels, which reduce blood pressure. Answer A is incorrect because cornflakes and whole milk are higher in sodium and are poor sources of fiber. Answers B and D are incorrect because they contain animal proteins that are high in both cholesterol and sodium.
A. True
A. Direct Vasodilators
A. Ineffective health maintenance. Managing hypertension is the priority for the client with hypertension. Clients with hypertension frequently do not experience pain, deficient volume, or impaired skin integrity. It is the asymptomatic nature of hypertension that makes it so difficult to treat.
B. Zestril
D. all the above
B. 10 to 15 g of a simple carbohydrate. To reverse hypoglycemia, the American Diabetes Association recommends ingesting 10 to 15 g of a simple carbohydrate, such as three to five pieces of hard candy, two to three packets of sugar (4 to 6 tsp), or 4 oz of fruit juice. If necessary, this treatment can be repeated in 15 minutes. Ingesting only 2 to 5 g of a simple carbohydrate may not raise the blood glucose level sufficiently. Ingesting more than 15 g may raise it above normal, causing hyperglycemia.
D. Stimulates alpha 2 receptors
D. All of the above
A. 45 year-old African American attorney. 45 year-old African American attorney The incidence of hypertension is greater among African Americans than other groups in the US. The incidence among the Hispanic population is rising.
D. Withdrawl phenomenon
C. Prinivil
A. ARBs, B. ACE Inhibitors, D. Tekturna
A. 140, 90 . According to the categories of blood pressure levels established by the JNC VI, stage 1 hypertension is demonstrated by a systolic pressure of 140–159 or a diastolic pressure of 90–99.
A. True
C. Respiratory failure . The client was reacting to the drug with respiratory signs of impending anaphylaxis, which could lead to eventually respiratory failure. Although the signs are also related to an asthma attack or a pulmonary embolism, consider the new drug first. Rheumatoid arthritis doesn’t manifest these signs.
A. Facial swelling. The nurse should pay close attention to swelling in the client with preeclampsia. Facial swelling indicates that the client’s condition is worsening and blood pressure will be increased. Answer B is not related to the question; therefore, it is incorrect. Answer C is incorrect because ankle edema is expected in pregnancy. Diminished reflexes are associated with the use of magnesium sulfate, which is the treatment of preeclampsia; therefore, answer D is incorrect.
B. False
C. Hyperkalemia
A. HR <50
D. all the above
C. Kidneys’ excretion of sodium and water . The kidneys respond to rise in blood pressure by excreting sodium and excess water. This response ultimately affects sysmolic blood pressure by regulating blood volume. Sodium or water retention would only further increase blood pressure. Sodium and water travel together across the membrane in the kidneys; one can’t travel without the other.
B. peripheral vasodilation
B. False
A. Pre-hypertension
B. Lisa has become hyperkalemic and needs reeducation on her medication.
B. It blocks the angiotensin I from turning into angiotensin II, leaving the vessels dilated for better blood flow.
D. Nitroprusside
A. Pain . Sharp, severe pain (renal colic) radiating toward the genitalia and thigh is caused by uretheral distention and smooth muscle spasm; relief form pain is the priority.
C. neuroleptic malignant syndrome. The client’s signs and symptoms suggest neuroleptic malignant syndrome, a life-threatening reaction to neuroleptic medication that requires immediate treatment. Tardive dyskinesia causes involuntary movements of the tongue, mouth, facial muscles, and arm and leg muscles. Dystonia is characterized by cramps and rigidity of the tongue, face, neck, and back muscles. Akathisia causes restlessness, anxiety, and jitteriness.
D. None of the above
C. Hydralazine
C. Drink a lot of water,exercise,consume less sodium and have a life style change
B. Administer the medications. Zestril is an ACE inhibitor and is frequently given with a diuretic such as Lasix for hypertension. Answers A, C, and D are incorrect because the order is accurate. There is no need to question the order, administer the medication separately, or contact the pharmacy.
A. Retinopathy , B. Kidney disease
A. True
C. Stage 2 Hypertension
C. Proteinuria, headaches, double vision . A patient with pregnancy-induced hypertension complains of headache, double vision, and sudden weight gain. A urine specimen reveals proteinuria. Vaginal bleeding and uterine contractions are not associated with pregnancy-induces hypertension.