Pharmaceuticals Used In The Treatment Of Hypertension

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  • 1/27 Questions

    Which drug class may cause the patient to develop dry cough?

    • Calcium channel blockers
    • ACE inhibitors
    • Direct vascular dilators
    • Central andrenergic agonists
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Pharmaceuticals Used In The Treatment Of Hypertension - Quiz
About This Quiz

This quiz covers pharmaceuticals used in hypertension treatment, focusing on mechanisms of action and effects of drugs like hydrochlorothiazide and nifedipine.

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  • 2. 

    A patient’s usual blood pressure while taking diltiazem (Cardizem), a calcium channel blocker, is 140/80. However, this morning, the patient’s blood pressure is 88/50. The nurse’s next action should be to:

    • Administer one-half the prescribed dose.

    • Withhold the dose and contact the physician.

    • Administer the dose as directed.

    • Administer an extra dose of the medication.

    Correct Answer
    A. Withhold the dose and contact the physician.
    Explanation
    The patient's blood pressure is significantly lower than their usual reading while taking diltiazem, indicating a potential adverse reaction or side effect of the medication. Withholding the dose and contacting the physician is the appropriate action to ensure patient safety and to determine if any adjustments need to be made to the medication regimen. Administering the dose as directed or administering an extra dose could potentially worsen the patient's low blood pressure and lead to further complications.

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  • 3. 

    The client is receiving  hydrochlorothiazide (HydroDIURIL) as well as digoxin (Lanoxin). Which lab result would the nurse recognize as most significant?

    • BUN level of 20 mg/dl

    • Potassium level of 2.9 mEq/L

    • Sodium level of 140 mEq/L

    • ALT level of 35 units/L

    Correct Answer
    A. Potassium level of 2.9 mEq/L
    Explanation
    The nurse would recognize the potassium level of 2.9 mEq/L as the most significant lab result. Hydrochlorothiazide is a diuretic that can cause potassium loss, and low potassium levels can increase the risk of digoxin toxicity. Therefore, monitoring and maintaining potassium levels within the normal range is crucial for clients receiving both hydrochlorothiazide and digoxin.

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  • 4. 

    Which hormone prompts the kidneys to conserve sodium and water?

    • Aldosterone

    • Angiotensinogen

    • Anglotensin II

    • Insulin

    Correct Answer
    A. Aldosterone
    Explanation
    Aldosterone is the hormone that prompts the kidneys to conserve sodium and water. It is released by the adrenal glands in response to low blood pressure or low blood volume. Aldosterone acts on the kidneys to increase the reabsorption of sodium and water, which helps to increase blood volume and blood pressure. This hormone plays a crucial role in regulating fluid balance in the body.

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  • 5. 

    The nurse is taking the initial history of a client admitted to the hospital for hypertension. The physician has ordered a beta-adrenergic blocker. Which statement by the client does the nurse recognize as most significant?

    • “I have always had problems with my asthma.”

    • “My father died of a heart attack when he was 48 years-old.”

    • “I don’t handle stress well; I have a lot of diarrhea.”

    • “When I have a migraine headache, I need to have the room darkened.”

    Correct Answer
    A. “I have always had problems with my asthma.”
    Explanation
    The nurse recognizes the statement "I have always had problems with my asthma" as most significant because beta-adrenergic blockers can exacerbate asthma symptoms and potentially cause bronchospasms. This information is crucial for the nurse to consider before administering the medication to the client.

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  • 6. 

    The first-line therapy for uncomplicated hypertension is:

    • A diuretic

    • A vasodilator

    • A calcium channel blocker

    • An angiotensin-converting enzyme (ACE) inhibitor.

    Correct Answer
    A. A diuretic
    Explanation
    A diuretic is the first-line therapy for uncomplicated hypertension because it helps to reduce blood pressure by increasing the excretion of salt and water from the body. This helps to decrease the volume of blood circulating through the blood vessels, leading to a decrease in blood pressure. Diuretics are considered effective and well-tolerated medications for treating hypertension and are often recommended as the initial treatment option. They are also available in different types, such as thiazide diuretics and loop diuretics, allowing for individualized treatment based on the patient's needs and medical history.

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  • 7. 

    Direct-acting vasodilators such as hydralazine (Apresoline) can produce reflex tachycardia that can be blocked by:

    • Furosemide (Lasix)

    • Propranolol (Inderal)

    • Doxazosin (Cardura)

    • Hydrochlorothiazide (HydroDIURUL)

    Correct Answer
    A. Propranolol (Inderal)
    Explanation
    Direct-acting vasodilators like hydralazine can cause reflex tachycardia, which is an increase in heart rate as a compensatory response to the drop in blood pressure. Propranolol, a beta blocker, can block the effects of the sympathetic nervous system on the heart, thereby reducing the reflex tachycardia caused by hydralazine. This is why propranolol is the correct answer in this case. Furosemide, doxazosin, and hydrochlorothiazide are not specifically indicated for blocking reflex tachycardia and do not directly affect the sympathetic nervous system.

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  • 8. 

    The calcium channel blocker nifedipine (Procardia, Adalat) lower blood pressure by:

    • Reducing blood volume.

    • Reducing total peripheral resistance.

    • Reducing cardiac output.

    • Causing reflex tachycardia.

    Correct Answer
    A. Reducing total peripheral resistance.
    Explanation
    Nifedipine, a calcium channel blocker, works by blocking the calcium channels in the smooth muscle cells of the blood vessels. This causes the blood vessels to relax and widen, reducing the resistance to blood flow. As a result, the total peripheral resistance decreases, leading to a reduction in blood pressure.

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  • 9. 

    Which of the following produces a fall in blood pressure?

    • Stimulation of the renin-angiotensin system

    • Blockade of alpha adrenergic receptors

    • Stimulation of the sympathetic nervous system

    • Stimulation of sodium reabsorption by the kidney

    Correct Answer
    A. Blockade of alpha adrenergic receptors
    Explanation
    Blockade of alpha adrenergic receptors produces a fall in blood pressure. Alpha adrenergic receptors are responsible for the constriction of blood vessels, so blocking these receptors prevents vasoconstriction and allows blood vessels to relax, leading to a decrease in blood pressure.

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  • 10. 

    Drinking grapefruit juice with a calcium channel blocker:

    • Greatly enhances the effectiveness of the drug.

    • Facilitates the excretion of the drug via the kidneys.

    • Can cause a rash on the arms and legs.

    • May increase drug blood levels.

    Correct Answer
    A. May increase drug blood levels.
    Explanation
    Drinking grapefruit juice may increase drug blood levels when taken with a calcium channel blocker. Grapefruit juice contains compounds that inhibit the enzymes responsible for breaking down the drug in the body. As a result, the drug is not metabolized as quickly and can accumulate in the bloodstream, leading to higher drug levels. This can potentially increase the effectiveness of the drug, but it can also increase the risk of side effects or drug toxicity.

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  • 11. 

    The client is receiving doxazosin (Cardura) for hypertension. He asks the nurse how the medication works. What is the nurse’s best response?

    • “It works by making your heart work more efficiently.”

    • “It works by decreasing the release of your stress hormones.”

    • “It works by making your blood vessels expand.”

    • “It works by causing your kidneys to excrete more urine.”

    Correct Answer
    A. “It works by making your blood vessels expand.”
    Explanation
    Doxazosin (Cardura) is an alpha-1 blocker that works by relaxing and widening the blood vessels. This helps to lower blood pressure by reducing the resistance against which the heart has to pump. By expanding the blood vessels, it allows for better blood flow and reduces the workload on the heart.

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  • 12. 

    An 80 year-old male with newly diagnosed primary hypertension has just been started on a beta-blocker. In addition to teaching him about this medication—such as side effects, purpose, and schedule—the nurse should also focus her teaching on:

    • Maintaining a diet high in dairy to increase protein necessary to prevent organ damage.

    • Use of supportive devices such as handrails and walkers to prevent falls stemming from postural hypotension.

    • Avoiding exercise to prevent injury from postural hypotension.

    • Increasing fluid intake to prevent dehydration.

    Correct Answer
    A. Use of supportive devices such as handrails and walkers to prevent falls stemming from postural hypotension.
    Explanation
    The correct answer is to focus on teaching the patient about the use of supportive devices such as handrails and walkers to prevent falls stemming from postural hypotension. Beta-blockers can cause postural hypotension, which is a drop in blood pressure when changing positions. This can increase the risk of falls, especially in older adults. Teaching the patient about the use of supportive devices can help prevent falls and injuries.

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  • 13. 

    Renin inhibitors block the ability of renin to:

    • Decrease reabsorption of potassium by the kidneys.

    • Decrease reabsorption of sodium by the kidneys.

    • Convert angiotensin I to angiotensinogen.

    • Convert angiontensinogen to angiotensin I.

    Correct Answer
    A. Convert angiontensinogen to angiotensin I.
    Explanation
    Renin inhibitors block the ability of renin to convert angiotensinogen to angiotensin I. Renin is an enzyme produced by the kidneys that plays a key role in the renin-angiotensin-aldosterone system (RAAS), which regulates blood pressure and fluid balance. Angiotensinogen is a precursor protein that is converted by renin into angiotensin I, which is further converted to angiotensin II. Angiotensin II is a potent vasoconstrictor that increases blood pressure. By inhibiting renin's ability to convert angiotensinogen to angiotensin I, renin inhibitors help to lower blood pressure.

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  • 14. 

    What is a priority nursing intervention for a client who has just begun antihypertensive treatment with enalapril (Vasotec)?

    • Review the client’s lab results for hypokalemia.

    • Take the client’s blood pressure.

    • Monitor the client for headaches.

    • Order a sodium-restricted diet for the client.

    Correct Answer
    A. Take the client’s blood pressure.
    Explanation
    Taking the client's blood pressure is a priority nursing intervention for a client who has just begun antihypertensive treatment with enalapril (Vasotec). This is because enalapril is a medication used to treat hypertension, and monitoring the client's blood pressure will help assess the effectiveness of the medication and determine if any adjustments need to be made in the dosage or treatment plan. It is important to closely monitor the client's blood pressure to ensure that it is within the desired range and to prevent any complications associated with high blood pressure.

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  • 15. 

    For a patient with hypertension who has had a stroke, the first-line therapy is a combination of:

    • A diuretic and an angiotensin II receptor blocker (ARB).

    • A calcium channel blocker and beta blocker.

    • A diuretic and an ACE inhibitor.

    • A calcium channel blocker and an ARB.

    Correct Answer
    A. A diuretic and an ACE inhibitor.
    Explanation
    A patient with hypertension who has had a stroke requires a first-line therapy that can effectively lower blood pressure and reduce the risk of future cardiovascular events. Diuretics are commonly used to reduce fluid volume and blood pressure, while ACE inhibitors help dilate blood vessels and reduce the production of angiotensin II, a hormone that constricts blood vessels. This combination therapy is recommended because it addresses both the fluid volume and vascular components of hypertension, providing comprehensive control of blood pressure and reducing the risk of further stroke or cardiovascular complications.

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  • 16. 

    Which drug causes vasodilation of the peripheral blood vessels and coronary arteries but no reduction in heart rate?

    • Atenolol

    • Diltiazem

    • Amlodipine

    • Verpamil

    Correct Answer
    A. Amlodipine
    Explanation
    Amlodipine is a calcium channel blocker that causes vasodilation of the peripheral blood vessels and coronary arteries. It does not reduce heart rate because it specifically targets calcium channels in blood vessels rather than in the heart. This selective action allows for the dilation of blood vessels without affecting the heart rate.

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  • 17. 

    Which is a key adverse effect of nondihydropyridines?

    • Bradycardia

    • Atrial fibrillation

    • Tachycardia

    • Ventricular fibrillation

    Correct Answer
    A. Bradycardia
    Explanation
    Nondihydropyridines are a type of calcium channel blockers commonly used to treat hypertension and angina. One of the key adverse effects of these medications is bradycardia, which refers to a slower than normal heart rate. This occurs because nondihydropyridines block calcium channels in the heart, which can decrease the conduction of electrical impulses and result in a slower heart rate. Bradycardia can lead to symptoms such as fatigue, dizziness, and fainting, and may require dose adjustment or discontinuation of the medication.

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  • 18. 

    Which agent can potentiate the effects of antihypertensives?

    • Advil

    • Antacid

    • Garlic

    • Motrin

    Correct Answer
    A. Garlic
    Explanation
    Garlic is known to have several health benefits, including its ability to lower blood pressure. It contains compounds that can relax blood vessels and improve blood flow, which can enhance the effects of antihypertensive medications. Therefore, consuming garlic alongside antihypertensives can potentially increase their effectiveness in managing high blood pressure.

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  • 19. 

    The client receives hydrochlorothiazide (HydroDIURIL). He tells the nurse he is urinating a lot and questions how this drug affects his blood pressure. What is the best response by the nurse?

    • “Hydrochlorothiazide (HydroDIURIL) dilates your blood vessels so you urinate more and your blood pressure decreases.”

    • “Hydrochlorothiazide (HydroDIURIL) decreases the fluid in your bloodstream and this lowers your blood pressure.”

    • “Hydrochlorothiazide (HydroDIURIL) enhances kidney function causing you to urinate more and that decreases your blood pressure.”

    • “Hydrochlorothiazide (HydroDIURIL) increases your heart rate; this pumps blood faster to your kidneys so you urinate more and your blood pressure decreases.”

    Correct Answer
    A. “Hydrochlorothiazide (HydroDIURIL) decreases the fluid in your bloodstream and this lowers your blood pressure.”
    Explanation
    Hydrochlorothiazide is a diuretic that works by increasing the excretion of water and sodium through the kidneys, which leads to a decrease in fluid volume in the bloodstream. This decrease in fluid volume reduces the pressure on the blood vessel walls, resulting in a decrease in blood pressure.

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  • 20. 

    Which two drug classes are recommended for patients with hypertension who also have heart disease?

    • Ace inhibitors and beta blockers

    • Beta blockers and calcium channel blockers

    • Diuretics and direct vascular dilators

    • ARBs and adrenergic blockers

    Correct Answer
    A. Ace inhibitors and beta blockers
    Explanation
    Ace inhibitors and beta blockers are recommended for patients with hypertension who also have heart disease. Ace inhibitors help to relax blood vessels and reduce the workload on the heart, while beta blockers help to slow down the heart rate and reduce the force of contractions. This combination of medications can effectively lower blood pressure and improve heart function in patients with hypertension and heart disease.

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  • 21. 

    The nursing care plan for a patient taking diuretics mentions observing the patient for dehydration. Which of the following are symptoms of dehydration. Select all that apply.

    • Dry mouth

    • Slow heart rate

    • Thirst

    • Hypotension

    Correct Answer(s)
    A. Dry mouth
    A. Thirst
    A. Hypotension
    Explanation
    Dehydration can cause a dry mouth as the body is not receiving enough fluids. Thirst is also a symptom of dehydration as the body tries to signal that it needs more water. Hypotension, or low blood pressure, can occur due to dehydration as there is a decrease in blood volume. Slow heart rate, however, is not a symptom of dehydration and may be indicative of another condition.

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  • 22. 

    Which is an adverse effect of a dihydropyridine calcium channel blocker?

    • Bradycardia

    • Lupus

    • Severe vasodilation

    • Abnormal hair growth

    Correct Answer
    A. Severe vasodilation
    Explanation
    A dihydropyridine calcium channel blocker is a medication that primarily works by relaxing and widening the blood vessels, leading to vasodilation. Severe vasodilation is an adverse effect of this type of medication because it can cause a significant drop in blood pressure, leading to symptoms such as dizziness, lightheadedness, and fainting. This adverse effect is more commonly seen with dihydropyridine calcium channel blockers compared to other types of calcium channel blockers. Bradycardia refers to a slow heart rate, lupus is an autoimmune disease, and abnormal hair growth is not typically associated with dihydropyridine calcium channel blockers.

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  • 23. 

    Which antihypertensive drug is correctly matched with its pharmacological mechanism of action?

    • Minoxidil (Loniten)—angiotensin converting enzyme inhibitor

    • Verapamil (Calan)—direct-acting vasodilator

    • Metoprolol (Toprol, Lopressor)—alpha-adrenergic receptor blocker

    • Triamterene (Dyrenium)—potassium-sparing diuretic

    Correct Answer
    A. Triamterene (Dyrenium)—potassium-sparing diuretic
    Explanation
    Triamterene (Dyrenium) is correctly matched with its pharmacological mechanism of action as a potassium-sparing diuretic. Diuretics are medications that increase urine production, and potassium-sparing diuretics specifically work by promoting diuresis while preventing the loss of potassium. Triamterene acts on the distal convoluted tubules of the kidneys to inhibit the reabsorption of sodium and decrease the excretion of potassium. This helps to reduce fluid volume and lower blood pressure.

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  • 24. 

    ARBs work by blocking:

    • Aldosterone

    • The type 1 angiotensin receptor

    • Calcium

    • The type 2 angiotensin receptor.

    Correct Answer
    A. The type 1 angiotensin receptor
    Explanation
    ARBs, or angiotensin receptor blockers, work by blocking the type 1 angiotensin receptor. This receptor is responsible for mediating the effects of angiotensin II, a hormone that causes vasoconstriction and increases blood pressure. By blocking this receptor, ARBs help to relax and widen blood vessels, reducing blood pressure and improving blood flow. This mechanism of action is different from other medications that target aldosterone or the type 2 angiotensin receptor.

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  • 25. 

    In patients taking an antihypertensive, St. Johns’ Wort can:

    • Decrease metabolism.

    • Decrease blood levels of some drugs.

    • Interfere with the absorption of some antihypertensives.

    • Cause a rash on the legs and trunk of the body.

    Correct Answer
    A. Decrease blood levels of some drugs.
    Explanation
    St. John's Wort is known to induce the activity of certain liver enzymes responsible for drug metabolism. This increased metabolism can lead to a decrease in blood levels of drugs that are metabolized by these enzymes, including some antihypertensive medications. Therefore, taking St. John's Wort alongside antihypertensives can result in lower blood levels of the drugs, potentially reducing their effectiveness in controlling blood pressure.

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  • 26. 

    Which of the following adrenergic blockers is correctly paired with its pharmacological mechanism?

    • Propranolol (Inderal)—selectively blocks beta1-adrenergic receptors

    • Doxazosin (Cardura)—blocks alpha2-adrenergic receptors in the brainstem

    • Methyldopa (Aldomet)—metabolized to a false neurotransimitter in the brainstem

    • Clonidine (Catapres)—blocks alpha1-adrenergic receptors on blood vessels

    Correct Answer
    A. Methyldopa (Aldomet)—metabolized to a false neurotransimitter in the brainstem
    Explanation
    Methyldopa (Aldomet) is correctly paired with its pharmacological mechanism as it is metabolized to a false neurotransmitter in the brainstem. Methyldopa is converted into alpha-methylnorepinephrine, which acts as a false neurotransmitter and reduces sympathetic outflow from the brainstem, leading to a decrease in blood pressure. This mechanism is different from the other options, which involve blocking adrenergic receptors rather than metabolizing into a false neurotransmitter.

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  • 27. 

    The nurse is conducting the initial group education session for clients who have hypertension. What is the most important information to include? Select all that apply.

    • The aorta has sensors that help regulate blood pressure.

    • Anger can result in hypertension.

    • Blood pressures tend to decrease as people age, due to decreased blood volume.

    • The vasomotor center, located in the limbic system of the brain, helps regulate blood pressure.

    Correct Answer(s)
    A. The aorta has sensors that help regulate blood pressure.
    A. Anger can result in hypertension.
    Explanation
    The most important information to include in the initial group education session for clients who have hypertension is that the aorta has sensors that help regulate blood pressure and that anger can result in hypertension. This information is crucial for clients to understand the physiological mechanisms involved in blood pressure regulation and the potential impact of emotional factors on their condition.

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  • Current Version
  • Mar 21, 2023
    Quiz Edited by
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  • Aug 17, 2009
    Quiz Created by
    Wleogrande

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