Pharmaceuticals Used In The Treatment Of Hypertension
Pharmaceuticals Used in the Treatment of Hypertension Quiz
- 1.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?
- A.
“Hydrochlorothiazide (HydroDIURIL) dilates your blood vessels so you urinate more and your blood pressure decreases.”
- B.
“Hydrochlorothiazide (HydroDIURIL) decreases the fluid in your bloodstream and this lowers your blood pressure.”
- C.
“Hydrochlorothiazide (HydroDIURIL) enhances kidney function causing you to urinate more and that decreases your blood pressure.”
- D.
“Hydrochlorothiazide (HydroDIURIL) increases your heart rate; this pumps blood faster to your kidneys so you urinate more and your blood pressure decreases.”
- 2.The calcium channel blocker nifedipine (Procardia, Adalat) lower blood pressure by:
- A.
Reducing blood volume.
- B.
Reducing total peripheral resistance.
- C.
Reducing cardiac output.
- D.
Causing reflex tachycardia.
- 3.Which antihypertensive drug is correctly matched with its pharmacological mechanism of action?
- A.
Minoxidil (Loniten)—angiotensin converting enzyme inhibitor
- B.
Verapamil (Calan)—direct-acting vasodilator
- C.
Metoprolol (Toprol, Lopressor)—alpha-adrenergic receptor blocker
- D.
Triamterene (Dyrenium)—potassium-sparing diuretic
- 4.Direct-acting vasodilators such as hydralazine (Apresoline) can produce reflex tachycardia that can be blocked by:
- A.
Furosemide (Lasix)
- B.
Propranolol (Inderal)
- C.
Doxazosin (Cardura)
- D.
Hydrochlorothiazide (HydroDIURUL)
- 5.Which of the following produces a fall in blood pressure?
- A.
Stimulation of the renin-angiotensin system
- B.
Blockade of alpha adrenergic receptors
- C.
Stimulation of the sympathetic nervous system
- D.
Stimulation of sodium reabsorption by the kidney
- 6.Which of the following adrenergic blockers is correctly paired with its pharmacological mechanism?
- A.
Propranolol (Inderal)—selectively blocks beta1-adrenergic receptors
- B.
Doxazosin (Cardura)—blocks alpha2-adrenergic receptors in the brainstem
- C.
Methyldopa (Aldomet)—metabolized to a false neurotransimitter in the brainstem
- D.
Clonidine (Catapres)—blocks alpha1-adrenergic receptors on blood vessels
- 7.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:
- A.
Maintaining a diet high in dairy to increase protein necessary to prevent organ damage.
- B.
Use of supportive devices such as handrails and walkers to prevent falls stemming from postural hypotension.
- C.
Avoiding exercise to prevent injury from postural hypotension.
- D.
Increasing fluid intake to prevent dehydration.
- 8.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.
- A.
Dry mouth
- B.
Slow heart rate
- C.
Thirst
- D.
Hypotension
- 9.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:
- A.
Administer one-half the prescribed dose.
- B.
Withhold the dose and contact the physician.
- C.
Administer the dose as directed.
- D.
Administer an extra dose of the medication.
- 10.Which two drug classes are recommended for patients with hypertension who also have heart disease?
- A.
Ace inhibitors and beta blockers
- B.
Beta blockers and calcium channel blockers
- C.
Diuretics and direct vascular dilators
- D.
ARBs and adrenergic blockers
- 11.Which is a key adverse effect of nondihydropyridines?
- A.
Bradycardia
- B.
Atrial fibrillation
- C.
Tachycardia
- D.
Ventricular fibrillation
- 12.Which hormone prompts the kidneys to conserve sodium and water?
- A.
Aldosterone
- B.
Angiotensinogen
- C.
Anglotensin II
- D.
Insulin
- 13.Which drug causes vasodilation of the peripheral blood vessels and coronary arteries but no reduction in heart rate?
- A.
Atenolol
- B.
Diltiazem
- C.
Amlodipine
- D.
Verpamil
- 14.Which agent can potentiate the effects of antihypertensives?
- A.
Advil
- B.
Antacid
- C.
Garlic
- D.
Motrin
- 15.The first-line therapy for uncomplicated hypertension is:
- A.
A diuretic
- B.
A vasodilator
- C.
A calcium channel blocker
- D.
An angiotensin-converting enzyme (ACE) inhibitor.
- 16.ARBs work by blocking:
- A.
Aldosterone
- B.
The type 1 angiotensin receptor
- C.
Calcium
- D.
The type 2 angiotensin receptor.
- 17.Which is an adverse effect of a dihydropyridine calcium channel blocker?
- A.
Bradycardia
- B.
Lupus
- C.
Severe vasodilation
- D.
Abnormal hair growth
- 18.Drinking grapefruit juice with a calcium channel blocker:
- A.
Greatly enhances the effectiveness of the drug.
- B.
Facilitates the excretion of the drug via the kidneys.
- C.
Can cause a rash on the arms and legs.
- D.
May increase drug blood levels.
- 19.In patients taking an antihypertensive, St. Johns’ Wort can:
- A.
Decrease metabolism.
- B.
Decrease blood levels of some drugs.
- C.
Interfere with the absorption of some antihypertensives.
- D.
Cause a rash on the legs and trunk of the body.
- 20.Renin inhibitors block the ability of renin to:
- A.
Decrease reabsorption of potassium by the kidneys.
- B.
Decrease reabsorption of sodium by the kidneys.
- C.
Convert angiotensin I to angiotensinogen.
- D.
Convert angiontensinogen to angiotensin I.
- 21.Which drug class may cause the patient to develop dry cough?
- A.
Calcium channel blockers
- B.
ACE inhibitors
- C.
Direct vascular dilators
- D.
Central andrenergic agonists
- 22.For a patient with hypertension who has had a stroke, the first-line therapy is a combination of:
- A.
A diuretic and an angiotensin II receptor blocker (ARB).
- B.
A calcium channel blocker and beta blocker.
- C.
A diuretic and an ACE inhibitor.
- D.
A calcium channel blocker and an ARB.
- 23.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.
- A.
The aorta has sensors that help regulate blood pressure.
- B.
Anger can result in hypertension.
- C.
Blood pressures tend to decrease as people age, due to decreased blood volume.
- D.
The vasomotor center, located in the limbic system of the brain, helps regulate blood pressure.
- 24.The client is receiving hydrochlorothiazide (HydroDIURIL) as well as digoxin (Lanoxin). Which lab result would the nurse recognize as most significant?
- A.
BUN level of 20 mg/dl
- B.
Potassium level of 2.9 mEq/L
- C.
Sodium level of 140 mEq/L
- D.
ALT level of 35 units/L
- 25.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?
- A.
“I have always had problems with my asthma.”
- B.
“My father died of a heart attack when he was 48 years-old.”
- C.
“I don’t handle stress well; I have a lot of diarrhea.”
- D.
“When I have a migraine headache, I need to have the room darkened.”
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