Pharm Lilley Ch. 22
1. A patient has a new order for the adrenergic drug doxazosin (Cardura). When providing
education about this drug, the nurse will include which instructions?
a. "Weigh yourself daily, and report any weight loss to your prescriber."
b. "Increase your potassium intake by eating more bananas and apricots."
c. "The impaired taste associated with this medication usually goes away in 2 to 3 weeks."
d. "Be sure to lie down after taking the first dose, because first-dose hypotension may make you
dizzy." - ANSANS: D
A patient who is starting doxazosin should take the first dose while lying down because there is
a first-dose hypotensive effect with this medication. The other options are incorrect.
DIF: COGNITIVE LEVEL: Analyzing (Analysis) REF: p. 354
TOP: NURSING PROCESS: Implementation
MSC: NCLEX: Physiological Integrity: Reduction of Risk Potential
2. A patient with severe liver disease is receiving the angiotensin-converting enzyme (ACE)
inhibitor, captopril (Capoten). The nurse is aware that the advantage of this drug for this patient
is which characteristic?
a. Captopril rarely causes first-dose hypotensive effects.
b. Captopril has little effect on electrolyte levels.
c. Captopril is a prodrug and is metabolized by the liver before becoming active.
d. Captopril is not a prodrug and does not need to be metabolized by the liver before becoming
active. - ANSANS: D
A prodrug relies on a functioning liver to be converted to its active form. Captopril is not a
prodrug, and therefore it would be safer for the patient with liver dysfunction.
DIF: COGNITIVE LEVEL: Applying (Application) REF: p. 348
TOP: NURSING PROCESS: Assessment
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
3. During a follow-up visit, the health care provider examines the fundus of the patient's eye.
Afterward, the patient asks the nurse, "Why is he looking at my eyes when I have high blood
pressure? It does not make sense to me!" What is the best response by the nurse?
a. "We need to monitor for drug toxicity."
b. "We must watch for increased intraocular pressure."
c. "The provider is assessing for visual changes that may occur with drug therapy."
d. "The provider is making sure the treatment is effective over the long term." - ANSANS: D
, The physician would examine the fundus of a patient's eyes during antihypertensive therapy
because it is a more reliable indicator than blood pressure readings of the long-term
effectiveness of treatment.
DIF: COGNITIVE LEVEL: Applying (Application) REF: p. 358
TOP: NURSING PROCESS: Evaluation
MSC: NCLEX: Physiological Integrity: Physiological Adaptation
4. The nurse is preparing for a community education program on hypertension. Which of these
parameters determine the regulation of arterial blood pressure?
a. Cardiac output and systemic vascular resistance
b. Heart rate and peripheral resistance
c. Blood volume and renal blood flow
d. Myocardial contractility and arteriolar constriction - ANSANS: A
Blood pressure is determined by the product of cardiac output and systemic vascular resistance.
The other options are incorrect.
DIF: COGNITIVE LEVEL: Understanding (Comprehension) REF: p. 343
TOP: NURSING PROCESS: General
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
5. When counseling a male patient about the possible adverse effects of antihypertensive drugs,
the nurse will discuss which potential problem?
a. Impotence
b. Bradycardia
c. Increased libido
d. Weight gain - ANSANS: A
Sexual dysfunction is a common complication of antihypertensive medications and may be
manifested in men as decreased libido or impotence. The other options are incorrect.
DIF: COGNITIVE LEVEL: Understanding (Comprehension) REF: p. 358
TOP: NURSING PROCESS: Assessment
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
6. The nurse is reviewing drug therapy for hypertension. According to the JNC-8 guidelines,
antihypertensive drug therapy for a newly diagnosed hypertensive African-American patient
would most likely include which drug or drug classes?
a. Vasodilators alone
b. ACE inhibitors alone
c. Calcium channel blockers with thiazide diuretics
d. Beta blockers with thiazide diuretics - ANSANS: C
According to the JNC-8 guidelines, calcium channel blockers and diuretics are recommended as
first-line therapy for management of hypertension in African-American patients. The other drugs
are not recommended as first-line drugs for this group.
1. A patient has a new order for the adrenergic drug doxazosin (Cardura). When providing
education about this drug, the nurse will include which instructions?
a. "Weigh yourself daily, and report any weight loss to your prescriber."
b. "Increase your potassium intake by eating more bananas and apricots."
c. "The impaired taste associated with this medication usually goes away in 2 to 3 weeks."
d. "Be sure to lie down after taking the first dose, because first-dose hypotension may make you
dizzy." - ANSANS: D
A patient who is starting doxazosin should take the first dose while lying down because there is
a first-dose hypotensive effect with this medication. The other options are incorrect.
DIF: COGNITIVE LEVEL: Analyzing (Analysis) REF: p. 354
TOP: NURSING PROCESS: Implementation
MSC: NCLEX: Physiological Integrity: Reduction of Risk Potential
2. A patient with severe liver disease is receiving the angiotensin-converting enzyme (ACE)
inhibitor, captopril (Capoten). The nurse is aware that the advantage of this drug for this patient
is which characteristic?
a. Captopril rarely causes first-dose hypotensive effects.
b. Captopril has little effect on electrolyte levels.
c. Captopril is a prodrug and is metabolized by the liver before becoming active.
d. Captopril is not a prodrug and does not need to be metabolized by the liver before becoming
active. - ANSANS: D
A prodrug relies on a functioning liver to be converted to its active form. Captopril is not a
prodrug, and therefore it would be safer for the patient with liver dysfunction.
DIF: COGNITIVE LEVEL: Applying (Application) REF: p. 348
TOP: NURSING PROCESS: Assessment
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
3. During a follow-up visit, the health care provider examines the fundus of the patient's eye.
Afterward, the patient asks the nurse, "Why is he looking at my eyes when I have high blood
pressure? It does not make sense to me!" What is the best response by the nurse?
a. "We need to monitor for drug toxicity."
b. "We must watch for increased intraocular pressure."
c. "The provider is assessing for visual changes that may occur with drug therapy."
d. "The provider is making sure the treatment is effective over the long term." - ANSANS: D
, The physician would examine the fundus of a patient's eyes during antihypertensive therapy
because it is a more reliable indicator than blood pressure readings of the long-term
effectiveness of treatment.
DIF: COGNITIVE LEVEL: Applying (Application) REF: p. 358
TOP: NURSING PROCESS: Evaluation
MSC: NCLEX: Physiological Integrity: Physiological Adaptation
4. The nurse is preparing for a community education program on hypertension. Which of these
parameters determine the regulation of arterial blood pressure?
a. Cardiac output and systemic vascular resistance
b. Heart rate and peripheral resistance
c. Blood volume and renal blood flow
d. Myocardial contractility and arteriolar constriction - ANSANS: A
Blood pressure is determined by the product of cardiac output and systemic vascular resistance.
The other options are incorrect.
DIF: COGNITIVE LEVEL: Understanding (Comprehension) REF: p. 343
TOP: NURSING PROCESS: General
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
5. When counseling a male patient about the possible adverse effects of antihypertensive drugs,
the nurse will discuss which potential problem?
a. Impotence
b. Bradycardia
c. Increased libido
d. Weight gain - ANSANS: A
Sexual dysfunction is a common complication of antihypertensive medications and may be
manifested in men as decreased libido or impotence. The other options are incorrect.
DIF: COGNITIVE LEVEL: Understanding (Comprehension) REF: p. 358
TOP: NURSING PROCESS: Assessment
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
6. The nurse is reviewing drug therapy for hypertension. According to the JNC-8 guidelines,
antihypertensive drug therapy for a newly diagnosed hypertensive African-American patient
would most likely include which drug or drug classes?
a. Vasodilators alone
b. ACE inhibitors alone
c. Calcium channel blockers with thiazide diuretics
d. Beta blockers with thiazide diuretics - ANSANS: C
According to the JNC-8 guidelines, calcium channel blockers and diuretics are recommended as
first-line therapy for management of hypertension in African-American patients. The other drugs
are not recommended as first-line drugs for this group.
