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STUVIA 2024/2025Chapter 39: Antihypertensives
A 65-year-old patient has a blood pressure of 155/95 mm Hg. The nurse understands that with
treatment, the goal for this patient's blood pressure is
a. 120/80 mm Hg
b. 130/89 mm Hg
c. 140/90 mm Hg
d. 150/90 mm Hg - ✔✔ANS: D
According to the Joint National Committee (JNC) 8, a blood pressure of 140/90 is the goal for the
population younger than 60 years, with a target of 150/90 for those above 60. A blood pressure less
than 120/80 mm Hg is considered normal.
A patient has an average blood pressure of 135/85 mm Hg based on the average of three separate
measurements. The nurse understands that this patient should be treated with which of the following?
a. a beta blocker.
b. a diuretic and a beta blocker.
c. a diuretic.
d. lifestyle changes - ✔✔ANS: D
%
Prehypertension is defined as a systolic pressure of 120 to 139 and a diastolic pressure between 80
and 89. Drug therapy is recommended if the blood pressure is in the hypertensive range.
Prehypertension is generally treated first with lifestyle changes.
A patient is diagnosed with borderline hypertension and states a desire to make lifestyle changes to
avoid needing to take medication. The nurse will recommend which changes?
a. Changing from weight bearing exercise to yoga
b. Decreased fluid intake and increased potassium intake
c. Stress reduction and increased protein intake
d. Weight reduction and decreased sodium intake - ✔✔ANS: D
Weight loss decreases the stress on the heart. Decreasing salt intake decreases vascular volume.
Changing to yoga from weight-bearing exercise, limiting fluids, and increasing potassium are not
indicated. Stress reduction is recommended, but increasing protein is not.
A patient who has recently begun taking captopril (Capoten) to treat hypertension calls a clinic to
report a persistent cough that started right after starting the captopril. The nurse will perform which
action?
a. Instruct the patient to go to an emergency department because this is a hypersensitivity reaction.
b. Reassure the patient that this side effect is nothing to worry about and will diminish over time.
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, STUVIA 2024/2025
c. Schedule an appointment with the provider to evaluate the cough and discuss changing to an
angiotensin II receptor blocker (ARB).
d. Tell the patient to stop taking the drug immediately since this is a serious side effect of this drug. -
✔✔ANS: C
An ACE inhibitor, such as captopril, can cause a constant, irritated cough. The cough will stop with
discontinuation of the drug, and many patients can switch to an ARB medication which will not
contribute to cough. It does not indicate a hypersensitivity reaction. The cough will not diminish while
still taking the drug. The patient does not need to stop taking the drug immediately.
The nurse is admitting a patient who has been taking minoxidil (Loniten) to treat resistant
hypertension. Prior to beginning therapy with this medication, the patient had a blood pressure of
170/95 mm Hg and a heart rate of 72 beats per minute. The nurse assesses the patient and
notes a blood pressure of 130/72 mm Hg and a heart rate of 78 beats per minute, and also notes a
2.2-kg weight gain since the previous hospitalization and edema of the hands and feet. The nurse will
contact the provider to discuss which intervention?
a. Adding hydrochlorothiazide to help increase urine output
b. Adding metoprolol (Lopressor) to help decrease the heart rate
c. Increasing the dose of minoxidil to lower the blood pressure
d. Restricting fluids to help with weight reduction - ✔✔ANS: A
%
Minoxidil is a direct-acting vasodilator, which can cause sodium and water retention. Combining this
drug with a diuretic can help reduce edema by increasing urine output. If the patient were tachycardic,
a beta blocker might be added. It is not necessary to increase the minoxidil dose or to restrict fluids.
The nurse is caring for a 70-year-old patient who has recently begun taking amlodipine (Norvasc) 5
mg/day to control hypertension. The nurse notes mild edema of the patient's ankles, a blood pressure
of 130/70 mm Hg, and a heart rate of 80 beats per minute. The patient reports flushing and dizziness.
The nurse will notify the provider and:
a. ask to decrease the dose to 2.5 mg/day.
b. discuss twice daily dosing.
c. request an order for a diuretic.
d. suggest adding propranolol to the regimen. - ✔✔ANS: A
This patient is experiencing side effects of the medication. Elderly patients often require lower doses,
so the nurse should ask about a dose reduction. Older adults generally require 2.5 to 5.0 mg/day.
Twice daily dosing is not recommended. Unless edema persists, a diuretic is not indicated.
The nurse is caring for a hospitalized patient who experiences an acute spike in blood pressure. The
nurse will expect an order to administer which medication?
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