RNSG 1301 Mid-Term Review Questions Graded A 2025

1. You are leading an educational discussion on childhood hypertension at a local school board meeting. A particular focus of the discussion is the promotion of non- pharmacologic treatment measures. Which of the following methods is appropriate for managing hypertension in children? Promotion of exercise Prevention of obesity Reduction of dietary sodium All the above 2. A community health nurse is facilitating a health promotion session to a group of seniors. Which topic related to hypertension is most important to include in the information? Hypertension will increase the risk of cancer. An increase is sodium is recommended with hypertension. Exercise will increase the risk of hypertension. Hypertension will increase the risk of heart disease. 3. When providing dietary instruction on a low-sodium diet, which dietary choice is most appropriate for a client with hypertension? Hot dog, baked beans, and Cole slaw Grilled hamburger, French fries, and cola drink Grilled chicken, green salad, and apple Ham sandwich, potato chips, and cookie 2 4. The nurse is teaching a client about hypertension. Non-pharmacologic methods to decrease blood pressure would include which? weight loss and decreased salt intake. decreased water intake and decreased potassium intake. increased exercise activity and fat intake. stress reduction techniques and high fat intake. 5. What should a client with newly diagnosed hypertension be counseled to do? Select all that apply. Lose weight Stop smoking Reduce stress Decrease exercise Increase sodium intake 6. An adult client recently diagnosed with hypertension has begun combination therapy. Which client statement would suggest a need for further health education? “I'm going to make up a schedule for checking my blood pressure on a regular basis.” “I'll only need to take these drugs on days when my blood pressure is particularly high.” “My wife and I are thinking of ways that we can cut down the amount of salt in our diet.” “I've made plans with my best friend to start going for walks in the morning four times a week.” 3 7. The goal of therapy for a client taking antihypertensive medication is to maintain: compliance. the blood pressure within normal limits. a fluid volume balance. homeostasis. 8. The nurse should inform the client of the possibility of developing what common adverse effect of captopril therapy? rhinitis dry cough photosensitivity rash to the trunk and extremities 9. The nurse would encourage clients with prehypertension to follow what type of diet? High-sodium diet DASH diet Restricted-calorie diet High-protein diet 10. A patient who is prescribed losartan for hypertension has stopped taking the drug immediately after experiencing adverse effects. Which of the following may result when antihypertensives are abruptly discontinued? Breathing difficulty Rebound hypertension Orthostatic hypotension Anginal attack 4 11. A client with a blood pressure of 165/95 mm Hg would be classified in which stage of hypertension? Stage 2 Stage 1 Prehypertension Normotensive 12. A staff nurse on a renal unit knows that most patients require treatment for hypertensive disease. What would the nurse expect to assess prior to the beginning of antihypertensive treatment? A temporary increase in renal function A sustained increase in renal dysfunction Baseline renal function A sustained decrease in renal function 13. A client prescribed a potassium-sparing diuretic is at a risk for developing which electrolyte imbalance? hypernatremia hyponatremia hypokalemia hyperkalemia 5 14. An older adult client who resides in a care facility has been prescribed antihypertensives for the first time following many years of generally good health. When administering the first dose of the prescribed antihypertensive medication to an older adult, the nurse should recognize the related risk to which possible side effect? falls Infection acute confusion impaired oxygenation 15. A client prescribed ramipril earlier in the week states, “Now I have a nagging, dry cough.” How should the nurse best follow up the client's statement? Inform the client that the drug should be immediately discontinued. Inform the client that this is an adverse effect of the medication that may lead to pneumonitis. Explain why it will be necessary to obtain a sputum sample. Explain that drugs like ramipril often cause a cough. 16. The client is diagnosed with primary hypertension. The nurse is educating a client about dietary changes that help decrease blood pressure. Which menu selection indicates the need for further client education? Salad with a grilled chicken; unsweetened tea Baked fish, broccoli, and oranges Ham sandwich with mustard, carrots and cheesy dip Turkey sandwich on whole wheat with lettuce and tomato; sweetened tea 6 1. What statement should underlie the nurse’s response when asked if ACE inhibitor therapy can be continued during pregnancy? Since ACE inhibitors cross the placenta, dosage during pregnancy should be reduced. ACE inhibitors are contraindicated during pregnancy because they are teratogenic. ACE inhibitors will exacerbate the fluid overload that commonly accompanies pregnancy. There is no research to support discontinuation of ACE inhibitor therapy during pregnancy. 2. A group of students are reviewing the various antihypertensive agents. The students demonstrate understanding of the information when they identify what as an example of an angiotensin II receptor blocker? Moexipril Losartan Minoxidil Amlodipine 3. A patient has been advised to use a transdermal patch of clonidine for hypertension. For which of the following time periods should the nurse ensure that the patch is intact? For one week For two weeks For three weeks For four weeks 4. A client is prescribed aliskiren. The nurse would monitor the laboratory test results of which electrolyte closely? Potassium Sodium 7 Magnesium Chloride 5. The nurse provides drug teaching to the client prescribed captopril. What statement made by the client does the nurse interpret to mean teaching has been effective? “I will monitor the effectiveness by watching for any symptoms of hypertension.” “I will call my doctor if I bruise easily or become extremely tired.” “I’ll take the drug in the morning so that I don’t have to go to the bathroom often at night.” “I will increase my intake of foods high in potassium, such as bananas.” 6. A 42-year-old client is seen by the health care provider for follow-up for diabetic nephropathy. The provider prescribed losartan for the treatment of this condition because the medication has been shown to reduce the rate of end-stage renal disease. Which drug class does this drug belong to? Antihyperlipidemic drugs Calcium channel blockers Selective aldosterone blockers Angiotensin II receptor blockers 7. How is hypertension defined with regard to blood pressure readings? systolic pressure above 140 mm Hg or diastolic pressure above 90 mm Hg systolic pressure above 160 mm Hg or diastolic pressure above 110 mm Hg systolic pressure above 130 mm Hg or diastolic pressure above 88 mm Hg systolic pressure above 150 mm Hg or diastolic pressure above 100 mm Hg 8. A client develops primary hypertension and asks the nurse, “How long will I need to receive therapy?” The nurse responds based on the understanding that therapy would be required for how long? 8 Lifelong Until blood pressure is 120/80 mmHg One year 5 years 9. A nurse is caring for a client who has been diagnosed with primary hypertension. What nursing interventions should be included in the teaching plan? Select all that apply. Regular aerobic exercise Diet with more fruits and vegetables Decreased alcohol consumption Smoking cessation Focus on finding a different job 10. The client has been started on an ACE inhibitor for hypertension. The client also takes spironolactone (Aldactone) daily. The nurse would evaluate the client for which of the following? Hyperkalemia Hypokalemia Hypercalcemia Hypocalcemia 11. A client, diagnosed with left-sided heart failure, should be taught to recognize the signs and symptoms of the onset of what classic manifestation of this condition? pulmonary edema venous ulcers chest pain palpitations 9 12. A nurse is caring for a client experiencing a hypertensive emergency. If blood pressure is not lowered immediately, what can occur? (Select all that apply.) Damage to the heart Damage to the kidneys Damage to the gall bladder Damage to the pancreas Damage to the eyes 13. The female client states that her father has had high blood pressure all of his life and he is healthy. She does not understand why the care provider has prescribed medication for her blood pressure. What is the nurse's best response? "Maybe you do not need medication with your history." "With high blood pressure, blood vessels may be damaged and that can cause heart and kidney disease." "The effects of high blood pressure are different for different people." "We always treat high blood pressure with medicine to prevent further damage to your body." 13. A client has come to the clinic for the past 7 months with elevated blood pressure. The client has now been prescribed three different antihypertensives as well as a diuretic. The nurse knows that what other factors may be contributing to the client’s consistent hypertension? (Select all that apply.) Meditation Walking program Nasal decongestant Herbal supplement OTC appetite suppressant 10 14. Which risk factors increase a client's risk for the development of hypertension? Select all that apply: advancing age family history Caucasian race cigarette smoking chronic alcohol consumption 15. Which risk factors increase a client's risk for the development of hypertension? Select all that apply: advancing age family history Caucasian race cigarette smoking chronic alcohol consumption 1. Which antihypertensive medication can be administered by transdermal patch? amlodipine candesartan enalapril clonidine 2. Mr. Zee is being discharged home after treatment for a myocardial infarction. During the hospital stay he was also diagnosed with uncomplicated diabetes mellitus type 2 and hypertension. The health care provider has prescribed several new drugs, one of which is captopril. What instruction is important to include in the teaching plan regarding captopril administration? Discontinue the drug if persistent dry cough occurs. 11 Avoid dairy products. Avoid potassium supplements. Implement a low-carbohydrate diet as part of your weight loss program. 12 3. A client does not want to take medication to treat existing hypertension if it can be avoided. The client asks the nurse whether any other options are available. What lifestyle changes should the nurse recommend? Select all that apply. “Increase the amount of exercise that you do.” “Eliminate all salt from your diet.” “Lose some weight, if possible.” “Try meditation, if it’s something you’re interested in.” “Reduce your overall intake of fluids.” 4. When educating a group of nursing students on the mechanism of action of angiotensin converting enzyme inhibitor (ACEI) drugs, the nurse identifies what as the action brought about by aldosterone? Inhibits renin secretion. Causes sodium and water retention. Causes excess potassium retention. Promotes angiotensin I conversion. 5. After reviewing the various antihypertensive agents, a group of students demonstrate the need for additional teaching when they identify which agent as a calcium channel blocker? Valsartan Nicardipine Diltiazem Verapamil 6. A group of students are reviewing the various antihypertensive agents available. The students demonstrate understanding of the information when they identify which agent as an example of a renin inhibitor? Mecamylamine Aliskiren 13 Candesartan Captopril 7. The nurse is caring for a client with hypertension who is preparing to be discharged from the hospital after suffering a myocardial infarction. What drug would both treat the client’s hypertension and reduce myocardial oxygen consumption? Captopril Losartan Diltiazem Nitroprusside 8. The client presents to the health care provider with a new onset of bradycardia. The nurse recognizes that which antihypertensive can cause bradycardia? Labetalol Clonidine Enalapril Diltiazem 14 9. A 77-year-old patient has a long-standing history of hypertension, a health problem that is being treated with metoprolol and a thiazide diuretic. Before administering the 8 AM dose of these medications, what assessments should the nurse perform and document? (Select all that apply.) Respiratory rate Oxygen saturation Temperature Heart rate Blood pressure 10. A 77-year-old patient has a long-standing history of hypertension, a health problem that is being treated with metoprolol and a thiazide diuretic. Before administering the 8 AM dose of these medications, what assessments should the nurse perform and document? (Select all that apply.) Respiratory rate Oxygen saturation Temperature Heart rate Blood pressure 15 11. A male client’s friend tells him to stop taking his metoprolol because he read that it causes cancer. The nurse encourages the client to consult his prescriber because abrupt withdrawal from the drug may cause what effect? Postural hypotension and falls Bradycardia Exacerbation of his angina Atrial dysrhythmias 12. A client with a long history of hypertension has just been prescribed an alpha1-adrenergic receptor blocker. To reduce this client’s risk of orthostatic hypotension and falls, the nurse should encourage the client to implement what intervention? Take the medication at bedtime. Take the medication with a high-fat meal. Increase fluid intake for 48 hours before taking the first dose. Start with a low dose and increase gradually over 2 to 3 weeks. 13. Which of the following steps are involved in the proper administration of a Catapes-TTS patch? Select all that apply: A new patch is applied daily. If the patch loosens, a new patch should be applied. The use of the adhesive overlay is not necessary. A different body area should be selected for each application. The patch should be applied to a hairless area. 16 14. Which event occurs in a client diagnosed with hypertension? The kidneys excrete more fluid in response to increased blood pressure. Fluid loss increases blood volume in the client with hypertension. Decreased blood volume increases blood pressure. Cardiac output increases and in turn causes an increase in blood pressure. 17 Chapter 27 15. The nurse is visiting the home of a client who is prescribed antidysrhythmic medication. The nurse will teach the client to report which possible adverse effect? Increased energy Improved functional status Dizziness Improved mentation 16. Which would the nurse explain is the pacemaker of the heart? SA node AV node Bundle of His Purkinje fibers 1. A patient, admitted to a health care facility with cardiac arrhythmia, is prescribed propranolol. Which factor should the nurse closely monitor as a part of the ongoing assessment during the therapy? Pulse rate Tendon reflexes Hydration Visual acuity 18 2. The client receiving propranolol (Inderal) at home for management of a ventricular dysrhythmia should monitor which parameter? Fluid intake Blood pressure daily Daily exercise Pulse once a week 3. A client diagnosed with heart disease is prescribed an antiarrhythmic drug. Further teaching is needed when the client makes which statement? “I will take my medication at the prescribed time.” “I need to call my primary care provider before taking any herbal supplements.” “I can check the drug label about taking the medicine with food.” “I know I must take my medication every day for my heartbeat to be fixed.” 4. The nurse is administering lidocaine to a client with ventricular tachycardia. The nurse will need to observe for adverse effects, including hyperthermia. hypotension. hypertension. dysphagia. 19 5. The nurse is preparing discharge teaching for a client prescribed chronic antiarrhythmic medication therapy. Which signs/symptoms should be reported to the health care provider immediately? (Select all that apply.) Chest pain Dyspnea Nausea Heart palpations Diarrhea 6. A 70-year-old woman with a history of atrial fibrillation takes digoxin and verapamil to control her health problem. Verapamil achieves a therapeutic effect by: blocking adrenergic receptors and producing antisympathetic effects. inhibiting the movement of calcium ions across the cardiac muscle cell membrane. decreasing sodium and potassium conduction. weakening diastolic depolarization and the action potential duration. 7. A client has been declared "brain dead". The family asks the nurse to explain why their loved one's heart continues to beat in spite of the damage to the brain. The nurse should provide what explanation to the family? The heart beats in response to impulses that are generated by specialized cells located in the heart not the brain. When the brain is unable to trigger the heart to beat, the sinoatrial (SA) node in the heart assumes that role. The inability to control the heart is not among the losses associated with "brain death". The heart will eventually stop beating as the losses associated with "brain death" become more extensive.