Chapter 43 - Drugs Affecting Blood Pressure |Test Bank - Focus on Nursing Pharmacology (8th Edition by Karch)
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Focus on Nursing Pharmacology
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Focus On Nursing Pharmacology
1. What does the clinic nurse anticipate as initial drug therapy for a 39-year-old African American man who is 25 pounds overweight and newly diagnosed with hypertension?
a. An angiotensin-converting enzyme (ACE) inhibitor
b. A beta-blocker
c. A calcium channel blocker
d. A diuretic
Ans: D
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Test Bank - Focus on Nursing Pharmacology (8th Edition by Karch)
1. What does the clinic nurse anticipate as initial drug therapy for a 39-year-old
African American man who is 25 pounds overweight and newly diagnosed with
hypertension?
a. An angiotensin-converting enzyme (ACE) inhibitor
b. A beta-blocker
c. A calcium channel blocker
d. A diuretic
Ans: D
Feedback:
African Americans are at highest risk for developing hypertension with men more
likely than women to develop the disease. African Americans have documented
differences in response to antihypertensive therapy. They are most responsive to
single-drug therapy and diuretics. The first line use of a diuretic is in combination
with diet and other lifestyle changes. The use of a calcium channel blocker and/or
alpha-adrenergic blocker should follow. African Americans are less responsive to
ACE inhibitors and beta-blocker.
2. The clinic nurse assesses a patient taking benazepril (Lotensin) to control
hypertension. What is the priority nursing assessment related to this drug?
a. Mental illness
b. Hepatic disease
c. Renal disease
d. Peptic ulcer disease
Ans: C
Feedback:
Benazepril is an angiotensin-converting enzyme inhibitor; drugs in this class are
contraindicated in the presence of impaired renal function. Mental illness, hepatic
disease, or peptic ulcer disease is not a contraindication with this drug.
3. A patient has been prescribed losartan (Cozaar) for hypertension. What patient
teaching points will the nurse include about this drug include?
a. Report onset of a cough or fever to health care provider.
b. Limit fluid intake to decrease urinary output.
c. Monitor blood pressure once a week.
d. Take the drug late in the day to prevent sleepiness.
, Ans: A
Feedback:
Losartan is an angiotensin IIreceptor blocker that is associated with a cough, back
pain, fever, muscle weakness, and upper respiratory tract infections, so the patient
should be taught to report a fever or cough to his health care provider. Fluid intake
should be normal and the drug is best taken in the morning. Blood pressure should be
monitored daily, especially when first starting the drug when adverse effects are not
yet known.
4. A patient newly diagnosed with hypertension has just been given a prescription for
medication. Along with promoting safety, what is the other goal of the nurse’s
teaching plan?
a. A blood pressure of 120/80
b. Medication compliance
c. A discussion with his insurance company about the cost of the drug
d. Verbalization of why drugs should be kept out of the reach of children
Ans: B
Feedback:
The nurse provides thorough patient teaching, including the name of the drug, dosage
prescribed, measures to avoid adverse effects, warning signs of problems, and the
need for periodic monitoring and evaluation, to enhance patient knowledge about drug
therapy and to promote compliance. All of the options are realistic outcomes for this
patient. However, compliance is a great concern for people who are in need of
hypertensive agents. It would be most important for his or her health care provider to
know that he or she has filled the prescription and is taking his or her medication as
prescribed. Keeping the drug out of the reach of children would be a safety measure.
5. A stepped care management approach to treating hypertension includes weight
loss, smoking cessation, decreased use of alcohol, reducing salt in the diet, and
increased physical exercise. In which step of a stepped-care management approach
will the nurse teach about these changes in lifestyle?
a. Step 1 only
b. Steps 1 and 2
c. Steps 1, 2, and 3
d. Steps 1, 2, 3, and 4
Ans: D
Feedback:
Lifestyle changes are encouraged in all four steps and should be advocated for the
maintenance of good health. These changes are stressed in steps 1 and 2 in the hope
that drug therapy will not be necessary. However, these changes should occur in steps
3 and 4 as well.
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