Ch 43: Drugs Affecting Blood Pressure Exam
Questions and Correct Answers
1. Key behavioral determinants of blood pressure are related to what
factor? answer: -
Dietary consumption of calories and salt
Explanation answer:Key behavioral determinants of blood pressure are related to dietary consumption of
calories and salt; the prevalence of hypertension rises proportionally to average body mass index.
2. A client who is malnourished and hypertensive client is being
treated with losartan. Considering the client's nutritional status, how
should the dose of the medication be adjusted in this client? answer:
Lowered
Explanation answer:Both losartan and the metabolite are highly bound to plasma albumin, and losartan
has a shorter duration of action. Due to malnutrition, a low dose of losartan should be prescribed. The
dose should not be higher than normal due to possible toxicity. The dose should not be the same as
normal due to possible toxicity. The medication will not be combined with a diuretic unless the blood
pressure is not controlled.
3. A 54-year-old client with CHF is admitted to the unit. The nurse
knows that what physiologic changes will affect a client's stroke
volume? answer: Changes in heart contraction
Explanation answer:Stroke volume is the volume of blood ejected from the heart at each beat. If a heart
contracts harder, more blood is ejected. If a heart cannot contract very well, then less blood is ejected
and stroke volume falls. Heparin dose, walking patterns, and respiratory rate do not directly attect stroke
volume.
4. A patient is admitted to the unit with problems controlling their
serum glu- cose levels. The patient has hypertension as a co-
morbidity, and the physician has ordered hydralazine for this
patient. The nurse caring for this patient knows that hydralazine is a(n)
answer: answer: direct vasodilator.
,Explanation answer:If other drug therapies do not achieve the desired reduction in blood pressure, it is
sometimes necessary to use a direct vasodilator. Most of the vasodilators are reserved for use in severe
hypertension or hypertensive emergencies. These include diazoxide , hydralazine (generic), minoxidil ,
and nitroprusside .
5. A client has been prescribed ramipril 5 mg PO daily with the
scheduled dose due at 08 answer:00. After reviewing the client's
most recent blood work, the nurse should consider withholding the
dose because of what laboratory finding? answer: ele- vated potassium
levels
,Explanation answer:ACE inhibitors like ramipril carry a risk of hyperkalemia, and an elevated potassium level
may warrant withholding the drug. Elevated neutrophils or low sodium and hemoglobin levels would not
likely prompt this action.
6. A nurse is educating a patient with hypertension who is prescribed
losartan on the mechanism of action of the drug. Which mode of
action helps losartan to bring about its antihypertensive effect? answer: By
blocking the angiotensin II receptors
Explanation answer:Losartan brings about an antihypertensive ettect by blocking the angiotensin II
receptors. Losartan is an angiotensin II receptor antagonist. By blocking the angiotensin II receptor, the
renin-angiotensin system is stopped and consequently blood pressure is reduced. Drugs such as
captopril prevent the conversion of angiotensin I. Losartan does not prevent renin secretion. Losartan
does not block aldosterone receptors.
7. The nurse is caring for a client who is being treated for opioid
withdrawal. The nurse notes that the health care provider has
ordered which medication that is also used as an antihypertensive?
answer: Clonidine
Explanation answer:Clonidine, an antihypertensive drug, is a nonopioid that may be used to treat opioid
withdrawal. Clonidine reduces the release of norepinephrine in the brain and thus reduces symptoms
associated with excessive stimulation of the sympathetic nervous system (e.g., anxiety, restlessness,
insomnia). Blood pressure must be closely monitored during clonidine therapy.
8. 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? answer: Angiotensin II receptor blockers
Explanation answer:Losartan is an angiotensin II receptor blocker (ARB) and is recommended for
clients with diabetic renal disease because ARBs have been shown to reduce the rate of end-stage
renal disease. Antihyperlipidemic drugs help to reduce cholesterol. Calcium channel blockers relax and
widen blood vessels by attecting the muscle cells in the arterial walls, these are recommended with
caution in pregnant women. Selective aldosterone blockers do not show reduction of end-stage renal
, disease but are ettective in treating severe CHF.
9. A client is receiving a diuretic as the first-line treatment of mild
hypertension. The nurse monitors the client for signs and symptoms
of hypokalemia with which agent? answer: Hydrochlorothiazide
Questions and Correct Answers
1. Key behavioral determinants of blood pressure are related to what
factor? answer: -
Dietary consumption of calories and salt
Explanation answer:Key behavioral determinants of blood pressure are related to dietary consumption of
calories and salt; the prevalence of hypertension rises proportionally to average body mass index.
2. A client who is malnourished and hypertensive client is being
treated with losartan. Considering the client's nutritional status, how
should the dose of the medication be adjusted in this client? answer:
Lowered
Explanation answer:Both losartan and the metabolite are highly bound to plasma albumin, and losartan
has a shorter duration of action. Due to malnutrition, a low dose of losartan should be prescribed. The
dose should not be higher than normal due to possible toxicity. The dose should not be the same as
normal due to possible toxicity. The medication will not be combined with a diuretic unless the blood
pressure is not controlled.
3. A 54-year-old client with CHF is admitted to the unit. The nurse
knows that what physiologic changes will affect a client's stroke
volume? answer: Changes in heart contraction
Explanation answer:Stroke volume is the volume of blood ejected from the heart at each beat. If a heart
contracts harder, more blood is ejected. If a heart cannot contract very well, then less blood is ejected
and stroke volume falls. Heparin dose, walking patterns, and respiratory rate do not directly attect stroke
volume.
4. A patient is admitted to the unit with problems controlling their
serum glu- cose levels. The patient has hypertension as a co-
morbidity, and the physician has ordered hydralazine for this
patient. The nurse caring for this patient knows that hydralazine is a(n)
answer: answer: direct vasodilator.
,Explanation answer:If other drug therapies do not achieve the desired reduction in blood pressure, it is
sometimes necessary to use a direct vasodilator. Most of the vasodilators are reserved for use in severe
hypertension or hypertensive emergencies. These include diazoxide , hydralazine (generic), minoxidil ,
and nitroprusside .
5. A client has been prescribed ramipril 5 mg PO daily with the
scheduled dose due at 08 answer:00. After reviewing the client's
most recent blood work, the nurse should consider withholding the
dose because of what laboratory finding? answer: ele- vated potassium
levels
,Explanation answer:ACE inhibitors like ramipril carry a risk of hyperkalemia, and an elevated potassium level
may warrant withholding the drug. Elevated neutrophils or low sodium and hemoglobin levels would not
likely prompt this action.
6. A nurse is educating a patient with hypertension who is prescribed
losartan on the mechanism of action of the drug. Which mode of
action helps losartan to bring about its antihypertensive effect? answer: By
blocking the angiotensin II receptors
Explanation answer:Losartan brings about an antihypertensive ettect by blocking the angiotensin II
receptors. Losartan is an angiotensin II receptor antagonist. By blocking the angiotensin II receptor, the
renin-angiotensin system is stopped and consequently blood pressure is reduced. Drugs such as
captopril prevent the conversion of angiotensin I. Losartan does not prevent renin secretion. Losartan
does not block aldosterone receptors.
7. The nurse is caring for a client who is being treated for opioid
withdrawal. The nurse notes that the health care provider has
ordered which medication that is also used as an antihypertensive?
answer: Clonidine
Explanation answer:Clonidine, an antihypertensive drug, is a nonopioid that may be used to treat opioid
withdrawal. Clonidine reduces the release of norepinephrine in the brain and thus reduces symptoms
associated with excessive stimulation of the sympathetic nervous system (e.g., anxiety, restlessness,
insomnia). Blood pressure must be closely monitored during clonidine therapy.
8. 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? answer: Angiotensin II receptor blockers
Explanation answer:Losartan is an angiotensin II receptor blocker (ARB) and is recommended for
clients with diabetic renal disease because ARBs have been shown to reduce the rate of end-stage
renal disease. Antihyperlipidemic drugs help to reduce cholesterol. Calcium channel blockers relax and
widen blood vessels by attecting the muscle cells in the arterial walls, these are recommended with
caution in pregnant women. Selective aldosterone blockers do not show reduction of end-stage renal
, disease but are ettective in treating severe CHF.
9. A client is receiving a diuretic as the first-line treatment of mild
hypertension. The nurse monitors the client for signs and symptoms
of hypokalemia with which agent? answer: Hydrochlorothiazide
