Chapter 36: Hypertension
Linton: Medical-Surgical Nursing, 7th Edition
MULTIPLE CHOICE
1. An 87-year-old patient is taking furosemide (Lasix) for elevated blood pressure: What
should the nurse know that older patients are at risk for?
a. Falls
b. Hypokalemia
c. Reflex tachycardia
d. Neutropenia
ANS: B
Older adults are at greater risk for side effects, especially hypokalemia:
DIF: Cognitive Level: Comprehension REF: p: 684 OBJ: 4
TOP: Drug Therapy in Hypertension KEY: Nursing Process Step:
Implementation
MSC: NCLEX: Physiological Integrity: Pharmacological Therapies
2. A nurse is providing patient education regarding a low-sodium diet: In addition to the use
of spices, what should the nurse recommend to help decrease sodium in the diet?
a. Catsup
b. Garlic
c. Soy sauce
d. Cheese
ANS: B
Spices, garlic, and onions are good substitutes for sodium as flavorings: Catsup, soy
sauce, and cheese all have large amounts of sodium:
DIF: Cognitive Level: Comprehension REF: p: 688 OBJ: 4
TOP: Sodium-Free Seasoning KEY: Nursing Process Step:
Implementation
MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early
Detection of Disease
3. Which lifestyle change has the greatest effect on reducing hypertension?
a. Sodium restriction
b. Reduction in alcohol consumption
c. Daily aerobic exercise
d. Weight reduction
ANS: D
, Weight reduction has the greatest effect on reducing hypertension:
DIF: Cognitive Level: Comprehension REF: p: 681 OBJ: 3
TOP: Blood Pressure Screening KEY: Nursing Process Step:
Implementation
MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early
Detection of Disease
4. A nurse is educating a group of patients regarding Dietary Approaches to Stop
Hypertension (DASH) diet: What recommendation should the nurse include as a source
of protein and fat?
a. Lean red meat
b. Whole grains
c. Low fiber
d. Sugar
ANS: B
The DASH diet uses whole grains as a source of protein and fat:
DIF: Cognitive Level: Comprehension REF: p: 687 OBJ: 6
TOP: DASH Diet KEY: Nursing Process Step: Implementation
MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early
Detection of Disease
5. Which antihypertensive medication is contraindicated in patients who have chronic
obstructive pulmonary disease (COPD) and asthma?
a. Propranolol (Inderal): beta-adrenergic receptor blocker
b. Hydrochlorothiazide (HydroDIURIL): diuretic
c. Diltiazem (Cardizem): calcium antagonist
d. Captopril (Capoten): ACE inhibitor
ANS: A
Beta-blocking adrenergic agents block stimulation of catecholamine receptors and
cause bronchoconstriction:
DIF: Cognitive Level: Comprehension REF: p: 683 OBJ: 4
TOP: Drug Therapy in Hypertension KEY: Nursing Process Step:
Implementation
MSC: NCLEX: Physiological Integrity: Pharmacological Therapies
6. A nurse is caring for a patient who is taking antihypertensive therapy: the patient reports
fatigue and has a pulse of 54 beats/min: Which medication administered is most likely the
cause of these symptoms?
a. Diltiazem (Cardizem)
b. Furosemide (Lasix)
c. Hydrochlorothiazide (HydroDIURIL)
d. Methyldopa (Aldomet)
, ANS: A
Calcium channel blockers such as diltiazem and verapamil can cause bradycardia
because conduction is slowed in the heart: These drugs also reduce stroke volume and
cardiac output, which may result in fatigue:
DIF: Cognitive Level: Application REF: p: 683 OBJ: 4
TOP: Drug Therapy for Hypertension KEY: Nursing Process Step:
Implementation
MSC: NCLEX: Physiological Integrity: Pharmacological Therapies
7. What should a nurse include when developing a teaching plan for a patient with
hypertension?
a. Stop medications if side effects occur:
b. Maintain a diet high in unsaturated fat:
c. Advise no further visits if no other symptoms occur:
d. Encourage relaxation techniques:
ANS: D
Patients with hypertension should never stop medications without discussing it with
their physicians: A diet low in saturated and unsaturated fat should be followed: Visits
to monitor blood pressure should continue because hypertension is often
asymptomatic: Stress can aggravate hypertension; stress management or relaxation
strategies should be implemented:
DIF: Cognitive Level: Application REF: p: 680 OBJ: 7
TOP: Care Plan for Hypertension KEY: Nursing Process Step:
Implementation
MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early
Detection of Disease
8. A patient inquires if his blood pressure is normal: What is the nurse’s most accurate
response regarding the definition of normal blood pressure?
a. Less than 144/90 mm Hg
b. Less than 138/86 mm Hg
c. Less than126/82 mm Hg
d. Less than 120/80 mm Hg
ANS: D
Normal blood pressure is defined as a systolic pressure of less than 120 mm Hg and a
diastolic blood pressure of less than 80 mm Hg:
DIF: Cognitive Level: Knowledge REF: p: 677 OBJ: 1
TOP: Normal Blood Pressure KEY: chapter_50
MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early
Detection of Disease
, 9. An obese African-American man reports that he smokes: How should the nurse stage this
patient’s hypertension?
a. Grade A
b. Grade B
c. Grade C
d. Grade D
ANS: B
Criteria for grade B are that the patient has more than one risk factor (African
American, obese, smoker), with no target organ damage and no clinical
cardiovascular problems: Criteria for grade A indicate that no risks have been
assessed, and the criteria for grade C include target organ damage and clinical
cardiovascular disease or diabetes mellitus:
DIF: Cognitive Level: Application REF: p: 677 OBJ: 3
TOP: Staging of Hypertension KEY: Nursing Process Step: Assessment
MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early
Detection of Disease
10. A patient reports drowsiness after initiating atenolol (Tenormin) for the treatment of
hypertension: What is the nurse’s best response when educating this patient about
atenolol (Tenormin)?
a. Take the medication at bedtime:
b. Reduce the dose of the medication until the desired effect occurs:
c. Avoid activities that require alertness:
d. Talk to the physician because drowsiness is not an anticipated side effect:
ANS: A
Sedation is an expected side effect of atenolol: This medication can be taken daily at
bedtime: Doses should not be changed without talking to the physician: Activities
requiring that the patient be alert should be postponed until later in the day:
DIF: Cognitive Level: Application REF: p: 683 OBJ: 4
TOP: Drug Therapy and Hypertension KEY: Nursing Process Step:
Implementation
MSC: NCLEX: Physiological Integrity: Pharmacological Therapies
11. A patient taking methyldopa (Aldomet) for hypertension reports to the emergency
department with a severe headache, blurred vision, and a blood pressure reading of
200/94 mm Hg: What should the nurse suspect is happening to this patient?
a. Hyperglycemia
b. Inadequate coping with sedation
c. Abrupt cessation of medication
d. Sexual dysfunction
ANS: C
Linton: Medical-Surgical Nursing, 7th Edition
MULTIPLE CHOICE
1. An 87-year-old patient is taking furosemide (Lasix) for elevated blood pressure: What
should the nurse know that older patients are at risk for?
a. Falls
b. Hypokalemia
c. Reflex tachycardia
d. Neutropenia
ANS: B
Older adults are at greater risk for side effects, especially hypokalemia:
DIF: Cognitive Level: Comprehension REF: p: 684 OBJ: 4
TOP: Drug Therapy in Hypertension KEY: Nursing Process Step:
Implementation
MSC: NCLEX: Physiological Integrity: Pharmacological Therapies
2. A nurse is providing patient education regarding a low-sodium diet: In addition to the use
of spices, what should the nurse recommend to help decrease sodium in the diet?
a. Catsup
b. Garlic
c. Soy sauce
d. Cheese
ANS: B
Spices, garlic, and onions are good substitutes for sodium as flavorings: Catsup, soy
sauce, and cheese all have large amounts of sodium:
DIF: Cognitive Level: Comprehension REF: p: 688 OBJ: 4
TOP: Sodium-Free Seasoning KEY: Nursing Process Step:
Implementation
MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early
Detection of Disease
3. Which lifestyle change has the greatest effect on reducing hypertension?
a. Sodium restriction
b. Reduction in alcohol consumption
c. Daily aerobic exercise
d. Weight reduction
ANS: D
, Weight reduction has the greatest effect on reducing hypertension:
DIF: Cognitive Level: Comprehension REF: p: 681 OBJ: 3
TOP: Blood Pressure Screening KEY: Nursing Process Step:
Implementation
MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early
Detection of Disease
4. A nurse is educating a group of patients regarding Dietary Approaches to Stop
Hypertension (DASH) diet: What recommendation should the nurse include as a source
of protein and fat?
a. Lean red meat
b. Whole grains
c. Low fiber
d. Sugar
ANS: B
The DASH diet uses whole grains as a source of protein and fat:
DIF: Cognitive Level: Comprehension REF: p: 687 OBJ: 6
TOP: DASH Diet KEY: Nursing Process Step: Implementation
MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early
Detection of Disease
5. Which antihypertensive medication is contraindicated in patients who have chronic
obstructive pulmonary disease (COPD) and asthma?
a. Propranolol (Inderal): beta-adrenergic receptor blocker
b. Hydrochlorothiazide (HydroDIURIL): diuretic
c. Diltiazem (Cardizem): calcium antagonist
d. Captopril (Capoten): ACE inhibitor
ANS: A
Beta-blocking adrenergic agents block stimulation of catecholamine receptors and
cause bronchoconstriction:
DIF: Cognitive Level: Comprehension REF: p: 683 OBJ: 4
TOP: Drug Therapy in Hypertension KEY: Nursing Process Step:
Implementation
MSC: NCLEX: Physiological Integrity: Pharmacological Therapies
6. A nurse is caring for a patient who is taking antihypertensive therapy: the patient reports
fatigue and has a pulse of 54 beats/min: Which medication administered is most likely the
cause of these symptoms?
a. Diltiazem (Cardizem)
b. Furosemide (Lasix)
c. Hydrochlorothiazide (HydroDIURIL)
d. Methyldopa (Aldomet)
, ANS: A
Calcium channel blockers such as diltiazem and verapamil can cause bradycardia
because conduction is slowed in the heart: These drugs also reduce stroke volume and
cardiac output, which may result in fatigue:
DIF: Cognitive Level: Application REF: p: 683 OBJ: 4
TOP: Drug Therapy for Hypertension KEY: Nursing Process Step:
Implementation
MSC: NCLEX: Physiological Integrity: Pharmacological Therapies
7. What should a nurse include when developing a teaching plan for a patient with
hypertension?
a. Stop medications if side effects occur:
b. Maintain a diet high in unsaturated fat:
c. Advise no further visits if no other symptoms occur:
d. Encourage relaxation techniques:
ANS: D
Patients with hypertension should never stop medications without discussing it with
their physicians: A diet low in saturated and unsaturated fat should be followed: Visits
to monitor blood pressure should continue because hypertension is often
asymptomatic: Stress can aggravate hypertension; stress management or relaxation
strategies should be implemented:
DIF: Cognitive Level: Application REF: p: 680 OBJ: 7
TOP: Care Plan for Hypertension KEY: Nursing Process Step:
Implementation
MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early
Detection of Disease
8. A patient inquires if his blood pressure is normal: What is the nurse’s most accurate
response regarding the definition of normal blood pressure?
a. Less than 144/90 mm Hg
b. Less than 138/86 mm Hg
c. Less than126/82 mm Hg
d. Less than 120/80 mm Hg
ANS: D
Normal blood pressure is defined as a systolic pressure of less than 120 mm Hg and a
diastolic blood pressure of less than 80 mm Hg:
DIF: Cognitive Level: Knowledge REF: p: 677 OBJ: 1
TOP: Normal Blood Pressure KEY: chapter_50
MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early
Detection of Disease
, 9. An obese African-American man reports that he smokes: How should the nurse stage this
patient’s hypertension?
a. Grade A
b. Grade B
c. Grade C
d. Grade D
ANS: B
Criteria for grade B are that the patient has more than one risk factor (African
American, obese, smoker), with no target organ damage and no clinical
cardiovascular problems: Criteria for grade A indicate that no risks have been
assessed, and the criteria for grade C include target organ damage and clinical
cardiovascular disease or diabetes mellitus:
DIF: Cognitive Level: Application REF: p: 677 OBJ: 3
TOP: Staging of Hypertension KEY: Nursing Process Step: Assessment
MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early
Detection of Disease
10. A patient reports drowsiness after initiating atenolol (Tenormin) for the treatment of
hypertension: What is the nurse’s best response when educating this patient about
atenolol (Tenormin)?
a. Take the medication at bedtime:
b. Reduce the dose of the medication until the desired effect occurs:
c. Avoid activities that require alertness:
d. Talk to the physician because drowsiness is not an anticipated side effect:
ANS: A
Sedation is an expected side effect of atenolol: This medication can be taken daily at
bedtime: Doses should not be changed without talking to the physician: Activities
requiring that the patient be alert should be postponed until later in the day:
DIF: Cognitive Level: Application REF: p: 683 OBJ: 4
TOP: Drug Therapy and Hypertension KEY: Nursing Process Step:
Implementation
MSC: NCLEX: Physiological Integrity: Pharmacological Therapies
11. A patient taking methyldopa (Aldomet) for hypertension reports to the emergency
department with a severe headache, blurred vision, and a blood pressure reading of
200/94 mm Hg: What should the nurse suspect is happening to this patient?
a. Hyperglycemia
b. Inadequate coping with sedation
c. Abrupt cessation of medication
d. Sexual dysfunction
ANS: C
