NRS 301 EXAM 6 (EAQ) QUESTIONS
WITH ACCURATE SOLUTIONS AND
RATED A.
Which statement indicates to the nurse that the patient needs additional
instruction about antihypertensive treatment?
1
"I will change my position slowly to prevent feeling dizzy."
2
"I will not mow my lawn until I see how this medication makes me feel."
3
"I will check my blood pressure daily and take my medication when it is
over 140/90."
4
"I will include rest periods during the day to help me tolerate the fatigue
my medicine may cause."
3
Antihypertensive medications need to be taken routinely to maintain a
normotensive state and prevent occurrence of complications. Many patients do
not adhere to this regimen because hypertension itself does not cause
symptoms, whereas the medication can cause some untoward effects. Patient
teaching is essential. If the patient indicates that he will take rest periods and
change positions slowly to avoid orthostatic hypotension, he is demonstrating
adherence to the treatment regimen.
Which assessment findings indicate the patient is experiencing adverse
effects from furosemide? Select all that apply.
1
Oliguria
2
Dry mouth
,3
Clear lungs
4
Unusual thirst
5
Clear yellow urine
1, 2, 4
Furosemide can produce dehydration. Signs of evolving dehydration include
dry mouth, unusual thirst, and oliguria (urine output less than 25 mL/hr).
Therapeutic effects of furosemide include clear lungs and an increased amount
of clear yellow urine.
A patient with a hypertensive emergency is admitted to the hospital.
Which medication should the nurse be prepared to administer to this
patient?
1
Minoxidil
2
Hydralazine
3
Sodium nitroprusside
4
Hydralazine and isosorbide dinitrate
3
Intravenous sodium nitroprusside has an immediate effect and is the drug of
choice for hypertensive emergencies. Minoxidil is used when all other
antihypertensives have failed to lower the patient's blood pressure.
Hydralazine is used for essential hypertension.
Which behavior by a patient indicates more teaching is needed about
taking diltiazem?
1
Takes with tea
2
,Takes with lemonade
3
Takes with apple juice
4
Takes with grapefruit juice
4
If the patient consumes grapefruit juice, it can raise the levels of diltiazem and
verapamil. The other drinks (tea, apple juice, lemonade) can be used by the
patient when taking diltiazem because they have no significant interaction.
A patient is taking verapamil. Which instruction should the nurse give the
patient to help prevent a common adverse effect of this drug?
1
"Use sunscreen."
2
"Increase calorie intake."
3
"Use a skin barrier cream."
4
"Increase fluid and fiber intake."
4
Constipation may occur with verapamil. Advise patients that constipation can
be minimized by increasing dietary fluid and fiber. Verapamil does not cause
photosensitivity, so sunscreen is not needed. Verapamil does not cause weight
loss, so an increase in calories is not needed. Verapamil does not cause
diarrhea, so a skin barrier cream is not needed.
The nurse is reviewing a medication history on a patient taking an
angiotensin-converting enzyme (ACE) inhibitor. The nurse will contact the
health care provider if the patient is also taking which medication?
1
Furosemide
2
Spironolactone
, 3
Morphine sulfate
4
Docusate sodium
2
ACE inhibitors block the conversion of angiotensin I to angiotensin II, thus also
blocking the stimulus for aldosterone production. Aldosterone is responsible for
potassium excretion—decreased aldosterone can result in increased serum
potassium levels. Spironolactone is a potassium-sparing diuretic and should not
be administered with an ACE inhibitor. The other medications do not cause
side effects with this medication.
In the failing heart, arterial pressure falls, stimulating the baroreceptor
reflex to increase sympathetic nervous system activity. The nurse
understands increased sympathetic activity will produce which response?
1
Bradypnea
2
Tachycardia
3
Hypotension
4
Hypoglycemia
2
Increased sympathetic activity results in an increased heart rate (tachycardia),
increased contractility, increased venous tone, and increased arteriolar tone
(elevated blood pressure). Sympathetic stimulation also causes bronchodilation
(not bradypnea) and possibly hyperglycemia.
A nurse is reviewing the medication record of a patient with chronic
kidney disease who developed hypertension. Which drugs will the nurse
anticipate administering initially? Select all that apply.
1
Beta blocker
WITH ACCURATE SOLUTIONS AND
RATED A.
Which statement indicates to the nurse that the patient needs additional
instruction about antihypertensive treatment?
1
"I will change my position slowly to prevent feeling dizzy."
2
"I will not mow my lawn until I see how this medication makes me feel."
3
"I will check my blood pressure daily and take my medication when it is
over 140/90."
4
"I will include rest periods during the day to help me tolerate the fatigue
my medicine may cause."
3
Antihypertensive medications need to be taken routinely to maintain a
normotensive state and prevent occurrence of complications. Many patients do
not adhere to this regimen because hypertension itself does not cause
symptoms, whereas the medication can cause some untoward effects. Patient
teaching is essential. If the patient indicates that he will take rest periods and
change positions slowly to avoid orthostatic hypotension, he is demonstrating
adherence to the treatment regimen.
Which assessment findings indicate the patient is experiencing adverse
effects from furosemide? Select all that apply.
1
Oliguria
2
Dry mouth
,3
Clear lungs
4
Unusual thirst
5
Clear yellow urine
1, 2, 4
Furosemide can produce dehydration. Signs of evolving dehydration include
dry mouth, unusual thirst, and oliguria (urine output less than 25 mL/hr).
Therapeutic effects of furosemide include clear lungs and an increased amount
of clear yellow urine.
A patient with a hypertensive emergency is admitted to the hospital.
Which medication should the nurse be prepared to administer to this
patient?
1
Minoxidil
2
Hydralazine
3
Sodium nitroprusside
4
Hydralazine and isosorbide dinitrate
3
Intravenous sodium nitroprusside has an immediate effect and is the drug of
choice for hypertensive emergencies. Minoxidil is used when all other
antihypertensives have failed to lower the patient's blood pressure.
Hydralazine is used for essential hypertension.
Which behavior by a patient indicates more teaching is needed about
taking diltiazem?
1
Takes with tea
2
,Takes with lemonade
3
Takes with apple juice
4
Takes with grapefruit juice
4
If the patient consumes grapefruit juice, it can raise the levels of diltiazem and
verapamil. The other drinks (tea, apple juice, lemonade) can be used by the
patient when taking diltiazem because they have no significant interaction.
A patient is taking verapamil. Which instruction should the nurse give the
patient to help prevent a common adverse effect of this drug?
1
"Use sunscreen."
2
"Increase calorie intake."
3
"Use a skin barrier cream."
4
"Increase fluid and fiber intake."
4
Constipation may occur with verapamil. Advise patients that constipation can
be minimized by increasing dietary fluid and fiber. Verapamil does not cause
photosensitivity, so sunscreen is not needed. Verapamil does not cause weight
loss, so an increase in calories is not needed. Verapamil does not cause
diarrhea, so a skin barrier cream is not needed.
The nurse is reviewing a medication history on a patient taking an
angiotensin-converting enzyme (ACE) inhibitor. The nurse will contact the
health care provider if the patient is also taking which medication?
1
Furosemide
2
Spironolactone
, 3
Morphine sulfate
4
Docusate sodium
2
ACE inhibitors block the conversion of angiotensin I to angiotensin II, thus also
blocking the stimulus for aldosterone production. Aldosterone is responsible for
potassium excretion—decreased aldosterone can result in increased serum
potassium levels. Spironolactone is a potassium-sparing diuretic and should not
be administered with an ACE inhibitor. The other medications do not cause
side effects with this medication.
In the failing heart, arterial pressure falls, stimulating the baroreceptor
reflex to increase sympathetic nervous system activity. The nurse
understands increased sympathetic activity will produce which response?
1
Bradypnea
2
Tachycardia
3
Hypotension
4
Hypoglycemia
2
Increased sympathetic activity results in an increased heart rate (tachycardia),
increased contractility, increased venous tone, and increased arteriolar tone
(elevated blood pressure). Sympathetic stimulation also causes bronchodilation
(not bradypnea) and possibly hyperglycemia.
A nurse is reviewing the medication record of a patient with chronic
kidney disease who developed hypertension. Which drugs will the nurse
anticipate administering initially? Select all that apply.
1
Beta blocker
