Question 1
1 out of 1 points
A clinic nurse has been assigned a 49-year-old female patient who has a
history of diabetes. A recent diagnosis of hypertension has been made,
and the patient has been prescribed a thiazide diuretic and labetalol. The
patient will be scheduled to return to the clinic once a month for the next
6 months. A priority action by the nurse will be to
Response Monitoring of blood pressure would be the priority assessment
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in the care of this patient. Questioning the patient about her
dietary intake and weighing her would be appropriate, but
secondary in importance. It is unnecessary to monitor the
patient's respiratory rate.
Question 2
1 out of 1 points
A 55-year-old man's hypertension has not responded adequately to his
current medication regimen consisting or an ACE inhibitor, a beta-blocker
and a thiazide diuretic. As a result, he will soon begin taking hydralazine
(Apresoline) in addition to his existing antihypertensives. The addition of
this medication to his regimen means that the nurse must prioritize which
of the following nursing actions?
Response Hydralazine is associated with an increase in cardiac output that
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can precipitate palpitations, tachycardia, and angina. As a
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, result, there is a need for astute cardiac assessment. The use of
hydralazine does not directly necessitate close monitoring of
electrolytes or blood sugars, even though these are prudent
assessment measures. There is a risk of dizziness and possibly
falls with the use of any antihypertensive, but it is unnecessary
to supervise all of the patient's ADLs.
Question 3
1 out of 1 points
A 39-year-old African-American male is 25 pounds overweight and has
been diagnosed with hypertension after three consecutive above-normal
blood pressure readings. The most likely initial drug therapy for this
patient will be
Response The patient would most likely be prescribed a diuretic in
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combination with diet and other lifestyle changes. African-
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American men are at increased risk for developing hypertension
and tend to respond differently to antihypertensive therapy. The
research shows that African-American men are most responsive
to single-drug therapy and diuretics. The use of a calcium
channel blocker and/or alpha-adrenergic blocker would follow if
he is unresponsive to the diuretic in combination with diet and
other lifestyle changes. African Americans tend to be less
responsive to ACE inhibitors and beta blockers.
Question 4
1 out of 1 points
, A patient is brought to the emergency department in hypertensive crisis.
Nitroprusside is administered intravenously. The patient experiences
diaphoresis and dizziness. Which of the following is the appropriate action
by the nurse?
Response Administering nitroprusside too quickly can result in abdominal
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pain, apprehension, diaphoresis, dizziness, headache, muscle
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twitching, nausea, palpitations, restlessness, retching, and
retrosternal discomfort. The nurse should quickly inform the
prescriber and slow the infusion. Symptoms quickly subside
when the nitroprusside infusion is slowed or stopped, and
usually do not return when the infusion resumes at a slower
rate. Consulting the prescriber for a dose change would not
help; the rate of drug administration is the issue. Continuing to
give the nitroprusside at the ordered rate could be fatal.
Question 5
1 out of 1 points
Several months of treatment with a statin accompanied by lifestyle
modifications have failed to appreciably improve a patient's cholesterol
levels. Consequently, the patient has been prescribed cholestyramine. The
nurse should recognize that this drugs achieves its therapeutic effect by
Response Unlike statins, which work by decreasing the synthesis of
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cholesterol, the bile acid sequestrants such as cholestyramine
promote the oxidation of cholesterol to bile acids. Bile acid
sequestrants do not promote vasodilation or bind HDL to LDL.