Nokea
A client is prescribed an antihypertensive drug. Which of the following would the nurse include in the teaching plan to promote the best outcome for the client? Select all that apply.
- A. Never discontinue use of the antihypertensive drug except on the advice of the physician.
- B. Avoid the use of nonprescription drugs unless approved by the physician.
- C. Avoid alcohol unless its use has been approved by the physician
- D. Know that unexplained weakness or fatigue is a normal adverse reaction.
- E. Notify the physician if the diastolic pressure suddenly increases to 130 \mathrm{~mm} \mathrm{Hg} or higher.
Correct Answer: A,B,C,E
Rationale: The client should be told to never discontinue the drug unless advised to do so, avoid nonprescription drugs unless approved, avoid alcohol unless it's approved, and notify the physician if the diastolic pressure suddenly increases to 130 \mathrm{~mm} \mathrm{Hg} or higher. The client also should contact the physician if unexplained weakness or fatigue occurs.
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After teaching a group of nursing students about antihypertensive drugs, the instructor determines a need for additional teaching when the students identify which of the following as an angiotensin-converting enzyme inhibitor?
- A. Pindolol
- B. Benazepril
- C. Quinapril
- D. Enalapril
Correct Answer: A
Rationale: Pindolol is a beta-adrenergic blocker. Benazepril, quinapril, and enalapril are ACEIs.
A client is receiving a diuretic for the treatment of hypertension. Which of the following conditions should the nurse monitor for in clients taking diuretics?
- A. Hyperkalemia
- B. Hyponatremia
- C. Hypomagnesemia
- D. Hypocalcemia
Correct Answer: B
Rationale: The nurse should assess for hyponatremia in clients receiving diuretics. Diuretic usage causes electrolyte disturbances such as hyponatremia and hypokalemia. The nurse should inform the primary health care provider if signs and symptoms of electrolyte imbalance occur. Hyperkalemia, hypomagnesemia, and hypocalcemia do not occur in clients taking diuretics.
A client is prescribed atenolol. After administering the drug, the nurse would be alert for which of the following? Select all that apply.
- A. Cough
- B. Hyperkalemia
- C. Bradycardia
- D. Dizziness
- E. Constipation
Correct Answer: C,D
Rationale: Common adverse reactions seen with atenolol, a beta-adrenergic blocker, include bradycardia, dizziness, fatigue, weakness, hypotension, nausea, vomiting, diarrhea, and nervousness. Cough is associated with ACE inhibitors. Hyperkalemia is associated with eplerenone and aliskiren. Constipation is not a common adverse reaction with atenolol.
A client, aged 60 years, is receiving nitroprusside for hypertensive emergency. The nurse would be alert for the development of which of the following?
- A. Significant hypotension
- B. Rebound hypertension
- C. Blindness
- D. Stroke
Correct Answer: A
Rationale: An older adult client is at risk for significant hypotension when receiving nitroprusside. To prevent this, the dosage should be reduced during the initial period of therapy. Rebound hypertension, stroke, and blindness will not occur during nitroprusside therapy.
A client has a nursing diagnosis of Activity Intolerance related to fatigue and weakness. Which of the following would be appropriate for the nurse to include in the client's plan of care?
- A. Encouraging ambulation as tolerated
- B. Maintaining bed rest as much as possible
- C. Mandating the use of assistive devices
- D. Encouraging activities early in the morning when fatigue is less
- E. Promoting rest periods throughout the day as necessary
Correct Answer: A,E
Rationale: The client is encouraged to walk and ambulate as he or she can tolerate. Assistive devices may be used if needed, but these should not be mandated for use. The client can gradually increase tolerance by increasing the daily amount of activity. Planning rest periods according to the individual's tolerance is appropriate. Rest can take many forms, such as sitting in a chair, napping, watching television, or sitting with legs elevated.