Nokea
A client with hypertension has a fungal infection and has been prescribed fluconazole for the fungal infection and losartan for hypertension. The nurse would be alert for which of the following?
- A. Increased risk of adverse effects of losartan
- B. Increased risk of hypersensitivity reaction
- C. Decreased hypotensive effect of losartan
- D. Increased risk of hypoglycemia
Correct Answer: A
Rationale: Increased risk of antihypertensive effects and adverse reactions are associated with the concomitant use of fluconazole and losartan. Decreased hypotensive effect of losartan is seen with use of indomethacin and does not occur with the concomitant use of these drugs. Increased risk of hypoglycemia and increased risk of hypersensitivity do not occur with the concomitant use of these drugs.
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During a routine check-up of a 45 -year-old client with renal disease, the nurse observes an increase in the client's blood pressure. The nurse identifies this as most likely which of the following?
- A. Essential hypertension
- B. Secondary hypertension
- C. Rebound hypertension
- D. Hypertensive emergency
Correct Answer: B
Rationale: Secondary hypertension results as a consequence of renal impairment. In secondary hypertension there is usually a known cause for the development of hypertension. Renal disease is one of the causes of secondary hypertension. When there is no known cause of hypertension, it is called essential hypertension. Rebound hypertension occurs when a client abruptly stops taking antihypertensive medication. Hypertensive emergency is a high blood pressure state, which has to be lowered immediately.
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.
While reviewing a client's lab work, the nurse notices the client's potassium is elevated. The nurse checks the client's medication record. Which of the following, if found, would the nurse identify as contributing to the client's elevated potassium level? Select all that apply.
- A. Atenolol
- B. Aliskiren
- C. Clonidine
- D. Metoprolol
- E. Eplerenone
Correct Answer: B,E
Rationale: Direct renin inhibitors such as aliskiren and the drug eplerenone can cause hyperkalemia. Atenolol and metoprolol are beta blockers. Clonidine is a centrally acting adrenergic drug.
When teaching a client newly diagnosed with hypertension, which instructions would the nurse incorporate into the teaching plan? Select all that apply.
- A. Lose weight.
- B. Stop smoking.
- C. Reduce stress.
- D. Decrease exercise.
- E. Increase sodium intake.
Correct Answer: A,B,C
Rationale: Nonpharmacologic management of hypertension should include weight loss, stress reduction, regular aerobic exercise, smoking cessation, moderation of alcohol, and decreased sodium intake.
When developing a presentation for a local community group on hypertension, the nurse integrates information about the importance of blood pressure control. Which of the following would the nurse include? Select all that apply.
- A. Hypertension increases the buildup of atherosclerotic plaque.
- B. Hypertension increases risk of stroke.
- C. Hypertension increases risk of colorectal carcinoma.
- D. Hypertension increases risk of liver disease.
- E. Hypertension increases the workload of the heart.
Correct Answer: A,B,E
Rationale: Hypertension is serious, because it causes the heart to work too hard and contributes to atherosclerosis. It also increases the risk of heart disease, heart failure (HF), kidney disease, blindness, and stroke. Hypertension is not associated with colorectal carcinoma or liver disease.