Nokea
A client with hypertension is to receive a calcium channel blocker. The nurse understands that this class of drug leads to which of the following? Select all that apply.
- A. Relaxation of blood vessels
- B. Increased oxygen supply to the heart
- C. Reduced workload on the heart
- D. Decreased blood pressure
- E. Increased workload on the kidneys
Correct Answer: A,B,C,D
Rationale: The use of calcium channel blockers results in relaxation of blood vessels, increased oxygen supply to the heart, reduced workload on the heart, and decreased blood pressure.
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The use of angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin II receptor blockers (ARBs) are contraindicated in clients with which of the following medical conditions? Select all that apply.
- A. Bilateral stenosis
- B. Angioedema
- C. Pregnancy
- D. Diabetes
- E. Hyperlipidemia
Correct Answer: A,B,C
Rationale: The use of ACEIs and ARBs is contraindicated if the client has impaired renal function, heart failure, salt or volume depletion, bilateral stenosis, angioedema, or as pregnant.
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.
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 is prescribed clonidine as a transdermal patch. After instructing the client about this drug, the nurse determines that the teaching was successful when the client states that the patch should remain in place for how long?
- A. 24 hours
- B. 3 days
- C. 7 days
- D. 2 weeks
Correct Answer: C
Rationale: The nurse should ensure that the transdermal patch is intact for a period of 1 week. A clonidine transdermal patch should be applied to a hairless area over the torso for 1 week. If the patch loosens before 7 days, it has to be reinforced. The nurse has to mark the date of placement and the date of removal of the patch on the surface of the patch.
A nurse is reviewing the medical records of several clients who have come to the clinic for a visit. The nurse determines that a client with which blood pressure readings would be identified as prehypertensive?
- A. 112 / 72 mm Hg
- B. 128 / 86 mm Hg
- C. 144 / 92 mm Hg
- D. 164 / 102 mm Hg
Correct Answer: B
Rationale: Prehypertension is classified as a systolic blood pressure ranging between 120 and 139 mm Hg or a diastolic pressure ranging between 80 and 89 mm Hg. A systolic pressure below 120 mm Hg and a diastolic pressure below 80 mm Hg is considered normal. Stage 1 hypertension would be characterized by a systolic pressure between 140 and 159 mm Hg or a diastolic pressure between 90 and 99 mm Hg. Stage 2 hypertension would be characterized by a systolic pressure of 160 mm Hg or greater or a diastolic pressure of 100 mm Hg or greater.