Nokea
A patient with primary hypertension is prescribed drug therapy for the first time. The patient asks how long drug therapy will be needed. Which answer by the nurse is the correct response?
- A. This therapy will take about 3 months.
- B. This therapy will take about a year.
- C. This therapy will go on until your symptoms disappear.
- D. Therapy for high blood pressure is usually lifelong.
Correct Answer: D
Rationale: There is no cure for hypertension, and treatment will be lifelong. The other answers are not appropriate.
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The nurse is reviewing the orders for a patient and notes a new order for an angiotensin-converting enzyme (ACE) inhibitor. The nurse checks the current medication orders, knowing that this drug class may have a serious interaction with what other drug class?
- A. Calcium channel blockers
- B. Diuretics
- C. Nonsteroidal anti-inflammatory drugs
- D. Nitrates
Correct Answer: C
Rationale: Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen can reduce the antihypertensive effect of ACE inhibitors. In addition, the use of NSAIDs and ACE inhibitors may also predispose patients to the development of acute renal failure.
A patient who has been taking antihypertensive drugs for a few months states that a new, persistent dry cough is very bothersome. The nurse knows that this cough is an adverse effect of which class of antihypertensive drugs?
- A. Beta blockers
- B. Angiotensin-converting enzyme (ACE) inhibitors
- C. Angiotensin II receptor blockers (ARBs)
- D. Calcium channel blockers
Correct Answer: B
Rationale: ACE inhibitors cause a characteristic dry, nonproductive cough that reverses when therapy is stopped. The other drug classes do not cause this cough.
During a follow-up visit, the health care provider examines the fundus of the patient's eye. Afterward, the patient asks the nurse, -Why is he looking at my eyes when I have high blood pressure? It does not make sense to me! What is the best response by the nurse?
- A. We need to monitor for drug toxicity.
- B. We must watch for increased intraocular pressure.
- C. The provider is assessing for visual changes that may occur with drug therapy.
- D. The provider is making sure the treatment is effective over the long term.
Correct Answer: D
Rationale: The physician would examine the fundus of a patient's eyes during antihypertensive therapy because it is a more reliable indicator than blood pressure readings of the long-term effectiveness of treatment.
A patient who is now in heart failure after a recent myocardial infarction will be receiving a new prescription for eplerenone. The nurse is reviewing the patient's laboratory results and will report which of these as a potential contraindication?
- A. Serum sodium level 136 mEq/L
- B. Serum potassium 5.6 mEq/L
- C. Elevated white blood cell count
- D. Elevated cardiac troponin levels
Correct Answer: B
Rationale: Eplerenone is contraindicated in patients with elevated serum potassium levels (higher than 5.5 mEq/L). The other answers are incorrect.
A patient is to receive enalapril 5 mg IV every 6 hours. Each dose is given over 5 minutes. The medication is available in an injectable form, 1.25 mg/mL. Identify how many milliliters of medication will the nurse draw up for each dose.
Correct Answer: 4 mL
Rationale: 1.25 mg : 1 mL :: 5 mg : x mL; (1.25 * x) = (1 * 5); 1.25x = 5; x = 4 mL.