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A patient's blood pressure elevates to 270/150 mm Hg, and a hypertensive emergency is obvious. He is transferred to the intensive care unit and started on a sodium nitroprusside drip to be titrated per his response. With this medication, the nurse knows that the maximum dose of this drug should be infused for how long?
- A. 10 minutes
- B. 30 minutes
- C. 1 hour
- D. 24 hours
Correct Answer: A
Rationale: Sodium nitroprusside is a potent vasodilator and may lead to extreme decreases in the patient's blood pressure. For this reason, it is never infused at the maximum dose for more than 10 minutes. If this drug does not control a patient's blood pressure after 10 minutes, it will most likely be ordered to be discontinued. The other times listed are incorrect.
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The nurse is preparing for a community education program on hypertension. Which of these parameters determine the regulation of arterial blood pressure?
- A. Cardiac output and systemic vascular resistance
- B. Heart rate and peripheral resistance
- C. Blood volume and renal blood flow
- D. Myocardial contractility and arteriolar constriction
Correct Answer: A
Rationale: Blood pressure is determined by the product of cardiac output and systemic vascular resistance. The other options are incorrect.
The nurse is creating a plan of care for a patient with a new diagnosis of hypertension. Which is a potential human needs statement for the patient taking antihypertensive medications?
- A. Altered GI elimination (diarrhea)
- B. Altered sexual function
- C. Altered urinary elimination (urge incontinence)
- D. Need for effective perception
Correct Answer: B
Rationale: Altered sexual function is a potential human needs statement related to possible adverse effects of antihypertensive drug therapy. The other human needs statements are not appropriate.
A patient with type 2 diabetes mellitus has been found to have trace proteinuria. The prescriber writes an order for an angiotensin-converting enzyme (ACE) inhibitor. What is the main reason for prescribing this class of drug for this patient?
- A. Cardioprotective effects
- B. Renal protective effects
- C. Reduces blood pressure
- D. Promotes fluid output
Correct Answer: B
Rationale: ACE inhibitors have been shown to have a protective effect on the kidneys because they reduce glomerular filtration pressure. This is one reason that they are among the cardiovascular drugs of choice for diabetic patients. The other drugs do not have this effect.
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.
When counseling a male patient about the possible adverse effects of antihypertensive drugs, the nurse will discuss which potential problem?
- A. Impotence
- B. Bradycardia
- C. Increased libido
- D. Weight gain
Correct Answer: A
Rationale: Sexual dysfunction is a common complication of antihypertensive medications and may be manifested in men as decreased libido or impotence. The other options are incorrect.