Nokea
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.
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A patient with severe liver disease is receiving the angiotensin-converting enzyme (ACE) inhibitor, captopril. The nurse is aware that the advantage of this drug for this patient is which characteristic?
- A. Captopril rarely causes first-dose hypotensive effects.
- B. Captopril has little effect on electrolyte levels.
- C. Captopril is a prodrug and is metabolized by the liver before becoming active.
- D. Captopril does not need to be metabolized by the liver before becoming active because it is not a prodrug.
Correct Answer: D
Rationale: A prodrug relies on a functioning liver to be converted to its active form. Captopril is not a prodrug, and therefore it would be safer for the patient with liver dysfunction.
When teaching a patient about antihypertensive drug therapy, which statements by the nurse are correct?
- A. You need to have your blood pressure checked once a week and keep track of the readings.
- B. If you notice that the symptoms have gone away, you should be able to stop taking the drug.
- C. An exercise program may be helpful in treating hypertension, but let's check with your doctor first.
- D. If you experience severe side effects, stop the medicine and let us know at your next office visit.
- E. Most over-the-counter decongestants are compatible with antihypertensive drugs.
- F. Please continue taking the medication, even if you are feeling better.
Correct Answer: A,C,F
Rationale: Keeping a record of weekly blood pressure checks helps to monitor the effectiveness of the therapy. An exercise program may be beneficial but should be confirmed with the prescriber. Therapy is often lifelong, and patients should continue taking the medication even if feeling better to prevent rebound hypertension. Abruptly stopping medication or assuming over-the-counter decongestants are safe can lead to serious complications.
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.
The nurse is reviewing drug therapy for hypertension. According to the JNC-8 guidelines, antihypertensive drug therapy for a newly diagnosed hypertensive black patient would most likely include which drug or drug classes?
- A. Vasodilators alone
- B. ACE inhibitors alone
- C. Calcium channel blockers with thiazide diuretics
- D. Beta blockers with thiazide diuretics
Correct Answer: C
Rationale: According to the JNC-8 guidelines, calcium channel blockers and thiazide diuretics are recommended as first-line therapy for management of hypertension in black patients. The other drugs are not recommended as first-line drugs for this group.
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.