Nokea
The nurse should advise the client to do which of the following to reduce the risk of falls due to orthostatic hypotension from antihypertensive drugs? Select all that apply.
- A. Sit on the bed for 1 or 2 minutes when rising from a lying position.
- B. Rise quickly from a chair when moving to a standing position.
- C. Take the antihypertensive less frequently if hypotension occurs.
- D. Have someone assist the client if dizziness or weakness occurs.
- E. Increase salt intake to counteract the hypotension.
Correct Answer: A,D
Rationale: The nurse explains that when rising from a lying position, the client should sit on the edge of the bed for 1 or 2 minutes; the client should rise slowly from a chair and then stand for 1 to 2 minutes; and when symptoms of orthostatic hypotension occur, someone assisting the client in getting out of bed or a chair can decrease the risk of falls due to orthostatic hypotension.
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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.
After teaching a group of nursing students about antihypertensive drugs, the instructor determines a need for additional teaching when the students identify which of the following as an angiotensin-converting enzyme inhibitor?
- A. Pindolol
- B. Benazepril
- C. Quinapril
- D. Enalapril
Correct Answer: A
Rationale: Pindolol is a beta-adrenergic blocker. Benazepril, quinapril, and enalapril are ACEIs.
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.
A client is prescribed an antihypertensive drug. Which of the following would the nurse include in the teaching plan to promote the best outcome for the client? Select all that apply.
- A. Never discontinue use of the antihypertensive drug except on the advice of the physician.
- B. Avoid the use of nonprescription drugs unless approved by the physician.
- C. Avoid alcohol unless its use has been approved by the physician
- D. Know that unexplained weakness or fatigue is a normal adverse reaction.
- E. Notify the physician if the diastolic pressure suddenly increases to 130 \mathrm{~mm} \mathrm{Hg} or higher.
Correct Answer: A,B,C,E
Rationale: The client should be told to never discontinue the drug unless advised to do so, avoid nonprescription drugs unless approved, avoid alcohol unless it's approved, and notify the physician if the diastolic pressure suddenly increases to 130 \mathrm{~mm} \mathrm{Hg} or higher. The client also should contact the physician if unexplained weakness or fatigue occurs.
Before administering an antihypertensive, the nurse should complete which of the following assessments? Select all that apply.
- A. Pulse rate on both arms
- B. Pulse rate on one arm
- C. Blood pressure in the sitting position
- D. Blood pressure on both arms
- E. Blood pressure on one arm
Correct Answer: A,C,D
Rationale: Preadministration assessment for antihypertensives should include blood pressure and pulse rate on both arms with the client in standing, sitting, and lying positions.