Nokea
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.
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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.
When teaching a client about the prescribed clonidine transdermal medication, which of the following would the nurse most likely include? Select all that apply.
- A. A new patch is applied daily.
- B. If the patch loosens, a new patch should be applied
- C. The use of the adhesive overlay is not necessary
- D. A different body area should be selected for each application.
- E. The patch should be applied to a hairless area
Correct Answer: D,E
Rationale: The patch is applied to a hairless area of intact skin on the upper arm or torso; the patch is kept in place for 7 days. The adhesive overlay is applied directly over the system to ensure the patch remains in place for the required time. A different body area is selected for each application. If the patch loosens before 7 days, the edges can be reinforced with nonallergenic tape.
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.
A client with hypertension has a fungal infection and has been prescribed fluconazole for the fungal infection and losartan for hypertension. The nurse would be alert for which of the following?
- A. Increased risk of adverse effects of losartan
- B. Increased risk of hypersensitivity reaction
- C. Decreased hypotensive effect of losartan
- D. Increased risk of hypoglycemia
Correct Answer: A
Rationale: Increased risk of antihypertensive effects and adverse reactions are associated with the concomitant use of fluconazole and losartan. Decreased hypotensive effect of losartan is seen with use of indomethacin and does not occur with the concomitant use of these drugs. Increased risk of hypoglycemia and increased risk of hypersensitivity do not occur with the concomitant use of these drugs.
A nurse is caring for a client experiencing a hypertensive emergency. The nurse understands that if blood pressure is not lowered immediately damage to which of the following can occur? Select all that apply.
- A. Heart
- B. Kidneys
- C. Gallbladder
- D. Pancreas
- E. Eyes
Correct Answer: A,B,E
Rationale: A hypertensive emergency, if not recognized and treated quickly, can result in damage to target organs including the head, kidneys, and eyes.