Nokea
When educating a group of nursing students on the mechanism of action of angiotensin-converting enzyme inhibitor (ACEI) drugs, the instructor identifies which of the following as the action brought about by aldosterone?
- A. Inhibits renin secretion
- B. Causes sodium and water retention
- C. Causes excess potassium retention
- D. Promotes angiotensin I conversion
Correct Answer: B
Rationale: Aldosterone causes retention of sodium and water. This in turn causes a rise in blood pressure. ACEIs act by inhibiting the conversion of angiotensin I to angiotensin II. Aldosterone does not inhibit the release of renin and is not involved in the retention of potassium. Angiotensin-converting enzymes, and not aldosterone, are involved in the conversion of angiotensin I to angiotensin II.
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An older adult client is prescribed a diuretic and an antihypertensive drug as treatment for his hypertension. The client tells the nurse that he has been perspiring a lot lately and has had some diarrhea. Which nursing diagnosis would the nurse most likely identify as a priority?
- A. Risk for Deficient Fluid Volume
- B. Ineffective Sexuality Patterns
- C. Activity Intolerance
- D. Acute Pain
Correct Answer: A
Rationale: Risk for Deficient Fluid Volume would be the most likely priority because the client is receiving a diuretic and an antihypertensive drug. The risk increases if the client is older or confused. Ineffective Sexuality Patterns would be appropriate if the client were to experience sexual dysfunction related to drug therapy. Activity Intolerance would be appropriate if the client complained of feeling tired and weak. Acute Pain would be related to the development of a headache that may occur with angiotensin II receptor blockers or antiadrenergics.
During a routine check-up of a 45 -year-old client with renal disease, the nurse observes an increase in the client's blood pressure. The nurse identifies this as most likely which of the following?
- A. Essential hypertension
- B. Secondary hypertension
- C. Rebound hypertension
- D. Hypertensive emergency
Correct Answer: B
Rationale: Secondary hypertension results as a consequence of renal impairment. In secondary hypertension there is usually a known cause for the development of hypertension. Renal disease is one of the causes of secondary hypertension. When there is no known cause of hypertension, it is called essential hypertension. Rebound hypertension occurs when a client abruptly stops taking antihypertensive medication. Hypertensive emergency is a high blood pressure state, which has to be lowered immediately.
When teaching a client newly diagnosed with hypertension, which instructions would the nurse incorporate into the teaching plan? Select all that apply.
- A. Lose weight.
- B. Stop smoking.
- C. Reduce stress.
- D. Decrease exercise.
- E. Increase sodium intake.
Correct Answer: A,B,C
Rationale: Nonpharmacologic management of hypertension should include weight loss, stress reduction, regular aerobic exercise, smoking cessation, moderation of alcohol, and decreased sodium intake.
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 has a nursing diagnosis of Activity Intolerance related to fatigue and weakness. Which of the following would be appropriate for the nurse to include in the client's plan of care?
- A. Encouraging ambulation as tolerated
- B. Maintaining bed rest as much as possible
- C. Mandating the use of assistive devices
- D. Encouraging activities early in the morning when fatigue is less
- E. Promoting rest periods throughout the day as necessary
Correct Answer: A,E
Rationale: The client is encouraged to walk and ambulate as he or she can tolerate. Assistive devices may be used if needed, but these should not be mandated for use. The client can gradually increase tolerance by increasing the daily amount of activity. Planning rest periods according to the individual's tolerance is appropriate. Rest can take many forms, such as sitting in a chair, napping, watching television, or sitting with legs elevated.