A client has a blood pressure of 148/96 mm Hg. According to the American Heart Association Guidelines, how should the nurse classify this blood pressure?
Hypertension stage 2
✓
Hypertension stage 1
Normal
Elevated
Correct Answer
Hypertension stage 2
Hypertension stage 2 is classified as a systolic blood pressure of 140 mm Hg or higher or a diastolic blood pressure of 90 mm Hg or higher.
Question 2
A home health nurse is monitoring a client who has a history of hypertension and is taking benazepril. Which outcome indicates a therapeutic effect of the medication?
Potassium level of 5.1 mEq/dl
Blood pressure of 126/76 mm Hg
✓
Heart rate of 96 beats/minute
Dry cough and fatigue
Correct Answer
Blood pressure of 126/76 mm Hg
Benazepril is an ACE inhibitor and may be used alone or in combination with other drugs in the management of hypertension and heart failure. A therapeutic effect of the medication is a normal blood pressure reading; 126/76 mm Hg falls within the AHA guidelines for normal blood pressure.
Question 3
A nurse is reviewing the health history of a client with hypertension and coronary artery disease. The health care provider is considering a beta-adrenergic blocker, nadolol, for the client. Which condition in the client's health history should the nurse report to the health care provider as a contraindication for nadolol?
Tachycardia
Myocardial infarction
Asthma
✓
Hypertension
Correct Answer
Asthma
Nadolol is a nonselective beta-adrenergic blocker used to treat hypertension and other cardiac disease processes. Nadolol inhibits beta 1 and beta 2. Blockade of beta 2 receptors in the lungs causes bronchospasm; thus, nadolol is contraindicated in clients with asthma.
Question 4
The health care provider's order is for metoprolol 0.1 g orally daily. The tablets are available in 50 mg. How many tablets should the nurse administer?
5 tablets
4 tablets
1 tablet
2 tablets
✓
Correct Answer
2 tablets
.
Question 5
A client with newly diagnosed stable angina is prescribed transdermal nitroglycerin. Which instruction should the nurse include in client teaching?
Apply a new patch at the onset of chest pain.
Apply a new patch after showering while skin is still moist.
Apply the patch for 12–14 hours and then remove for 10–12 hours.
✓
Apply to the same area of the body every day.
Correct Answer
Apply the patch for 12–14 hours and then remove for 10–12 hours.
Transdermal nitroglycerin is prescribed as a maintenance medication for stable angina, which takes 30–60 minutes for therapeutic effects to begin. The patch should be applied around the same time every day and worn for 12–14 hours and then removed for 10–12 hours to avoid client tolerance.
Question 6
A nurse is providing education to a client who has a new prescription for verapamil. The nurse should instruct the client to avoid which beverage when taking verapamil?
Tomato juice
Milk
Coffee
Grapefruit juice
✓
Correct Answer
Grapefruit juice
Verapamil is a calcium channel blocker. Grapefruit juice increases blood levels of verapamil by inhibiting its metabolism. The excess amount of medication can intensify the medication's hypotensive effect, placing the client at an increased risk for syncopal episodes.
Question 7
A nurse is teaching a client with newly diagnosed hypertension about a prescription for hydrochlorothiazide. Which instruction should the nurse include in the client teaching?
Monitor for leg cramps.
✓
Reduce your intake of potassium-rich foods.
Take this medication at bedtime.
Avoid citrus juices.
Correct Answer
Monitor for leg cramps.
Hydrochlorothiazide is a thiazide diuretic and can deplete potassium levels in the body. Clients should eat foods rich in potassium. Clients should monitor themselves for signs of hypokalemia such as fatigue, tachycardia, muscle weakness, and leg cramps.
Question 8
The nurse is to administer carvedilol 6.25 mg orally twice daily. The tablets available contain 3.125 mg. How many tablets will the client receive per dose?
1 tablet
2 tablets
✓
3 tablets
4 tablets
Correct Answer
2 tablets
.
Question 9
A client is being prescribed losartan at discharge from the hospital by the health care provider. The discharge instructions by the nurse should include what information about how losartan acts?
It blocks angiotensin II from angiotensin I receptors.
✓
It inhibits beta 1 and beta 2.
It inhibits angiotensin-converting enzyme.
It prevents the release of angiotensin.
Correct Answer
It blocks angiotensin II from angiotensin I receptors.
Losartan is a selective and competitive angiotensin II receptor blocker (ARB) at the angiotensin I receptor.
Question 10
A nurse is preparing to administer carvedilol to a client with hypertension. Which assessment finding should the nurse report to the health care provider before administering the drug?
Respiratory rate 18 breaths/minute
Apical heart rate 56 beats/minute
✓
Blood pressure 114/74 mm Hg
Temperature 98.6°F
Correct Answer
Apical heart rate 56 beats/minute
Carvedilol is a beta-adrenergic blocker and slows the heart rate. A side effect of carvedilol is bradycardia. The health care provider should be notified of bradycardia in a client before the administration of the drug.