Hypertension Case Discussion
Hypertension Case Discussion
Hypertension Case Discussion
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Week 3 Assignment 2 Quiz Question 1.Ray has been diagnosed with hypertension, and an ACE inhibitor is determined to be needed. Prior to prescribing this drug, the nurse practitioner should assess for: Hypokalemia Impotence Decreased renal function Inability to concentrate Question 2. A potentially life-threatening adverse response to ACE inhibitors is angioedema. Which of the following statements is true about this adverse response? Swelling of the tongue and hoarseness are the most common symptoms. It appears to be related to a decrease in aldosterone production. The presence of a dry, hacky cough indicates a high risk for this adverse response. Because it takes time to build up a blood level, it occurs after being on the drug for about one week. Question 3. Rodrigo has been prescribed procainamide after an episode of MI. He is monitored for dyspnea, jugular venous distention, and peripheral edema because they may indicate: Widening of the area of infarction Onset of congestive heart failure An electrolyte imbalance involving potassium Renal dysfunction Question 4. Which of the following is true about procainamide and its dosing schedule? It produces bradycardia and should be used cautiously in patients with cardiac conditions that a slower heart rate might worsen. GI adverse effects are common, so the drug should be taken with food. Adherence can be improved by using a sustained-release formulation that can be given once daily. Doses of this drug should be taken evenly spaced around the clock to keep an even blood level. Question 5. Furosemide is added to a treatment regimen for heart failure, which includes digoxin. Monitoring for this combination includes: Hemoglobin Serum potassium Blood urea nitrogen Serum glucose Question 6. Art is a fifty-five-year-old smoker who has been diagnosed with angina and placed on nitrates. He complains of headaches after using his nitrate. An appropriate reply might be: “This is a parasympathetic response to the vasodilating effects of the drug.” “Headaches are common side effects with these drugs. How severe are they?” “This is associated with your smoking. Let’s work on having you stop smoking.” “This is not related to your medication. Are you under a lot of stress?” Question 7. Donald has been diagnosed with hyperlipidemia. On the basis of his lipid profile, atorvastatin is prescribed. Rhabdomyolysis is a rare but serious adverse response to this drug. Donald should be told to: Become a vegetarian since this disorder is associated with eating red meat Stop taking the drug if abdominal cramps and diarrhea develop Report muscle weakness or tenderness and dark urine to his provider immediately Expect “hot flash” sensations during the first two weeks of therapy Question 8. Which of the following classes of drugs is contraindicated in heart failure? Nitrates Long-acting dihydropyridines Calcium channel blockers Alpha-beta blockers Question 9. First-line therapy for hyperlipidemia is: Statins Niacin Lifestyle changes Bile acid-binding resins Question 10. Patients who are being treated for folate deficiency require monitoring of: Complete blood count every four weeks Hematocrit and hemoglobin at one week and then at eight weeks Reticulocyte count at one week Folate levels every four weeks until the hemoglobin stabilizes Question 11. Isosorbide dinitrate is a long-acting nitrate given twice daily (BID). The schedule for administration is 7 a.m. and 2 p.m. because: Long-acting forms have a higher risk for toxicity. Orthostatic hypotension is a common adverse effect. It must be taken with milk or food. Nitrate tolerance can develop. Question 12. The New York Heart Association and the Canadian Cardiovascular Society have described grading criteria for levels of angina. Angina that occurs with unusually strenuous activity or on walking or climbing stair after meals is: Class I Class II Class III Class IV Question 13. Which of the following drugs has been associated with increased risk for MI in women? Aspirin Beta blockers Estrogen replacement Lipid-lowering agents Question 14. Scott is presenting for follow-up on his lipid panel. He had elevated total cholesterol, elevated triglycerides, and an LDL of 122 mg/dL. He has already implemented diet changes and increased physical activity. He has mildly elevated liver studies. An appropriate next step for therapy would be: Atorvastatin (Lipitor) Niacin (Niaspan) Simvastatin and ezetimibe (Vytorin) Gemfibrozil (Lopid) Question 15. An ACE inhibitor and what other class of drug may reduce proteinuria in patients with diabetes better than either drug alone? Beta blockers Diuretics Nondihydropyridine calcium channel blockers Angiotensin II receptor blockers Question 16. Jose is a twelve-year-old overweight child with a total cholesterol level of 180 mg/dL and LDL of 125 mg/dL. Along with diet education and recommending increased physical activity, a treatment plan for Jose would include ____ with a reevaluation in six months. statins niacin sterols bile acid-binding resins Question 17. Which of the following disease processes could be made worse by taking a nonselective beta blocker? Asthma might worsen. Diabetes might worsen. Both might worsen. Beta blockade does not affect these disorders. Question 18. At which stage/classification of hypertension should drug therapy be instituted according to the JNC-7 Report? Prehypertension Stage 1 Stage 2 Any stage where the blood pressure is greater than 120/80 mm Hg Question 19. Beta blockers treat hypertension because they: Reduce peripheral resistance. Vasoconstrict coronary arteries. Reduce norepinephrine. Reduce angiotensin II production. Question 20. Because primary hypertension has no identifiable cause, treatment is based on interfering with the physiological mechanisms that regulate blood pressure. Thiazide diuretics treat hypertension because they: Increase renin secretion. Decrease the production of aldosterone. Deplete body sodium and reduce fluid volume. Decrease blood viscosity.
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