Holland/Adams/Brice, Core Concepts in Pharmacology 5th Edition Test Bank
Chapter 19

Question 1

Type: MCSA

The nurse is caring for a client who has a consistent elevation of arterial blood pressure. Which diagnosis does the nurse expect for this client?

1. Hypertension
2. Hypotension
3. Tachycardia
4. Bradycardia

Cognitive Level: Remembering

Client Need: Health Promotion and Maintenance

Page Number: 292

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 19-2 Describe how the pumping action of the heart creates blood pressure.

Question 2

Type: MCMA

The nurse is teaching the client about the long-term consequences of untreated hypertension. What should the nurse include in the teaching? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected.

1. Diabetes
2. Stroke
3. Kidney failure
4. Cardiac arrest
5. Diabetes insipidus

Cognitive Level: Applying

Client Need: Health Promotion and Maintenance

Page Number: 293

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 19-1 Identify the long-term consequences of untreated hypertension.

Question 3

Type: MCSA

The client asks the nurse what the first number given in a blood pressure stands for. What is the best response by the nurse?

1. “The first number is the diastolic pressure.”
2. “The first number is the heart rate.”
3. “The first number is the pulse pressure.”
4. “The first number is the systolic pressure.”

Cognitive Level: Remembering

Client Need: Health Promotion and Maintenance

Page Number: 293

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 19-2 Describe how the pumping action of the heart creates blood pressure.

Question 4

Type: MCSA

What is the appropriate definition of cardiac output?

1. The systolic pressure
2. The diastolic pressure
3. The volume of blood pumped per minute
4. Equal to the mean arterial pressure

Cognitive Level: Remembering

Client Need: Health Promotion and Maintenance

Page Number: 295

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 19-3 Explain the effects of cardiac output, peripheral resistance, and blood volume on blood pressure.

Question 5

Type: MCSA

The nurse is teaching a client about blood pressure regulation. Which would the nurse include in this teaching session as the structure that regulates blood pressure on a minute-to-minute basis?

1. The liver
2. The heart
3. The vasomotor center
4. The lungs

Cognitive Level: Remembering

Client Need: Health Promotion and Maintenance

Page Number: 295

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 19-4 Discuss nervous and hormonal factors that influence blood pressure.

Question 6

Type: MCMA

The client asks the nurse how to control hypertension without taking medications. Which teaching topics would be appropriate for the nurse to include? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected.

1. Increase exercise
2. Decrease sodium intake
3. Stop smoking
4. Increase weight if overweight
5. Increase intake of dietary fat

Cognitive Level: Applying

Client Need: Health Promotion and Maintenance

Page Numbers: 296–297

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 19-5 Discuss the role of positive lifestyle changes in the management of hypertension.

Question 7

Type: MCSA

Which statement indicates understanding of hypertensive therapy by the client?

1. “If I think my blood pressure is increased, I should take a double dose of my medications.”
2. “I should take all medications as prescribed to control my high blood pressure.”
3. “When I feel good, I don’t need to take my medications.”
4. “I should take hypertension medications only when I do not feel well.”

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 298

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 19-6 Describe the goals in using pharmacotherapy to treat hypertension.

Question 8

Type: MCSA

A client is prescribed multiple medications for hypertension. The client asks the nurse which of the medications prescribed is a beta blocker. Which response by the nurse is correct?

1. Amlodipine (Norvasc)
2. Furosemide (Lasix)
3. Ramipril (Altace)
4. Metoprolol (Lopressor)

Cognitive Level: Understanding

Client Need: Physiological Integrity

Page Number: 308

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 19-10 Explain the role of adrenergic blockers in the management of hypertension.

Question 9

Type: MCSA

A client is prescribed multiple medications for hypertension. The client asks the nurse which of the medications prescribed is an ACE inhibitor. Which response by the nurse is appropriate?

1. Furosemide (Lasix)
2. Amlodipine (Norvasc)
3. Ramipril (Altace)
4. Metoprolol (Lopressor)

Cognitive Level: Understanding

Client Need: Physiological Integrity

Page Number: 301

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 19-9 Explain the role of renin-angiotensin-aldosterone modifiers in the management of hypertension.

Question 10

Type: MCSA

A client is prescribed multiple medications for hypertension. The client asks the nurse which of the medications prescribed is a loop diuretic. Which response by the nurse is appropriate?

1. Ramipril (Altace)
2. Furosemide (Lasix)
3. Metoprolol (Lopressor)
4. Amlodipine (Norvasc)

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 299

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 19-7 Explain the role of diuretics in the management of hypertension.

Question 11

Type: MCSA

A client is prescribed multiple medications for hypertension. The client asks the nurse which of the medications prescribed is a calcium channel blocker. Which response by the nurse is most appropriate?

1. Metoprolol (Lopressor)
2. Ramipril (Altace)
3. Furosemide (Lasix)
4. Amlodipine (Norvasc)

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 304

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 19-8 Explain the role of calcium channel blockers in the management of hypertension.

Question 12

Type: MCSA

What side effect should the nurse include in the teaching session as the most common side effect of ACE inhibitor therapy?

1. Cough
2. Hypokalemia
3. Angioedema
4. Headache

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 300

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 19-9 Explain the role of renin-angiotensin-aldosterone modifiers in the management of hypertension.

Question 13

Type: MCSA

Which medication is not a calcium channel blocker?

1. Amlodipine (Norvasc)
2. Propranolol (Inderal)
3. Verapamil (Calan)
4. Diltiazem (Cardizem)

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 304

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 19-8 Explain the role of calcium channel blockers in the management of hypertension.

Question 14

Type: MCSA

The nurse is caring for a client prescribed enalapril (Vasotec). The nurse educates the client on the side effects of the medication. Which side effect of this medication is potentially life threatening?

1. Hypokalemia
2. Supraventricular tachycardia
3. Ventricular fibrillation
4. Angioedema

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 301

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 19-9 Explain the role of renin-angiotensin-aldosterone modifiers in the management of hypertension.

Question 15

Type: MCSA

The physician ordered atenolol (Tenormin) for a client. The nurse checks vital signs for this client. Which vital sign would cause the nurse to question administering the medication?

1. Temperature 99.4°F
2. Blood pressure 148/62
3. Respirations 18 breaths per minute
4. Pulse 48 beats per minute

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 308

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 19-10 Explain the role of adrenergic blockers in the management of hypertension.

Question 16

Type: MCMA

The nurse is teaching the client about side effects of medications for hypertension. Which side effects will the nurse educate the client to contact the physician if they occur? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected.

1. Blood pressure 120/70
2. Pulse 125 beats per minute
3. Dizziness
4. Headache
5. Respiratory rate of 20
6. Edema in the legs

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 310

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 19-6 Describe the goals in using pharmacotherapy to treat hypertension.

Question 17

Type: MCSA

The physician has prescribed an alpha blocker for the client. What medication does the nurse anticipate to be prescribed?

1. Atenolol (Tenormin)
2. Doxazosin (Cardura)
3. Lisinopril (Zestril)
4. Diltiazem (Cardizem)

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 308

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 19-10 Explain the role of adrenergic blockers in the management of hypertension.

Question 18

Type: MCSA

Which medication is often the first choice for treating hypertension?

1. Diuretics
2. Beta blockers
3. ACE inhibitors
4. Alpha blockers

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 299

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 19-7 Explain the role of diuretics in the management of hypertension.

Question 19

Type: MCSA

The client has been prescribed furosemide (Lasix). What condition does this medication cause?

1. Hyperkalemia
2. Increased blood pressure
3. Increased respirations
4. Hypokalemia

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 300

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 19-7 Explain the role of diuretics in the management of hypertension.

Question 20

Type: MCSA

What teaching point should the nurse include for a client who is prescribed a thiazide diuretic?

1. Take the medication in the morning
2. Take with two full glasses of water
3. Avoid foods containing potassium
4. Take before bed

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 300

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 19-7 Explain the role of diuretics in the management of hypertension.

Question 21

Type: MCMA

A client has been prescribed a loop diuretic and instructed to eat foods rich in potassium. Which foods are rich in potassium? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected.

1. Bananas
2. Milk
3. Salmon
4. Bread
5. Rice

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 300

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 19-7 Explain the role of diuretics in the management of hypertension.

Question 22

Type: MCSA

A client has been prescribed candesartan (Atacand) daily. What classification does this medication belong to?

1. Calcium channel blocker
2. ACE inhibitor
3. Beta blocker
4. Angiotensin-receptor blocker

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 301

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 19-9 Explain the role of renin-angiotensin-aldosterone modifiers in the management of hypertension.

Question 23

Type: MCSA

What should be used with caution in clients with asthma and heart failure?

1. Nonselective beta blockers
2. ACE inhibitors
3. Beta₁-blockers
4. Alpha blockers

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 308

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 19-11 Explain the role of direct vasodilators in the management of hypertension.

Question 24

Type: MCSA

The nurse is caring for a client who is experiencing a hypertensive crisis. Which medication does the nurse anticipate, as it is the drug of choice for this condition?

1. Nitroprusside (Nitropress)
2. Enalapril (Vasotec)
3. Diltiazem (Cardizem)
4. Lisinopril (Zestril)

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 309

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 19-11 Explain the role of direct vasodilators in the management of hypertension.

Question 25

Type: MCSA

A client who was recently diagnosed with high blood pressure asks why they need the medication. The client tells the nurse that they feel just fine and questions the need for medication. Which is the nurse’s best response?

1. “Many people don’t really need the medication.”

2. “If left untreated, high blood pressure can lead to serious problems.”

3. “A healthy diet and exercise can cure this problem.”

4. “You should think about going to a different prescriber.”

Cognitive Level: Applying

Client Need: Health Promotion and Maintenance

Page Number: 296

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 19-1 Identify the long-term consequences of untreated hypertension.

Question 26

Type: MCSA

What role does peripheral resistance play in blood pressure?

1. The higher the peripheral resistance, the higher the blood pressure.

2. The lower the peripheral resistance, the higher the blood pressure.

3. The higher the peripheral resistance, the lower the blood pressure.

4. There is no relationship to peripheral resistance and blood pressure.

Cognitive Level: Applying

Client Need: Health Promotion and Maintenance

Page Number: 295

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 19-3 Explain the effects of cardiac output, peripheral resistance, and blood volume on blood pressure.

Question 27

Type: MCMA

What factors are associated with blood pressure? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected.

1. Cardiac output

2. Urine output

3. Blood volume

4. Ventricular filling pressure

5. Peripheral resistance

Cognitive Level: Remembering

Client Need: Health Promotion and Maintenance

Page Number: 295

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 19-3 Explain the effects of cardiac output, peripheral resistance, and blood volume on blood pressure.

Question 28

Type: MCSA

A client is being seen after being on hypertension medication for the last 3 months. The client has lost weight since the last visit. The client also tells the nurse that he or she is walking 2 miles 5 days a week and has been eating more fruits and vegetables. What does the nurse anticipate from the prescriber?

1. A nutrition consult

2. A decrease in the medication

3. A weight check

4. A smoking cessation program

Cognitive Level: Applying

Client Need: Health Promotion and Maintenance

Page Numbers: 296–297

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 19-5 Discuss the role of positive lifestyle changes in the management of hypertension.

Question 29

Type: MCSA

The nurse is teaching a client about lifestyle changes including reducing stress and learning to implement coping strategies. The client asks why it is important to reduce stress. Which is the nurse’s best response?

1. “Stress can cause an increase in heart rate which can affect blood pressure.”

2. “Studies have shown that having a pet can increase stress.”

3. “Reducing stress can decrease blood pressure.”

4. “Increased stress has been linked to high cholesterol and depression.”

Cognitive Level: Understanding

Client Need: Health Promotion and Maintenance

Page Number: 296

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 19-4 Discuss nervous and hormonal factors that influence blood pressure.