Adams, Pharmacology for Nurse: A Pathophysiologic Approach, 4/E Chapter 25

Question 1 Type: MCSA The patient receives hydrochlorothiazide (HydroDIURIL). He tells the n rse he is rinatin! a lot and " estions ho# this dr ! a$$ects his %lood press re. &hat is the %est response %y the n rse' 1. (Hydrochlorothiazide (HydroDIURIL) enhances )idney $ nction ca sin! yo to rinate *ore and that decreases yo r %lood press re.( 2. (Hydrochlorothiazide (HydroDIURIL) decreases the $l id in yo r %loodstrea* and this lo#ers yo r %lood press re.( 3. (Hydrochlorothiazide (HydroDIURIL) dilates yo r %lood vessels so yo decreases.( rinate *ore and yo r %lood press re

4. (Hydrochlorothiazide (HydroDIURIL) increases yo r heart rate+ this p *ps %lood $aster to yo r )idneys so yo rinate *ore and yo r %lood press re decreases.( Correct Answer: , ationa!e 1- .lood vol *e is one o$ the three $actors in$l encin! %lood press re. Di retics li)e hydrochlorothiazide (HydroDIURIL) decrease %lood press re %y decreasin! total %lood vol *e. Hydrochlorothiazide (HydroDIURIL) does not increase heart rate. Hydrochlorothiazide (HydroDIURIL) does not dilate %lood vessels. Hydrochlorothiazide (HydroDIURIL) does not enhance )idney $ nction. ationa!e 2- .lood vol *e is one o$ the three $actors in$l encin! %lood press re. Di retics li)e hydrochlorothiazide (HydroDIURIL) decrease %lood press re %y decreasin! total %lood vol *e. Hydrochlorothiazide (HydroDIURIL) does not increase heart rate. Hydrochlorothiazide (HydroDIURIL) does not dilate %lood vessels. Hydrochlorothiazide (HydroDIURIL) does not enhance )idney $ nction. ationa!e 3- .lood vol *e is one o$ the three $actors in$l encin! %lood press re. Di retics li)e hydrochlorothiazide (HydroDIURIL) decrease %lood press re %y decreasin! total %lood vol *e. Hydrochlorothiazide (HydroDIURIL) does not increase heart rate. Hydrochlorothiazide (HydroDIURIL) does not dilate %lood vessels. Hydrochlorothiazide (HydroDIURIL) does not enhance )idney $ nction. ationa!e 4- .lood vol *e is one o$ the three $actors in$l encin! %lood press re. Di retics li)e hydrochlorothiazide (HydroDIURIL) decrease %lood press re %y decreasin! total %lood vol *e. Hydrochlorothiazide (HydroDIURIL) does not increase heart rate. Hydrochlorothiazide (HydroDIURIL) does not dilate %lood vessels. Hydrochlorothiazide (HydroDIURIL) does not enhance )idney $ nction. "!o#a! ationa!e: Co$niti%e &e%e!: Applyin! C!ient 'eed: /hysiolo!ical Inte!rity
Ada*s, Pharmacology for Nurse: A Pathophysiologic Approach, 012 Copyri!ht ,340 %y /earson 2d cation5 Inc.

C!ient 'eed (u#: 'ursin$/)nte$rated Concepts: 6 rsin! /rocess- I*ple*entation &earnin$ *utcome: ,789 Question 2 Type: MCMA The n rse is cond ctin! the initial !ro p ed cation session $or patients #ho have hypertension. &hat is the *ost i*portant in$or*ation to incl de' 6ote- Credit #ill %e !iven only i$ all correct choices and no incorrect choices are selected. (tandard Te+t: Select all that apply. 1. .lood press res tend to decrease as people a!e5 d e to decreased %lood vol *e. 2. The aorta has sensors that help re! late %lood press re. 3. An!er can res lt in hypertension. 4. The vaso*otor center5 located in the li*%ic syste* o$ the %rain5 helps re! late %lood press re. 5. Hypertension is dia!nosed #hen the %lood press re is !reater than 4071:7 **H!. Correct Answer: ,59 ationa!e 1- An!er and stress can ca se %lood press re to rise. The aorta and internal carotid artery have %aroreceptors that sense chan!es in press re in %lood vessels and che*oreceptors that detect o;y!en5 car%on dio;ide5 and pH levels. Accordin! to <6C8=5 a person is considered to have hypertension #hen s stained %lood press re is 49:1>: **H!. The vaso*otor center is located in the *ed lla o%lon!ata. .lood press res tend to rise as people a!e. ationa!e 2- An!er and stress can ca se %lood press re to rise. The aorta and internal carotid artery have %aroreceptors that sense chan!es in press re in %lood vessels and che*oreceptors that detect o;y!en5 car%on dio;ide5 and pH levels. Accordin! to <6C8=5 a person is considered to have hypertension #hen s stained %lood press re is 49:1>: **H!. The vaso*otor center is located in the *ed lla o%lon!ata. .lood press res tend to rise as people a!e. ationa!e 3- An!er and stress can ca se %lood press re to rise. The aorta and internal carotid artery have %aroreceptors that sense chan!es in press re in %lood vessels and che*oreceptors that detect o;y!en5 car%on dio;ide5 and pH levels. Accordin! to <6C8=5 a person is considered to have hypertension #hen s stained %lood press re is 49:1>: **H!. The vaso*otor center is located in the *ed lla o%lon!ata. .lood press res tend to rise as people a!e. ationa!e 4- An!er and stress can ca se %lood press re to rise. The aorta and internal carotid artery have %aroreceptors that sense chan!es in press re in %lood vessels and che*oreceptors that detect o;y!en5 car%on dio;ide5 and pH levels. Accordin! to <6C8=5 a person is considered to have hypertension #hen s stained %lood
Ada*s, Pharmacology for Nurse: A Pathophysiologic Approach, 012 Copyri!ht ,340 %y /earson 2d cation5 Inc.

press re is 49:1>: **H!. The vaso*otor center is located in the *ed lla o%lon!ata. .lood press res tend to rise as people a!e. ationa!e 5- An!er and stress can ca se %lood press re to rise. The aorta and internal carotid artery have %aroreceptors that sense chan!es in press re in %lood vessels and che*oreceptors that detect o;y!en5 car%on dio;ide5 and pH levels. Accordin! to <6C8=5 a person is considered to have hypertension #hen s stained %lood press re is 49:1>: **H!. The vaso*otor center is located in the *ed lla o%lon!ata. .lood press res tend to rise as people a!e. "!o#a! ationa!e: Co$niti%e &e%e!: Applyin! C!ient 'eed: /hysiolo!ical Inte!rity C!ient 'eed (u#: 'ursin$/)nte$rated Concepts: 6 rsin! /rocess- I*ple*entation &earnin$ *utcome: ,780 Question 3 Type: MCSA The patient has a %lood press re readin! o$ 4,?1>0 **H!. She as)s the n rse i$ she has hi!h %lood press re. &hat is the %est response %y the n rse' 1. (@o have prehypertension5 % t it isnAt really serio s.( 2. (@o have prehypertension+ letAs disc ss yo r li$estyle.( 3. (@o have prehypertension+ n$ort nately5 this #ill pro!ress to hypertension.( 4. (@o have prehypertension5 and * st %e!in *edication.( Correct Answer: , ationa!e 1- Accordin! to <6C8=5 prehypertension incl des individ als #ith systolic readin!s o$ 4,3 to 493 **H! or diastolic readin!s o$ >3 to >: **H!. /rehypertension sho ld %e initially treated %y *odi$ication in li$estyle. Initiation o$ *edication is incorrect %eca se prehypertension is initially treated #ith li$estyle *odi$ications. Hypertension is incorrect %eca se *any individ als can treat prehypertension #ith li$estyle *odi$ications and #ill never pro!ress to hypertension. /rehypertension is al#ays serio s and re" ires li$estyle *odi$ications. ationa!e 2- Accordin! to <6C8=5 prehypertension incl des individ als #ith systolic readin!s o$ 4,3 to 493 **H! or diastolic readin!s o$ >3 to >: **H!. /rehypertension sho ld %e initially treated %y *odi$ication in li$estyle. Initiation o$ *edication is incorrect %eca se prehypertension is initially treated #ith li$estyle *odi$ications. Hypertension is incorrect %eca se *any individ als can treat prehypertension #ith li$estyle *odi$ications and #ill never pro!ress to hypertension. /rehypertension is al#ays serio s and re" ires li$estyle *odi$ications.
Ada*s, Pharmacology for Nurse: A Pathophysiologic Approach, 012 Copyri!ht ,340 %y /earson 2d cation5 Inc.

ationa!e 3- Accordin! to <6C8=5 prehypertension incl des individ als #ith systolic readin!s o$ 4,3 to 493 **H! or diastolic readin!s o$ >3 to >: **H!. /rehypertension sho ld %e initially treated %y *odi$ication in li$estyle. Initiation o$ *edication is incorrect %eca se prehypertension is initially treated #ith li$estyle *odi$ications. Hypertension is incorrect %eca se *any individ als can treat prehypertension #ith li$estyle *odi$ications and #ill never pro!ress to hypertension. /rehypertension is al#ays serio s and re" ires li$estyle *odi$ications. ationa!e 4- Accordin! to <6C8=5 prehypertension incl des individ als #ith systolic readin!s o$ 4,3 to 493 **H! or diastolic readin!s o$ >3 to >: **H!. /rehypertension sho ld %e initially treated %y *odi$ication in li$estyle. Initiation o$ *edication is incorrect %eca se prehypertension is initially treated #ith li$estyle *odi$ications. Hypertension is incorrect %eca se *any individ als can treat prehypertension #ith li$estyle *odi$ications and #ill never pro!ress to hypertension. /rehypertension is al#ays serio s and re" ires li$estyle *odi$ications. "!o#a! ationa!e: Co$niti%e &e%e!: Applyin! C!ient 'eed: /hysiolo!ical Inte!rity C!ient 'eed (u#: 'ursin$/)nte$rated Concepts: 6 rsin! /rocess- I*ple*entation &earnin$ *utcome: ,784 Question 4 Type: MCMA The patient has %een recently dia!nosed #ith hypertension #ith a s stained %lood press re o$ 4001:3 **H!. The patient is concerned a%o t e$$ects on the %ody. &hat e$$ects o$ hypertension on the %ody #ill the n rse incl de in her ed cation o$ this patient' 6ote- Credit #ill %e !iven only i$ all correct choices and no incorrect choices are selected. (tandard Te+t: Select all that apply. 1. Bidney da*a!e 2. Stro)e 3. Liver $ail re 4. Heart $ail re 5. .lindness Correct Answer: 45,5057 ationa!e 1- The $o r tar!et or!ans *ost co**only a$$ected %y hypertension are the heart5 )idneys5 %rain5 and retina. Liver $ail re is not co**only associated #ith hypertension.
Ada*s, Pharmacology for Nurse: A Pathophysiologic Approach, 012 Copyri!ht ,340 %y /earson 2d cation5 Inc.

ationa!e 2- The $o r tar!et or!ans *ost co**only a$$ected %y hypertension are the heart5 )idneys5 %rain5 and retina. Liver $ail re is not co**only associated #ith hypertension. ationa!e 3- The $o r tar!et or!ans *ost co**only a$$ected %y hypertension are the heart5 )idneys5 %rain5 and retina. Liver $ail re is not co**only associated #ith hypertension. ationa!e 4- The $o r tar!et or!ans *ost co**only a$$ected %y hypertension are the heart5 )idneys5 %rain5 and retina. Liver $ail re is not co**only associated #ith hypertension. ationa!e 5- The $o r tar!et or!ans *ost co**only a$$ected %y hypertension are the heart5 )idneys5 %rain5 and retina. Liver $ail re is not co**only associated #ith hypertension. "!o#a! ationa!e: Co$niti%e &e%e!: Applyin! C!ient 'eed: /hysiolo!ical Inte!rity C!ient 'eed (u#: 'ursin$/)nte$rated Concepts: 6 rsin! /rocess- I*ple*entation &earnin$ *utcome: ,78, Question 5 Type: MCSA The patient has %een recently dia!nosed #ith hypertension. Assess*ent data incl des &t- ,33 po nds Ht- 7A 0( Diet- Mostly starches Alcohol inta)e- 9 %eers1#ee) Stressors- &or)s ?3 ho rs1#ee) In plannin! care #ith this patient5 #hat is the priority o tco*e' 1. /atient #ill eli*inate alcohol $ro* the diet. 2. /atient #ill decrease stress %y li*itin! #or) to 03 ho rs1#ee). 3. /atient #ill %alance diet accordin! to the $ood pyra*id. 4. /atient #ill achieve and *aintain opti* * #ei!ht. Correct Answer: 0 ationa!e 1- Achievin! and *aintainin! opti* * #ei!ht is o$ !reatest i*portance #hen a patient has hypertension. Cor o%ese patients5 a 43 to ,3 po nd #ei!ht loss can prod ce a *eas ra%le chan!e in %lood press re. A %alanced diet is i*portant5 % t not the priority o tco*e. Decreasin! stress is i*portant5 % t not the priority o tco*e. 2li*inatin! alcohol is i*portant5 % t not the priority o tco*e.

Ada*s, Pharmacology for Nurse: A Pathophysiologic Approach, 012 Copyri!ht ,340 %y /earson 2d cation5 Inc.

ationa!e 2- Achievin! and *aintainin! opti* * #ei!ht is o$ !reatest i*portance #hen a patient has hypertension. Cor o%ese patients5 a 43 to ,3 po nd #ei!ht loss can prod ce a *eas ra%le chan!e in %lood press re. A %alanced diet is i*portant5 % t not the priority o tco*e. Decreasin! stress is i*portant5 % t not the priority o tco*e. 2li*inatin! alcohol is i*portant5 % t not the priority o tco*e. ationa!e 3- Achievin! and *aintainin! opti* * #ei!ht is o$ !reatest i*portance #hen a patient has hypertension. Cor o%ese patients5 a 43 to ,3 po nd #ei!ht loss can prod ce a *eas ra%le chan!e in %lood press re. A %alanced diet is i*portant5 % t not the priority o tco*e. Decreasin! stress is i*portant5 % t not the priority o tco*e. 2li*inatin! alcohol is i*portant5 % t not the priority o tco*e. ationa!e 4- Achievin! and *aintainin! opti* * #ei!ht is o$ !reatest i*portance #hen a patient has hypertension. Cor o%ese patients5 a 43 to ,3 po nd #ei!ht loss can prod ce a *eas ra%le chan!e in %lood press re. A %alanced diet is i*portant5 % t not the priority o tco*e. Decreasin! stress is i*portant5 % t not the priority o tco*e. 2li*inatin! alcohol is i*portant5 % t not the priority o tco*e. "!o#a! ationa!e: Co$niti%e &e%e!: Applyin! C!ient 'eed: /hysiolo!ical Inte!rity C!ient 'eed (u#: 'ursin$/)nte$rated Concepts: 6 rsin! /rocess- /lannin! &earnin$ *utcome: ,787 Question , Type: MCSA The patient is receivin! hydrochlorothiazide (HydroDIURIL) as #ell as di!o;in (Lano;in). &hich la% res lt #o ld the n rse reco!nize as *ost si!ni$icant' 1. ALT level o$ 97 nits1L 2. Sodi * level o$ 403 *2"1L 3. /otassi * level o$ ,.: *2"1L 4. .U6 level o$ ,3 *!1dl Correct Answer: 9 ationa!e 1- Hypo)ale*ia ca sed %y hydrochlorothiazide (HydroDIURIL) *ay increase di!o;in (Lano;in) to;icity. The nor*al ran!e $or potassi * is 9.7 to 7., *2"1L. The concern is hypo)ale*ia5 not sodi * levels+ this sodi * level is #ithin nor*al ran!e. The concern is hypo)ale*ia5 not liver da*a!e5 and this ALT level is #ithin nor*al ran!e. The concern is hypo)ale*ia5 not )idney $ nction5 and this .U6 is #ithin nor*al ran!e. ationa!e 2- Hypo)ale*ia ca sed %y hydrochlorothiazide (HydroDIURIL) *ay increase di!o;in (Lano;in) to;icity. The nor*al ran!e $or potassi * is 9.7 to 7., *2"1L. The concern is hypo)ale*ia5 not sodi * levels+ this sodi * level is #ithin nor*al ran!e. The concern is hypo)ale*ia5 not liver da*a!e5 and this ALT level is #ithin nor*al ran!e. The concern is hypo)ale*ia5 not )idney $ nction5 and this .U6 is #ithin nor*al ran!e.
Ada*s, Pharmacology for Nurse: A Pathophysiologic Approach, 012 Copyri!ht ,340 %y /earson 2d cation5 Inc.

ationa!e 3- Hypo)ale*ia ca sed %y hydrochlorothiazide (HydroDIURIL) *ay increase di!o;in (Lano;in) to;icity. The nor*al ran!e $or potassi * is 9.7 to 7., *2"1L. The concern is hypo)ale*ia5 not sodi * levels+ this sodi * level is #ithin nor*al ran!e. The concern is hypo)ale*ia5 not liver da*a!e5 and this ALT level is #ithin nor*al ran!e. The concern is hypo)ale*ia5 not )idney $ nction5 and this .U6 is #ithin nor*al ran!e. ationa!e 4- Hypo)ale*ia ca sed %y hydrochlorothiazide (HydroDIURIL) *ay increase di!o;in (Lano;in) to;icity. The nor*al ran!e $or potassi * is 9.7 to 7., *2"1L. The concern is hypo)ale*ia5 not sodi * levels+ this sodi * level is #ithin nor*al ran!e. The concern is hypo)ale*ia5 not liver da*a!e5 and this ALT level is #ithin nor*al ran!e. The concern is hypo)ale*ia5 not )idney $ nction5 and this .U6 is #ithin nor*al ran!e. "!o#a! ationa!e: Co$niti%e &e%e!: Analyzin! C!ient 'eed: /hysiolo!ical Inte!rity C!ient 'eed (u#: 'ursin$/)nte$rated Concepts: 6 rsin! /rocess- Assess*ent &earnin$ *utcome: ,78> Question Type: MCSA The patient #ith hypertension is receivin! ne$edipine (/rocardia DL). The n rse deter*ines that the patient needs additional *edication ed cation #hen the patient selects #hich *en $or %rea)$ast' 1. &hole8#heat panca)es #ith syr p5 and %acon5 oat*eal5 and oran!e E ice 2. 2!!s5 #hole8#heat toast #ith % tter5 L c)y Char*s cereal5 *il)5 and !rape$r it E ice 3. 2!!s and sa sa!e5 a %isc it #ith *ar!arine5 co$$ee #ith crea*5 and cran%erry E ice 4. 2!! and cheese o*elet5 tea #ith s !ar and le*on5 hash %ro#n potatoes5 and pr ne E ice Correct Answer: , ationa!e 1- Frape$r it E ice in co*%ination #ith a s stained8release calci * channel %loc)er co ld res lt in rapid to;ic overdose5 #hich is a *edical e*er!ency. There is no $oodGdr ! interaction #ith calci * channel %loc)ers and #hole8#heat panca)es #ith syr p5 and %acon5 oat*eal5 and oran!e E ice. There is no $oodGdr ! interaction #ith calci * channel %loc)ers and e!!s5 sa sa!e5 a %isc it #ith *ar!arine5 and cran%erry E ice. There is no $oodGdr ! interaction #ith calci * channel %loc)ers and e!! and cheese o*elet5 tea #ith s !ar and le*on5 hash %ro#n potatoes5 and pr ne E ice. ationa!e 2- Frape$r it E ice in co*%ination #ith a s stained8release calci * channel %loc)er co ld res lt in rapid to;ic overdose5 #hich is a *edical e*er!ency. There is no $oodGdr ! interaction #ith calci * channel %loc)ers and #hole8#heat panca)es #ith syr p5 and %acon5 oat*eal5 and oran!e E ice. There is no $oodGdr ! interaction #ith calci * channel %loc)ers and e!!s5 sa sa!e5 a %isc it #ith *ar!arine5 and cran%erry E ice. There is no $oodGdr ! interaction #ith calci * channel %loc)ers and e!! and cheese o*elet5 tea #ith s !ar and le*on5 hash %ro#n potatoes5 and pr ne E ice.
Ada*s, Pharmacology for Nurse: A Pathophysiologic Approach, 012 Copyri!ht ,340 %y /earson 2d cation5 Inc.

ationa!e 3- Frape$r it E ice in co*%ination #ith a s stained8release calci * channel %loc)er co ld res lt in rapid to;ic overdose5 #hich is a *edical e*er!ency. There is no $oodGdr ! interaction #ith calci * channel %loc)ers and #hole8#heat panca)es #ith syr p5 and %acon5 oat*eal5 and oran!e E ice. There is no $oodGdr ! interaction #ith calci * channel %loc)ers and e!!s5 sa sa!e5 a %isc it #ith *ar!arine5 and cran%erry E ice. There is no $oodGdr ! interaction #ith calci * channel %loc)ers and e!! and cheese o*elet5 tea #ith s !ar and le*on5 hash %ro#n potatoes5 and pr ne E ice. ationa!e 4- Frape$r it E ice in co*%ination #ith a s stained8release calci * channel %loc)er co ld res lt in rapid to;ic overdose5 #hich is a *edical e*er!ency. There is no $oodGdr ! interaction #ith calci * channel %loc)ers and #hole8#heat panca)es #ith syr p5 and %acon5 oat*eal5 and oran!e E ice. There is no $oodGdr ! interaction #ith calci * channel %loc)ers and e!!s5 sa sa!e5 a %isc it #ith *ar!arine5 and cran%erry E ice. There is no $oodGdr ! interaction #ith calci * channel %loc)ers and e!! and cheese o*elet5 tea #ith s !ar and le*on5 hash %ro#n potatoes5 and pr ne E ice. "!o#a! ationa!e: Co$niti%e &e%e!: Analyzin! C!ient 'eed: /hysiolo!ical Inte!rity C!ient 'eed (u#: 'ursin$/)nte$rated Concepts: 6 rsin! /rocess- 2val ation &earnin$ *utcome: ,78= Question . Type: MCSA The n rse is ta)in! the initial history o$ a patient ad*itted to the hospital $or hypertension. The physician has ordered a %eta8adrener!ic %loc)er. &hich state*ent %y the patient does the n rse reco!nize as *ost si!ni$icant' 1. (I donAt handle stress #ell+ I have a lot o$ diarrhea.( 2. (&hen I have a *i!raine headache5 I need to have the roo* dar)ened.( 3. (My $ather died o$ a heart attac) #hen he #as 0>8years8old.( 4. (I have al#ays had pro%le*s #ith *y asth*a.( Correct Answer: 0 ationa!e 1- &ith increased doses5 %eta8adrener!ic %loc)ers can slo# the heart rate and ca se %ronchoconstriction. They sho ld %e sed #ith ca tion in patients #ith asth*a. .eta8adrener!ic %loc)ers do not a$$ect *i!raine headaches. Havin! a $ather #ho died o$ a heart attac) #hen he #as yo n! is si!ni$icant5 % t has no correlation to this patient and se o$ %eta8adrener!ic %loc)ers. There is no correlation %et#een increased stress5 diarrhea5 and %eta8adrener!ic %loc)ers. ationa!e 2- &ith increased doses5 %eta8adrener!ic %loc)ers can slo# the heart rate and ca se %ronchoconstriction. They sho ld %e sed #ith ca tion in patients #ith asth*a. .eta8adrener!ic %loc)ers do not a$$ect *i!raine headaches. Havin! a $ather #ho died o$ a heart attac) #hen he #as yo n! is si!ni$icant5 % t has
Ada*s, Pharmacology for Nurse: A Pathophysiologic Approach, 012 Copyri!ht ,340 %y /earson 2d cation5 Inc.

no correlation to this patient and se o$ %eta8adrener!ic %loc)ers. There is no correlation %et#een increased stress5 diarrhea5 and %eta8adrener!ic %loc)ers. ationa!e 3- &ith increased doses5 %eta8adrener!ic %loc)ers can slo# the heart rate and ca se %ronchoconstriction. They sho ld %e sed #ith ca tion in patients #ith asth*a. .eta8adrener!ic %loc)ers do not a$$ect *i!raine headaches. Havin! a $ather #ho died o$ a heart attac) #hen he #as yo n! is si!ni$icant5 % t has no correlation to this patient and se o$ %eta8adrener!ic %loc)ers. There is no correlation %et#een increased stress5 diarrhea5 and %eta8adrener!ic %loc)ers. ationa!e 4- &ith increased doses5 %eta8adrener!ic %loc)ers can slo# the heart rate and ca se %ronchoconstriction. They sho ld %e sed #ith ca tion in patients #ith asth*a. .eta8adrener!ic %loc)ers do not a$$ect *i!raine headaches. Havin! a $ather #ho died o$ a heart attac) #hen he #as yo n! is si!ni$icant5 % t has no correlation to this patient and se o$ %eta8adrener!ic %loc)ers. There is no correlation %et#een increased stress5 diarrhea5 and %eta8adrener!ic %loc)ers. "!o#a! ationa!e: Co$niti%e &e%e!: Analyzin! C!ient 'eed: /hysiolo!ical Inte!rity C!ient 'eed (u#: 'ursin$/)nte$rated Concepts: 6 rsin! /rocess- Assess*ent &earnin$ *utcome: ,78: Question / Type: MCSA &hat is a priority n rsin! intervention $or a patient #ho has E st %e! n antihypertensive treat*ent #ith enalapril (Hasotec)' 1. Monitor the patient $or headaches. 2. Ta)e the patientAs %lood press re. 3. Irder a sodi *8restricted diet $or the patient. 4. Revie# the patientAs la% res lts $or hypo)ale*ia. Correct Answer: , ationa!e 1- 2nalapril (Hasotec) *ay prod ce a $irst8dose pheno*enon res ltin! in pro$o nd hypotension5 #hich *ay res lt in syncope. 2nalapril (Hasotec) is *ore li)ely to ca se hyper)ale*ia5 not hypo)ale*ia. 2nalapril (Hasotec) does not a$$ect sodi * levels. Altho !h headache is a side e$$ect5 it is not as %i! a priority as pro$o nd hypotension. ationa!e 2- 2nalapril (Hasotec) *ay prod ce a $irst8dose pheno*enon res ltin! in pro$o nd hypotension5 #hich *ay res lt in syncope. 2nalapril (Hasotec) is *ore li)ely to ca se hyper)ale*ia5 not hypo)ale*ia. 2nalapril (Hasotec) does not a$$ect sodi * levels. Altho !h headache is a side e$$ect5 it is not as %i! a priority as pro$o nd hypotension.
Ada*s, Pharmacology for Nurse: A Pathophysiologic Approach, 012 Copyri!ht ,340 %y /earson 2d cation5 Inc.

ationa!e 3- 2nalapril (Hasotec) *ay prod ce a $irst8dose pheno*enon res ltin! in pro$o nd hypotension5 #hich *ay res lt in syncope. 2nalapril (Hasotec) is *ore li)ely to ca se hyper)ale*ia5 not hypo)ale*ia. 2nalapril (Hasotec) does not a$$ect sodi * levels. Altho !h headache is a side e$$ect5 it is not as %i! a priority as pro$o nd hypotension. ationa!e 4- 2nalapril (Hasotec) *ay prod ce a $irst8dose pheno*enon res ltin! in pro$o nd hypotension5 #hich *ay res lt in syncope. 2nalapril (Hasotec) is *ore li)ely to ca se hyper)ale*ia5 not hypo)ale*ia. 2nalapril (Hasotec) does not a$$ect sodi * levels. Altho !h headache is a side e$$ect5 it is not as %i! a priority as pro$o nd hypotension. "!o#a! ationa!e: Co$niti%e &e%e!: Applyin! C!ient 'eed: /hysiolo!ical Inte!rity C!ient 'eed (u#: 'ursin$/)nte$rated Concepts: 6 rsin! /rocess- /lannin! &earnin$ *utcome: ,78> Question 10 Type: MCSA The patient co*es to the e*er!ency depart*ent #ith a %lood press re o$ ,3314,3 **H!. The physician orders hydralazine (Apresoline) IH. &hat #ill the n rseAs priority assess*ent incl de' 1. Hypotension and %radycardia 2. Hypotension and hyperther*ia 3. Hypotension and tachycardia 4. Hypotension and tachypnea Correct Answer: 9 ationa!e 1- Direct vasodilators prod ce re$le; tachycardia5 a co*pensatory response to the s dden decrease in %lood press re ca sed %y the dr !. Direct vasodilators prod ce hypotension and tachycardia5 not %radycardia. Direct vasodilators do not a$$ect %ody te*perat re. Direct vasodilators do not a$$ect respiratory rate. ationa!e 2- Direct vasodilators prod ce re$le; tachycardia5 a co*pensatory response to the s dden decrease in %lood press re ca sed %y the dr !. Direct vasodilators prod ce hypotension and tachycardia5 not %radycardia. Direct vasodilators do not a$$ect %ody te*perat re. Direct vasodilators do not a$$ect respiratory rate. ationa!e 3- Direct vasodilators prod ce re$le; tachycardia5 a co*pensatory response to the s dden decrease in %lood press re ca sed %y the dr !. Direct vasodilators prod ce hypotension and tachycardia5 not %radycardia. Direct vasodilators do not a$$ect %ody te*perat re. Direct vasodilators do not a$$ect respiratory rate.

Ada*s, Pharmacology for Nurse: A Pathophysiologic Approach, 012 Copyri!ht ,340 %y /earson 2d cation5 Inc.

ationa!e 4- Direct vasodilators prod ce re$le; tachycardia5 a co*pensatory response to the s dden decrease in %lood press re ca sed %y the dr !. Direct vasodilators prod ce hypotension and tachycardia5 not %radycardia. Direct vasodilators do not a$$ect %ody te*perat re. Direct vasodilators do not a$$ect respiratory rate. "!o#a! ationa!e: Co$niti%e &e%e!: Applyin! C!ient 'eed: /hysiolo!ical Inte!rity C!ient 'eed (u#: 'ursin$/)nte$rated Concepts: 6 rsin! /rocess- Assess*ent &earnin$ *utcome: ,78? Question 11 Type: MCSA The n rse co*pleted *edication ed cation #ith the patient #ho receives hydrochlorothiazide (HydroDIURIL). The n rse deter*ines that teachin! has %een e$$ective #hen the patient *a)es #hich state*ent' 1. (I really need to avoid !rape$r it E ice #hen I ta)e this *edication.( 2. (I need to avoid salt s %stit tes and potassi *8rich $oods.( 3. (I ta)e *y *edication early in the *ornin!.( 4. (I$ I develop a co !h5 I sho ld call *y doctor.( Correct Answer: 9 ationa!e 1- Ta)in! hydrochlorothiazide (HydroDIURIL) early in the day #ill help prevent noct ria. Hydrochlorothiazide (HydroDIURIL) is a potassi *8e;cretin! di retic and potassi * s pple*entation is o$ten necessary. Develop*ent o$ a co !h occ rs #ith AC2 Inhi%itors5 not di retics. Frape$r it E ice inhi%its the *eta%olis* o$ the calci * channel %loc)ers. ationa!e 2- Ta)in! hydrochlorothiazide (HydroDIURIL) early in the day #ill help prevent noct ria. Hydrochlorothiazide (HydroDIURIL) is a potassi *8e;cretin! di retic and potassi * s pple*entation is o$ten necessary. Develop*ent o$ a co !h occ rs #ith AC2 Inhi%itors5 not di retics. Frape$r it E ice inhi%its the *eta%olis* o$ the calci * channel %loc)ers. ationa!e 3- Ta)in! hydrochlorothiazide (HydroDIURIL) early in the day #ill help prevent noct ria. Hydrochlorothiazide (HydroDIURIL) is a potassi *8e;cretin! di retic and potassi * s pple*entation is o$ten necessary. Develop*ent o$ a co !h occ rs #ith AC2 Inhi%itors5 not di retics. Frape$r it E ice inhi%its the *eta%olis* o$ the calci * channel %loc)ers. ationa!e 4- Ta)in! hydrochlorothiazide (HydroDIURIL) early in the day #ill help prevent noct ria. Hydrochlorothiazide (HydroDIURIL) is a potassi *8e;cretin! di retic and potassi * s pple*entation is o$ten necessary. Develop*ent o$ a co !h occ rs #ith AC2 Inhi%itors5 not di retics. Frape$r it E ice inhi%its the *eta%olis* o$ the calci * channel %loc)ers.
Ada*s, Pharmacology for Nurse: A Pathophysiologic Approach, 012 Copyri!ht ,340 %y /earson 2d cation5 Inc.

"!o#a! ationa!e: Co$niti%e &e%e!: Applyin! C!ient 'eed: /hysiolo!ical Inte!rity C!ient 'eed (u#: 'ursin$/)nte$rated Concepts: 6 rsin! /rocess- 2val ation &earnin$ *utcome: ,78= Question 12 Type: MCSA The n rse is teachin! the patient a%o t li$estyle *odi$ications to help *ana!e the patientAs hypertension. The n rse deter*ines that teachin! has %een e$$ective #hen the patient *a)es #hich state*ent' 1. (I need to !et started on *y *edications ri!ht a#ay.( 2. (My $ather had hypertension5 did nothin!5 and lived to %e :38years8old.( 3. (I )no# I need to !ive p *y ci!arettes and alcohol.( 4. (I #onAt %e a%le to r n in the *arathon race any*ore.( Correct Answer: 9 ationa!e 1- Li*itin! inta)e o$ alcohol and discontin in! to%acco prod cts are i*portant nonphar*acolo!ical *ethods $or controllin! hypertension. I*ple*entin! li$estyle *odi$ications *ay eli*inate the need $or phar*acotherapy5 so the patient *ay not have to ta)e *edication ri!ht a#ay. Increasin! physical activity is an i*portant li$estyle *odi$ication $or controllin! hypertension. The $act that the patientAs $ather had hypertension and lived to %e :38years8old does not *ean that the patient #ill have the sa*e e;perience+ the patient is in denial. ationa!e 2- Li*itin! inta)e o$ alcohol and discontin in! to%acco prod cts are i*portant nonphar*acolo!ical *ethods $or controllin! hypertension. I*ple*entin! li$estyle *odi$ications *ay eli*inate the need $or phar*acotherapy5 so the patient *ay not have to ta)e *edication ri!ht a#ay. Increasin! physical activity is an i*portant li$estyle *odi$ication $or controllin! hypertension. The $act that the patientAs $ather had hypertension and lived to %e :38years8old does not *ean that the patient #ill have the sa*e e;perience+ the patient is in denial. ationa!e 3- Li*itin! inta)e o$ alcohol and discontin in! to%acco prod cts are i*portant nonphar*acolo!ical *ethods $or controllin! hypertension. I*ple*entin! li$estyle *odi$ications *ay eli*inate the need $or phar*acotherapy5 so the patient *ay not have to ta)e *edication ri!ht a#ay. Increasin! physical activity is an i*portant li$estyle *odi$ication $or controllin! hypertension. The $act that the patientAs $ather had hypertension and lived to %e :38years8old does not *ean that the patient #ill have the sa*e e;perience+ the patient is in denial. ationa!e 4- Li*itin! inta)e o$ alcohol and discontin in! to%acco prod cts are i*portant nonphar*acolo!ical *ethods $or controllin! hypertension. I*ple*entin! li$estyle *odi$ications *ay eli*inate the need $or phar*acotherapy5 so the patient *ay not have to ta)e *edication ri!ht a#ay. Increasin! physical activity is an i*portant li$estyle *odi$ication $or controllin! hypertension. The $act that the patientAs $ather had hypertension and lived to %e :38years8old does not *ean that the patient #ill have the sa*e e;perience+ the patient is in denial.
Ada*s, Pharmacology for Nurse: A Pathophysiologic Approach, 012 Copyri!ht ,340 %y /earson 2d cation5 Inc.

"!o#a! ationa!e: Co$niti%e &e%e!: Applyin! C!ient 'eed: /hysiolo!ical Inte!rity C!ient 'eed (u#: 'ursin$/)nte$rated Concepts: 6 rsin! /rocess- 2val ation &earnin$ *utcome: ,787 Question 13 Type: MCSA The patient has a ni!htti*e co !h related to ta)in! enalapril (Hasotec). &hat is the %est n rsin! intervention to pro*ote rest in this patient' 1. Have the patient sit p at an >38de!ree an!le in a co*$orta%le chair at ni!ht. 2. Contact the physician $or an order $or a co !h8s ppressant *edication. 3. Have the patient sleep on t#o or three pillo#s at ni!ht. 4. Contact the physician $or an order $or a sedative8hypnotic *edication. Correct Answer: 9 ationa!e 1- The patient sho ld sleep #ith the head elevated i$ a co !h %eco*es tro %leso*e #hen in s pine position. An AC2I8ind ced co !h #ill not %e relieved %y co !h *edication. Sittin! p at an >38de!ree an!le #o ld %e e$$ective5 % t #o ld %e too nco*$orta%le $or the patient. A sedative8hypnotic *edication #o ld p t the patient to sleep5 % t it does nothin! to address the patientAs co !h. ationa!e 2- The patient sho ld sleep #ith the head elevated i$ a co !h %eco*es tro %leso*e #hen in s pine position. An AC2I8ind ced co !h #ill not %e relieved %y co !h *edication. Sittin! p at an >38de!ree an!le #o ld %e e$$ective5 % t #o ld %e too nco*$orta%le $or the patient. A sedative8hypnotic *edication #o ld p t the patient to sleep5 % t it does nothin! to address the patientAs co !h. ationa!e 3- The patient sho ld sleep #ith the head elevated i$ a co !h %eco*es tro %leso*e #hen in s pine position. An AC2I8ind ced co !h #ill not %e relieved %y co !h *edication. Sittin! p at an >38de!ree an!le #o ld %e e$$ective5 % t #o ld %e too nco*$orta%le $or the patient. A sedative8hypnotic *edication #o ld p t the patient to sleep5 % t it does nothin! to address the patientAs co !h. ationa!e 4- The patient sho ld sleep #ith the head elevated i$ a co !h %eco*es tro %leso*e #hen in s pine position. An AC2I8ind ced co !h #ill not %e relieved %y co !h *edication. Sittin! p at an >38de!ree an!le #o ld %e e$$ective5 % t #o ld %e too nco*$orta%le $or the patient. A sedative8hypnotic *edication #o ld p t the patient to sleep5 % t it does nothin! to address the patientAs co !h. "!o#a! ationa!e: Co$niti%e &e%e!: Applyin!
Ada*s, Pharmacology for Nurse: A Pathophysiologic Approach, 012 Copyri!ht ,340 %y /earson 2d cation5 Inc.

C!ient 'eed: /hysiolo!ical Inte!rity C!ient 'eed (u#: 'ursin$/)nte$rated Concepts: 6 rsin! /rocess- I*ple*entation &earnin$ *utcome: ,78> Question 14 Type: MCSA The patient #ith hypertension has e;perienced heart $ail re. The n rse notes that the patient is receivin! ne$edipine (/rocardia). &hat is a priority assess*ent $or the n rse' 1. Revie# recent la% res lts $or hypo)ale*ia. 2. Assess rinary o tp t. 3. Assess level o$ orientation. 4. A sc ltate %reath so nds $or crac)les. Correct Answer: 0 ationa!e 1- So*e calci * channel %loc)ers can red ce *yocardial contractility and can #orsen heart $ail re. Crac)les in the l n!s can indicate p l*onary ede*a #hich co ld indicate heart $ail re. Calci * channel %loc)ers do not ca se hypo)ale*ia. Level o$ orientation *ay %e decreased #ith heart $ail re5 % t it is not a priority assess*ent at this ti*e. Urinary o tp t *ay %e decreased #ith heart $ail re5 % t it is not a priority assess*ent at this ti*e. ationa!e 2- So*e calci * channel %loc)ers can red ce *yocardial contractility and can #orsen heart $ail re. Crac)les in the l n!s can indicate p l*onary ede*a #hich co ld indicate heart $ail re. Calci * channel %loc)ers do not ca se hypo)ale*ia. Level o$ orientation *ay %e decreased #ith heart $ail re5 % t it is not a priority assess*ent at this ti*e. Urinary o tp t *ay %e decreased #ith heart $ail re5 % t it is not a priority assess*ent at this ti*e. ationa!e 3- So*e calci * channel %loc)ers can red ce *yocardial contractility and can #orsen heart $ail re. Crac)les in the l n!s can indicate p l*onary ede*a #hich co ld indicate heart $ail re. Calci * channel %loc)ers do not ca se hypo)ale*ia. Level o$ orientation *ay %e decreased #ith heart $ail re5 % t it is not a priority assess*ent at this ti*e. Urinary o tp t *ay %e decreased #ith heart $ail re5 % t it is not a priority assess*ent at this ti*e. ationa!e 4- So*e calci * channel %loc)ers can red ce *yocardial contractility and can #orsen heart $ail re. Crac)les in the l n!s can indicate p l*onary ede*a #hich co ld indicate heart $ail re. Calci * channel %loc)ers do not ca se hypo)ale*ia. Level o$ orientation *ay %e decreased #ith heart $ail re5 % t it is not a priority assess*ent at this ti*e. Urinary o tp t *ay %e decreased #ith heart $ail re5 % t it is not a priority assess*ent at this ti*e. "!o#a! ationa!e: Co$niti%e &e%e!: Applyin!
Ada*s, Pharmacology for Nurse: A Pathophysiologic Approach, 012 Copyri!ht ,340 %y /earson 2d cation5 Inc.

C!ient 'eed: /hysiolo!ical Inte!rity C!ient 'eed (u#: 'ursin$/)nte$rated Concepts: 6 rsin! /rocess- Assess*ent &earnin$ *utcome: ,78: Question 15 Type: MCSA The patient is receivin! do;azosin (Card ra) $or hypertension. He as)s the n rse ho# the *edication #or)s. &hat is the n rseAs %est response' 1. (It #or)s %y ca sin! yo r )idneys to e;crete *ore rine.( 2. (It #or)s %y *a)in! yo r heart #or) *ore e$$iciently.( 3. (It #or)s %y *a)in! yo r %lood vessels e;pand.( 4. (It #or)s %y decreasin! the release o$ yo r stress hor*ones.( Correct Answer: 9 ationa!e 1- Do;azosin (Card ra) is selective $or %loc)in! alpha48receptors in vasc lar s*ooth * scle5 #hich res lts in dilation o$ arteries and veins. 2;cretin! *ore rine is an e$$ect o$ di retic *edications. Increasin! the e$$iciency o$ the heart is not an e$$ect o$ do;azosin (Card ra). Decreasin! the release o$ stress hor*ones is not an e$$ect o$ do;azosin (Card ra). ationa!e 2- Do;azosin (Card ra) is selective $or %loc)in! alpha48receptors in vasc lar s*ooth * scle5 #hich res lts in dilation o$ arteries and veins. 2;cretin! *ore rine is an e$$ect o$ di retic *edications. Increasin! the e$$iciency o$ the heart is not an e$$ect o$ do;azosin (Card ra). Decreasin! the release o$ stress hor*ones is not an e$$ect o$ do;azosin (Card ra). ationa!e 3- Do;azosin (Card ra) is selective $or %loc)in! alpha48receptors in vasc lar s*ooth * scle5 #hich res lts in dilation o$ arteries and veins. 2;cretin! *ore rine is an e$$ect o$ di retic *edications. Increasin! the e$$iciency o$ the heart is not an e$$ect o$ do;azosin (Card ra). Decreasin! the release o$ stress hor*ones is not an e$$ect o$ do;azosin (Card ra). ationa!e 4- Do;azosin (Card ra) is selective $or %loc)in! alpha48receptors in vasc lar s*ooth * scle5 #hich res lts in dilation o$ arteries and veins. 2;cretin! *ore rine is an e$$ect o$ di retic *edications. Increasin! the e$$iciency o$ the heart is not an e$$ect o$ do;azosin (Card ra). Decreasin! the release o$ stress hor*ones is not an e$$ect o$ do;azosin (Card ra). "!o#a! ationa!e: Co$niti%e &e%e!: Applyin! C!ient 'eed: /hysiolo!ical Inte!rity C!ient 'eed (u#: 'ursin$/)nte$rated Concepts:
Ada*s, Pharmacology for Nurse: A Pathophysiologic Approach, 012 Copyri!ht ,340 %y /earson 2d cation5 Inc.

&earnin$ *utcome: ,78> Question 1, Type: MCSA Accordin! to the <6C8=5 a patient #ith a %lood press re o$ 4001>, #o ld %e classi$ied as 1. prehypertensive. 2. sta!e , hypertensive. 3. nor*al. 4. sta!e 4 hypertensive. Correct Answer: 0 ationa!e 1- A systolic %lood press re o$ 403G47: indicates sta!e 4 hypertension. Since the diastolic is in a class lo#er than sta!e 45 the patient is classi$ied as sta!e 4 hypertensive. ationa!e 2- A systolic %lood press re o$ 403G47: indicates sta!e 4 hypertension. Since the diastolic is in a class lo#er than sta!e 45 the patient is classi$ied as sta!e 4 hypertensive. ationa!e 3- A systolic %lood press re o$ 403G47: indicates sta!e 4 hypertension. Since the diastolic is in a class lo#er than sta!e 45 the patient is classi$ied as sta!e 4 hypertensive. ationa!e 4- A systolic %lood press re o$ 403G47: indicates sta!e 4 hypertension. Since the diastolic is in a class lo#er than sta!e 45 the patient is classi$ied as sta!e 4 hypertensive. "!o#a! ationa!e: Co$niti%e &e%e!: Re*e*%erin! C!ient 'eed: /hysiolo!ical Inte!rity C!ient 'eed (u#: 'ursin$/)nte$rated Concepts: 6 rsin! /rocess- Assess*ent &earnin$ *utcome: ,784 Question 1Type: MCSA &hich o$ the $ollo#in! lists incl de the three $actors that *a)e p %lood press re' 1. .lood vol *e5 heart rate5 and stro)e vol *e 2. Cardiac o tp t5 %lood vol *e5 and peripheral vasc lar resistance 3. A!e5 #ei!ht5 and race
Ada*s, Pharmacology for Nurse: A Pathophysiologic Approach, 012 Copyri!ht ,340 %y /earson 2d cation5 Inc.

4. .ody *ass inde;5 diet5 and !enetics Correct Answer: , ationa!e 1- Altho !h *any $actors can contri% te to %lood press re5 s ch as diet and #ei!ht5 it is a personJs cardiac o tp t5 %lood vol *e5 and peripheral vasc lar resistance that create the press re. ationa!e 2- Altho !h *any $actors can contri% te to %lood press re5 s ch as diet and #ei!ht5 it is a personJs cardiac o tp t5 %lood vol *e5 and peripheral vasc lar resistance that create the press re. ationa!e 3- Altho !h *any $actors can contri% te to %lood press re5 s ch as diet and #ei!ht5 it is a personJs cardiac o tp t5 %lood vol *e5 and peripheral vasc lar resistance that create the press re. ationa!e 4- Altho !h *any $actors can contri% te to %lood press re5 s ch as diet and #ei!ht5 it is a personJs cardiac o tp t5 %lood vol *e5 and peripheral vasc lar resistance that create the press re. "!o#a! ationa!e: Co$niti%e &e%e!: Re*e*%erin! C!ient 'eed: /hysiolo!ical Inte!rity C!ient 'eed (u#: 'ursin$/)nte$rated Concepts: 6 rsin! /rocess- 2val ation &earnin$ *utcome: ,789 Question 1. Type: MCSA Di retics are o$ten sed to lo#er %lood press re. &hich $actor do they a$$ect *ost' 1. Cardiac o tp t 2. .lood vol *e 3. Heart rate 4. /eripheral vasc lar resistance Correct Answer: , ationa!e 1- Di retics ca se $l id loss thro !h rination. The decrease in %lood vol *e lo#ers %lood press re. ationa!e 2- Di retics ca se $l id loss thro !h rination. The decrease in %lood vol *e lo#ers %lood press re. ationa!e 3- Di retics ca se $l id loss thro !h rination. The decrease in %lood vol *e lo#ers %lood press re. ationa!e 4- Di retics ca se $l id loss thro !h rination. The decrease in %lood vol *e lo#ers %lood press re. "!o#a! ationa!e:
Ada*s, Pharmacology for Nurse: A Pathophysiologic Approach, 012 Copyri!ht ,340 %y /earson 2d cation5 Inc.

Co$niti%e &e%e!: Understandin! C!ient 'eed: /hysiolo!ical Inte!rity C!ient 'eed (u#: 'ursin$/)nte$rated Concepts: 6 rsin! /rocess- 2val ation &earnin$ *utcome: ,78? Question 1/ Type: MCSA Chan!es in #hich o$ the $ollo#in! #o ld %e sensed %y %aroreceptors and relayed to the vaso*otor center' 1. I;y!enation 2. .lood press re 3. Car%on dio;ide 4. .lood pH Correct Answer: , ationa!e 1- .aroreceptors sense and relay chan!es in %lood press re. Che*oreceptors reco!nize levels o$ o;y!en5 car%on dio;ide5 and pH levels. ationa!e 2- .aroreceptors sense and relay chan!es in %lood press re. Che*oreceptors reco!nize levels o$ o;y!en5 car%on dio;ide5 and pH levels. ationa!e 3- .aroreceptors sense and relay chan!es in %lood press re. Che*oreceptors reco!nize levels o$ o;y!en5 car%on dio;ide5 and pH levels. ationa!e 4- .aroreceptors sense and relay chan!es in %lood press re. Che*oreceptors reco!nize levels o$ o;y!en5 car%on dio;ide5 and pH levels. "!o#a! ationa!e: Co$niti%e &e%e!: Re*e*%erin! C!ient 'eed: /hysiolo!ical Inte!rity C!ient 'eed (u#: 'ursin$/)nte$rated Concepts: 6 rsin! /rocess- 2val ation &earnin$ *utcome: ,780 Question 20 Type: MCSA &hich state*ent is acc rate in re!ard to secondary hypertension'
Ada*s, Pharmacology for Nurse: A Pathophysiologic Approach, 012 Copyri!ht ,340 %y /earson 2d cation5 Inc.

1. There is no )no#n ca se. 2. It can res lt $ro* chronic renal i*pair*ent. 3. It is also )no#n as idiopathic. 4. It acco nts $or :3K o$ all hypertensive cases. Correct Answer: , ationa!e 1- Secondary hypertension has an identi$ia%le ca se5 and acco nts $or 43K o$ all cases. /ri*ary hypertension is )no#n as idiopathic5 and has no )no#n ca se. ationa!e 2- Secondary hypertension has an identi$ia%le ca se5 and acco nts $or 43K o$ all cases. /ri*ary hypertension is )no#n as idiopathic5 and has no )no#n ca se. ationa!e 3- Secondary hypertension has an identi$ia%le ca se5 and acco nts $or 43K o$ all cases. /ri*ary hypertension is )no#n as idiopathic5 and has no )no#n ca se. ationa!e 4- Secondary hypertension has an identi$ia%le ca se5 and acco nts $or 43K o$ all cases. /ri*ary hypertension is )no#n as idiopathic5 and has no )no#n ca se. "!o#a! ationa!e: Co$niti%e &e%e!: Re*e*%erin! C!ient 'eed: /hysiolo!ical Inte!rity C!ient 'eed (u#: 'ursin$/)nte$rated Concepts: 6 rsin! /rocess- 2val ation &earnin$ *utcome: ,784 Question 21 Type: MCSA &hich o$ the $ollo#in! interventions #o ld %e indicated and ta)e hi!hest priority $or a s*o)in! 938year8old $e*ale #ith a .MI o$ ,3 and a %lood press re o$ 49=1>>' 1. S*o)in!8cessation pro!ra* 2. Di retic therapy 3. &ei!ht8loss pro!ra* 4. Stress *ana!e*ent Correct Answer: 4 ationa!e 1- Altho !h #ei!ht *ana!e*ent is very i*portant5 this patient has a nor*al %ody *ass inde; o$ ,3. There$ore5 s*o)in! is the priority. This patient is not necessarily a candidate $or dr ! therapy5 !iven that she is in
Ada*s, Pharmacology for Nurse: A Pathophysiologic Approach, 012 Copyri!ht ,340 %y /earson 2d cation5 Inc.

the prehypertension class. There is nothin! provided in the " estion that indicates the #o*an is s $$erin! $ro* stress. ationa!e 2- Altho !h #ei!ht *ana!e*ent is very i*portant5 this patient has a nor*al %ody *ass inde; o$ ,3. There$ore5 s*o)in! is the priority. This patient is not necessarily a candidate $or dr ! therapy5 !iven that she is in the prehypertension class. There is nothin! provided in the " estion that indicates the #o*an is s $$erin! $ro* stress. ationa!e 3- Altho !h #ei!ht *ana!e*ent is very i*portant5 this patient has a nor*al %ody *ass inde; o$ ,3. There$ore5 s*o)in! is the priority. This patient is not necessarily a candidate $or dr ! therapy5 !iven that she is in the prehypertension class. There is nothin! provided in the " estion that indicates the #o*an is s $$erin! $ro* stress. ationa!e 4- Altho !h #ei!ht *ana!e*ent is very i*portant5 this patient has a nor*al %ody *ass inde; o$ ,3. There$ore5 s*o)in! is the priority. This patient is not necessarily a candidate $or dr ! therapy5 !iven that she is in the prehypertension class. There is nothin! provided in the " estion that indicates the #o*an is s $$erin! $ro* stress. "!o#a! ationa!e: Co$niti%e &e%e!: Understandin! C!ient 'eed: /hysiolo!ical Inte!rity C!ient 'eed (u#: 'ursin$/)nte$rated Concepts: 6 rsin! /rocess- /lannin! &earnin$ *utcome: ,787 and ,78? Question 22 Type: MCSA &hich la%oratory test #o ld %e the priority $or a hypertensive patient ta)in! a thiazide di retic' 1. Ma!nesi * 2. Calci * 3. Chloride 4. /otassi * Correct Answer: 0 ationa!e 1- Sodi * and potassi * are the electrolytes o$ *ost concern. A patient on thiazide di retics sho ld %e *onitored $or hypo)ale*ia. ationa!e 2- Sodi * and potassi * are the electrolytes o$ *ost concern. A patient on thiazide di retics sho ld %e *onitored $or hypo)ale*ia.

Ada*s, Pharmacology for Nurse: A Pathophysiologic Approach, 012 Copyri!ht ,340 %y /earson 2d cation5 Inc.

ationa!e 3- Sodi * and potassi * are the electrolytes o$ *ost concern. A patient on thiazide di retics sho ld %e *onitored $or hypo)ale*ia. ationa!e 4- Sodi * and potassi * are the electrolytes o$ *ost concern. A patient on thiazide di retics sho ld %e *onitored $or hypo)ale*ia. "!o#a! ationa!e: Co$niti%e &e%e!: Re*e*%erin! C!ient 'eed: /hysiolo!ical Inte!rity C!ient 'eed (u#: 'ursin$/)nte$rated Concepts: 6 rsin! /rocess- /lannin! &earnin$ *utcome: ,78> Question 23 Type: MCSA A hypertensive $e*ale patient %ein! treated #ith #hich o$ the $ollo#in! #o ld %e o$ pri*ary concern i$ she %eca*e pre!nant' 1. 2nalapril (Hasotec) 2. /otassi * s pple*ent 3. Do;azosin (Card ra) 4. Hydrochlorothiazide (HCTL) Correct Answer: 4 ationa!e 1- 2nalapril is a /re!nancy Cate!ory D dr ! that has a hi!her $etal ris) than do the other dr !s listed. ationa!e 2- 2nalapril is a /re!nancy Cate!ory D dr ! that has a hi!her $etal ris) than do the other dr !s listed. ationa!e 3- 2nalapril is a /re!nancy Cate!ory D dr ! that has a hi!her $etal ris) than do the other dr !s listed. ationa!e 4- 2nalapril is a /re!nancy Cate!ory D dr ! that has a hi!her $etal ris) than do the other dr !s listed. "!o#a! ationa!e: Co$niti%e &e%e!: Understandin! C!ient 'eed: /hysiolo!ical Inte!rity C!ient 'eed (u#: 'ursin$/)nte$rated Concepts: 6 rsin! /rocess- Assess*ent &earnin$ *utcome: ,78= Question 24
Ada*s, Pharmacology for Nurse: A Pathophysiologic Approach, 012 Copyri!ht ,340 %y /earson 2d cation5 Inc.

Type: S2M The n rse is disc ssin! the lon!8ter* conse" ences o$ ncontrolled hypertension #ith a !ro p o$ patients #ith prehypertension. /lace in order the patholo!ical chan!es that occ r as a res lt o$ ncontrolled hypertension. (tandard Te+t: Clic) and dra! the options %elo# to *ove the* p or do#n. Correct Answer: "!o#a! ationa!e: Co$niti%e &e%e!: Applyin! C!ient 'eed: /hysiolo!ical Inte!rity C!ient 'eed (u#: /hysiolo!ical Adaptation 'ursin$/)nte$rated Concepts: 6 rsin! /rocess- I*ple*entation &earnin$ *utcome: ,78, Question 25 Type: MCMA The n rse is ed catin! a patient #hose %lood press re is 4031:3 **H! on #ays to lo#er %lood press re and avoid hypertension. &hich li$estyle choices *ay eli*inate the need $or phar*acotherapy in this patient' Note: Credit will be given only if all correct choices and no incorrect choices are selected. (tandard Te+t: Select all that apply. 1. Increasin! inta)e o$ #ine 2. Restrictin! salt inta)e 3. Increasin! inta)e o$ red *eat 4. Increasin! activity 5. Stoppin! s*o)in! Correct Answer: ,5057 ationa!e 1- Increasin! the inta)e o$ alcohol5 incl din! #ine5 is not a positive li$estyle chan!e associated #ith the nonphar*acolo!ic treat*ent o$ hypertension. The patient sho ld %e enco ra!ed to decrease the inta)e o$ alcohol. ationa!e 2- Restrictin! sodi * inta)e is a positive li$estyle chan!e associated #ith the nonphar*acolo!ic treat*ent o$ hypertension. ationa!e 3- Increasin! the inta)e o$ sat rated $at is not a positive li$estyle chan!e associated #ith the nonphar*acolo!ic treat*ent o$ hypertension. The patient sho ld %e enco ra!ed to decrease the inta)e o$ red *eat and other so rces o$ sat rated $at.
Ada*s, Pharmacology for Nurse: A Pathophysiologic Approach, 012 Copyri!ht ,340 %y /earson 2d cation5 Inc.

ationa!e 4- Increased activity5 especially aero%ic activity5 is a positive li$estyle chan!e associated #ith the nonphar*acolo!ic treat*ent o$ hypertension. ationa!e 5- 2li*inatin! to%acco prod cts is a positive li$estyle chan!e associated #ith the nonphar*acolo!ic treat*ent o$ hypertension. "!o#a! ationa!e: Co$niti%e &e%e!: Analyzin! C!ient 'eed: Health /ro*otion and Maintenance C!ient 'eed (u#: 'ursin$/)nte$rated Concepts: 6 rsin! /rocess- /lannin! &earnin$ *utcome: ,789 Question 2, Type: MCMA The n rse is ed catin! a patient #ho has %een dia!nosed #ith hypertension and e;plains that the criteria that #ill %e sed to deter*ine *edication *ana!e*ent incl de the patientAs Note: Credit will be given only if all correct choices and no incorrect choices are selected. (tandard Te+t: Select all that apply. 1. ris) $actors. 2. co*or%id *edical conditions. 3. a!e. 4. de!ree o$ %lood press re elevation. 5. occ pational stat s. Correct Answer: 45,50 ationa!e 1- The patientAs ris) $actors ! ide the phar*acotherapy o$ hypertension. ationa!e 2- The patientAs co*or%id *edical conditions ! ide the phar*acotherapy o$ hypertension. ationa!e 3- The patientAs a!e is not a $actor in the phar*acotherapy o$ hypertension. ationa!e 4- The patientAs de!ree o$ hypertension ! ides the phar*acotherapy o$ hypertension. ationa!e 5- The patientAs c rrent occ pation is not a $actor in the phar*acotherapy o$ hypertension. "!o#a! ationa!e:
Ada*s, Pharmacology for Nurse: A Pathophysiologic Approach, 012 Copyri!ht ,340 %y /earson 2d cation5 Inc.

Co$niti%e &e%e!: Applyin! C!ient 'eed: /hysiolo!ical Inte!rity C!ient 'eed (u#: /har*acolo!ical and /arenteral Therapies 'ursin$/)nte$rated Concepts: 6 rsin! /rocess- I*ple*entation &earnin$ *utcome: ,780 Question 2Type: MCMA The n rse is carin! $or an A$rican A*erican *ale #ho has E st %een dia!nosed #ith hypertension. The n rse anticipates that this patient #ill %e started on #hich *edications' Note: Credit will be given only if all correct choices and no incorrect choices are selected. (tandard Te+t: Select all that apply. 1. A thiazide di retic 2. A calci * channel %loc)er 3. An AC2 inhi%itor 4. A %eta8adrener!ic anta!onist 5. An an!iotensin8II receptor %loc)er Correct Answer: 45, ationa!e 1- Thiazide di retics see* to provide the !reatest %lood press re red ction in this pop lation. ationa!e 2- Calci * channel %loc)ers see* to provide the !reatest %lood press re red ction in this pop lation. ationa!e 3- Monotherapy #ith AC2 inhi%itors does not red ce %lood press re as e$$ectively in A$rican A*ericans as in other !ro ps. ationa!e 4- Monotherapy #ith %eta8adrener!ic anta!onists does not red ce %lood press re as e$$ectively in A$rican A*ericans as in other !ro ps. ationa!e 5- Monotherapy #ith an!iotensin8II receptor %loc)ers does not red ce %lood press re as e$$ectively in A$rican A*ericans as in other !ro ps. "!o#a! ationa!e: Co$niti%e &e%e!: Applyin! C!ient 'eed: /hysiolo!ical Inte!rity C!ient 'eed (u#: /har*acolo!ical and /arenteral Therapies
Ada*s, Pharmacology for Nurse: A Pathophysiologic Approach, 012 Copyri!ht ,340 %y /earson 2d cation5 Inc.

'ursin$/)nte$rated Concepts: 6 rsin! /rocess- /lannin! &earnin$ *utcome: ,780 Question 2. Type: MCMA A patient is ne#ly dia!nosed #ith hypertension and dia%etes. &hich classes o$ dr !s are li)ely to %e prescri%ed' Note: Credit will be given only if all correct choices and no incorrect choices are selected. (tandard Te+t: Select all that apply. 1. AC2 inhi%itors 2. .eta %loc)ers 3. Thiazide di retics 4. Calci * channel %loc)ers 5. An!iotensin receptor %loc)ers (AR.s) Correct Answer: 457 ationa!e 1- AC2 inhi%itors protect the )idneys in patients #ith dia%etes. <6C HI reco**ends that patients #ith other co*pellin! $actors %e !iven an antihypertensive that also treats the (other( $actors. ationa!e 2- .eta %loc)ers treat hypertension % t do not help dia%etes and can *as) si!ns o$ hypo!lyce*ia. ationa!e 3- Thiazide di retics treat hypertension5 % t do not help dia%etes. ationa!e 4- Calci * channel %loc)ers treat hypertension5 % t do not help dia%etes. ationa!e 5- AR.s protect the )idneys in patients #ith dia%etes. <6C HI reco**ends that patients #ith other co*pellin! $actors %e !iven an antihypertensive that also treats the (other( $actors. "!o#a! ationa!e: Co$niti%e &e%e!: Applyin! C!ient 'eed: /hysiolo!ical Inte!rity C!ient 'eed (u#: /har*acolo!ical and /arenteral Therapies 'ursin$/)nte$rated Concepts: 6 rsin! /rocess- /lannin! &earnin$ *utcome: ,787 Question 2/ Type: MCMA
Ada*s, Pharmacology for Nurse: A Pathophysiologic Approach, 012 Copyri!ht ,340 %y /earson 2d cation5 Inc.

The n rse is carin! $or a patient recently dia!nosed #ith hypertension. The patient as)s #hat *edications *ay %e sed to treat the condition. The n rse %e!ins %y disc ssin! the pri*ary antihypertensive a!ents5 #hich incl de Note: Credit will be given only if all correct choices and no incorrect choices are selected. (tandard Te+t: Select all that apply. 1. di retics. 2. an!iotensin8II receptor %loc)ers (AR.s). 3. %eta8adrener!ic anta!onists. 4. direct8actin! vasodilators. 5. peripheral adrener!ic anta!onists. Correct Answer: 45,59 ationa!e 1- Di retics are considered a pri*ary antihypertensive a!ent and sho ld %e disc ssed #ith this patient. ationa!e 2- AR.s are considered a pri*ary antihypertensive a!ent and sho ld %e disc ssed #ith this patient. ationa!e 3- .eta8adrener!ic anta!onists are considered a pri*ary antihypertensive a!ent and sho ld %e disc ssed #ith this patient. ationa!e 4- Direct8actin! vasodilators are considered an alternative antihypertensive *edication and are prescri%ed only #hen $irst8line a!ents do not prod ce a satis$actory response. ationa!e 5- /eripheral adrener!ic anta!onists are considered an alternative antihypertensive *edication and are prescri%ed only #hen $irst8line a!ents do not prod ce a satis$actory response. "!o#a! ationa!e: Co$niti%e &e%e!: Applyin! C!ient 'eed: /hysiolo!ical Inte!rity C!ient 'eed (u#: /har*acolo!ical and /arenteral Therapies 'ursin$/)nte$rated Concepts: 6 rsin! /rocess- I*ple*entation &earnin$ *utcome: ,787

Ada*s, Pharmacology for Nurse: A Pathophysiologic Approach, 012 Copyri!ht ,340 %y /earson 2d cation5 Inc.