Antohypertensives

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Sample questions from Antohypertensives

This material has 90 questions with answers and rationales. Here are the first 5.

1. 1.At change of shift on a medical unit, a 68-year-old client with hypertension has a BP of 86/50 mm Hg, HR 54/min, and dizziness after receiving metoprolol. Which action should the nurse take first?

   • A.Document the findings and reassess in 1 hour
   • B.Give the next scheduled metoprolol dose with food
   • C.Encourage the client to walk to improve circulation
   • D.Assist the client to lie supine and assess perfusion and symptoms

   Rationale: The symptomatic hypotension and bradycardia require immediate safety measures and assessment; lying supine can support perfusion while the nurse evaluates the client. Giving another dose could worsen both findings, and walking increases fall risk. Waiting an hour to reassess delays evaluation of a potentially unstable client.

2. 2.During a home visit, a 72-year-old client taking lisinopril reports several new symptoms. The BP is 128/76 mm Hg, and the client has no respiratory distress. Which findings should the nurse instruct the client to report immediately? Select all that apply.

   • A.Difficulty breathing
   • B.Mild dizziness when standing that resolves promptly
   • C.A potassium level of 6.0 mEq/L on today's laboratory report
   • D.A persistent dry cough
   • E.Swelling of the lips or tongue
   • F.A new hoarse voice with throat tightness

   Rationale: Lip or tongue swelling, breathing difficulty, and throat tightness with hoarseness may signal angioedema and require emergency assessment. A potassium level of 6.0 mEq/L is dangerous hyperkalemia and needs prompt provider notification. A persistent dry cough is a recognized adverse effect to discuss with the prescriber but is not, by itself, an immediate emergency; brief postural dizziness warrants safety counseling and assessment but is less urgent than airway compromise or severe hyperkalemia.

3. 3.In the intensive care unit, a 59-year-old client receiving an IV nitroprusside infusion for a hypertensive emergency develops confusion and a rising lactate level. Which action has priority?

   • A.Recheck the lactate level at the end of the shift
   • B.Stop the infusion and notify the provider immediately
   • C.Increase the infusion to lower the BP more rapidly
   • D.Administer the next oral antihypertensive dose

   Rationale: New confusion and rising lactate during nitroprusside therapy raise concern for serious toxicity, including cyanide accumulation, so the infusion should be stopped and the provider notified promptly. Increasing the infusion could worsen toxicity and hypotension. Oral therapy or delayed laboratory reassessment does not address the immediate change in condition.

4. 4.A 45-year-old client is being discharged from a hospital after starting amlodipine for hypertension. Which instructions should the nurse include? Select all that apply.

   • A.Expect a persistent cough as a common effect
   • B.Report new or worsening ankle swelling
   • C.Discuss bothersome flushing or headache with the prescriber
   • D.Change positions slowly if lightheaded
   • E.Stop the medication once home BP readings are normal
   • F.Continue checking BP as directed

   Answer and rationale are in the full material.

5. 5.A provider prescribes an oral antihypertensive for a 37-year-old client whose BP is 188/112 mm Hg in an outpatient clinic. The client reports taking sildenafil 2 hours ago and has no symptoms of acute organ injury. Which prescription should the nurse question before administration?

   • A.Oral captopril
   • B.Oral amlodipine
   • C.Sublingual nifedipine immediate-release
   • D.Oral labetalol

   Answer and rationale are in the full material.