A patient is diagnosed with hypertension.
What is the initial recommendation for this patient likely to be?
Angiotensin-converting enzyme (ACE) inhibitor.
Combination diuretic.
Beta-adrenergic blocking agent.
Diet and exercise.
The Correct Answer is D
According to the International Society of Hypertension, lifestyle interventions are recommended for three to six months before medication in patients with grade 1 hypertension (BP < 160/100 mm Hg) and no comorbidities. Diet and exercise can lower BP by reducing weight, sodium intake, alcohol consumption, and stress levels.
Choice A is wrong because angiotensin-converting enzyme (ACE) inhibitors are not the first-line medication for hypertension in the general population. They are preferred in patients with diabetes, chronic kidney disease, or heart failure.
Choice B is wrong because combination diuretics are not the initial recommendation for hypertension. They are used when monotherapy is not sufficient to achieve the target BP or when there is fluid retention.
Choice C is wrong because beta-adrenergic blocking agents are not the first-line medication for hypertension in the general population. They are preferred in patients with ischemic heart disease, heart failure, or arrhythmias.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Alpha 1 adrenergic blocking agents have a vasodilating effect and can be used for the management of hypertension.They work by preventing the hormone norepinephrine from tightening the muscles in the walls of smaller arteries and veins, thus lowering the blood pressure.Some examples of alpha 1 blockers are doxazosin, prazosin, and terazosin.
Choice A is wrong because alpha 3 adrenergic blockers do not exist.There are only two subtypes of alpha receptors: alpha 1 and alpha 2.
Choice B is wrong because alpha 2 adrenergic antagonists are not used for hypertension.They are used for conditions like attention deficit hyperactivity disorder (ADHD) and opioid withdrawal.Alpha 2 antagonists block the negative feedback mechanism of norepinephrine release, thus increasing the amount of norepinephrine in the blood and raising the blood pressure.
Choice C is wrong because alpha 1 adrenergic agonists have the opposite effect of alpha 1 blockers.They stimulate the alpha 1 receptors and cause vasoconstriction, which increases the blood pressure.Alpha 1 agonists are used for conditions like nasal congestion and hypotension.
Correct Answer is C
Explanation
Digibind is the trade name forantidigoxin, which is an antibody made up of anti-digoxin immunoglobulin fragments.It is thespecific antidoteto digoxin toxicity, which can occur even when the serum digoxin concentration is within the therapeutic range.Digoxin toxicity causes anorexia, nausea, vomiting, neurological symptoms and arrhythmias.
Choice A, Protamine sulfate, is wrong because it is the antidote for heparin overdose, not digoxin toxicity.
Protamine sulfate reverses the anticoagulant effect of heparin by binding to it and forming a stable complex.
Choice B, Acetylcysteine, is wrong because it is the antidote for acetaminophen overdose, not digoxin toxicity.
Acetylcysteine replenishes glutathione, which is depleted by acetaminophen metabolites that cause hepatotoxicity.
Choice D, Vitamin K, is wrong because it is the antidote for warfarin overdose, not digoxin toxicity.
Vitamin K restores the synthesis of clotting factors that are inhibited by warfarin.
Normal ranges for serum digoxin concentration are 0.6 to 1.2 nanomol/L (0.5 to 0.9 nanograms/mL) for heart failure and unknown for atrial fibrillation without heart failure.
Normal ranges for serum potassium level are 3.5 to 5.0 mmol/L and for serum magnesium level are 0.7 to 1.0 mmol/L.
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