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 B
Explanation
Vitamin K is the antidote for warfarin toxicity because it can reverse the effects of warfarin by restoring the clotting factors.Warfarin is an oral anticoagulant that works by inhibiting vitamin K epoxide reductase, an enzyme that activates vitamin K in the body.Vitamin K is needed for the synthesis of active coagulation factors, such as II, VII, IX and X.By blocking vitamin K, warfarin reduces the blood’s clotting activity and prevents the formation of blood clots.
Choice A is wrong because vitamin B12 is not involved in the coagulation cascade.Vitamin B12 is mainly involved in DNA synthesis, red blood cell production and nerve function.
Choice C is wrong because calcium gluconate is not an antidote for warfarin toxicity.Calcium gluconate is used to treat low blood calcium levels or hypocalcemia.Calcium is also a cofactor for some coagulation factors, but it does not reverse the effects of warfarin.
Choice D is wrong because protamine sulfate is not an antidote for warfarin toxicity.
Protamine sulfate is used to reverse the effects of heparin, another type of anticoagulant that works by inhibiting thrombin and factor Xa.
Protamine sulfate does not affect the vitamin K-dependent coagulation factors that are inhibited by warfarin.
Normal ranges for coagulation tests that are affected by warfarin are:
• Prothrombin time (PT): 11 to 13.5 seconds
• International normalized ratio (INR): 0.8 to 1.2
• Activated partial thromboplastin time (aPTT): 25 to 35 seconds
Correct Answer is B
Explanation
Class IV antidysrhythmics or calcium channel blockers have the action ofdecreasing the flow of calcium ionsinto the cardiac and vascular smooth muscle cells, thusdecreasing heart rate and contractions.
This leads to vasodilation and myocardial depression, which can help control arrhythmias, hypertension and angina.
Choice A is wrong because calcium channel blockers do not increase blood vessel spasm, but rather relax them by inhibiting the calcium influx that causes contraction.
Choice C is wrong because calcium channel blockers do not promote platelet aggregation, but rather inhibit it by interfering with the calcium-dependent binding of fibrinogen to platelets.
Choice D is wrong because calcium channel blockers do not enhance sympathetic nervous system activity, but rather counteract it by reducing the cardiac output and peripheral resistance.
Some normal ranges for reference are:
• Heart rate: 60-100 beats per minute
• Blood pressure: 120/80 mmHg
• Calcium: 8.5-10.5 mg/dL
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