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 A
Explanation
Atorvastatin is a type ofstatin, which are the most potent antilipidemic agents, and have proven to lower the risk of myocardial infarction by reducing the levels of low-density lipoprotein (LDL) cholesterol and triglycerides in the blood.Statins also slightly increase the level of high-density lipoprotein (HDL) cholesterol, which is beneficial for cardiovascular health.
Choice B, niacin, is a type ofnicotinic acid, which can lower LDL cholesterol and triglycerides, and increase HDL cholesterol, but it is less effective than statins and has more side effects, such as flushing, itching, and liver toxicity.
Choice C, gemfibrozil, is a type offibric acid derivative, which can lower triglycerides and increase HDL cholesterol, but have little effect on LDL cholesterol.They are mainly used for patients with high triglyceride levels or low HDL cholesterol levels.
Choice D, amlodipine, is not an antilipidemic agent at all.It is a type ofcalcium channel blocker, which is used to treat hypertension and angina by relaxing the blood vessels and reducing the workload of the heart.
Correct Answer is A
Explanation
This is because low potassium levels (hypokalemia) increase the sensitivity of the heart to digoxin and can lead to toxicity even with normal serum digoxin levels. Digoxin inhibits the sodium-potassium pump on the cardiac cells, which causes potassium to accumulate outside the cells.Low potassium levels in the blood create a larger gradient for potassium to move out of the cells, which enhances the effect of digoxin and can cause arrhythmias.
Choice B is wrong because calcium 9.2 mg/dL is within the normal range (8.5 to 10.2 mg/dL) and does not increase the risk of digoxin toxicity.However, high calcium levels (hypercalcemia) can potentiate the effects of digoxin and cause toxicity.
Choice C is wrong because sodium 140 mEq/L is within the normal range (135 to 145 mEq/L) and does not increase the risk of digoxin toxicity.However, high sodium levels (hypernatremia) can reduce the binding of digoxin to the sodium-potassium pump and decrease its efficacy.
Choice D is wrong because magnesium 2.2 mg/dL is within the normal range (1.7 to 2.4 mg/dL) and does not increase the risk of digoxin toxicity.However, low magnesium levels (hypomagnesemia) can increase the sensitivity of the heart to digoxin and cause toxicity.
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