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
Intermittent claudication is a condition where leg pain is produced upon increased activity and ischemia to tissues, but then the pain is reduced with rest.This is because the lack of oxygen to the muscles causes pain, and resting allows the blood flow to resume.
Choice B, sporadic ischemia, is wrong because it is not a specific condition, but a general term for reduced blood supply to a tissue or organ.
Choice C, angina, is wrong because it is a chest pain caused by reduced blood flow to the heart, not the legs.
Choice D, paresthesia, is wrong because it is a sensation of tingling, numbness, or prickling in the skin, not pain.
It can be caused by various conditions, such as nerve damage, diabetes, or Raynaud’s disease.
Correct Answer is B
Explanation
Diuretics are drugs that increase the amount of urine and salt (sodium) excreted by the kidneys. They are used to treat high blood pressure, heart failure, and edema (fluid retention). However, some diuretics can cause low levels of potassium in the blood (hypokalemia), which can lead to muscle weakness, cramps, and arrhythmias. To prevent this, a combination of diuretics acting on different parts of the kidney (such as a loop diuretic and a thiazide diuretic) may be prescribed.This way, the potassium-sparing effect of one diuretic can balance the potassium-wasting effect of the other, while still achieving a net sodium loss.
Choice A is wrong because they are not a part of the initial diuretic therapy.Combination diuretic therapy is usually reserved for patients who are resistant to or intolerant of monotherapy.
Choice C is wrong because little follow up is not needed after the initial treatment.Patients on combination diuretic therapy require close monitoring of their blood pressure, electrolytes, renal function, and weight to avoid adverse effects such as dehydration, hyponatremia, hypotension, and worsening renal function.
Choice D is wrong because they do not increase the risk of hypokalemia.As explained above, combination diuretic therapy aims to reduce the risk of hypokalemia by using a potassium-sparing diuretic along with a potassium-wasting diuretic.
Normal ranges for serum potassium are 3.5 to 5.0 mmol/L and for serum sodium are 135 to 145 mmol/L.
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