The stepped-care approach to the treatment of hypertension includes

lifestyle modification, including exercise, diet and decreased smoking and alcohol intake.

use of diuretic, beta-blocker, or ACE inhibitor to supplement lifestyle changes.

all of the above.

a combination of antihypertensive drug classes to achieve desired control.

Answer and Explanation

The Correct Answer is C

A) Lifestyle modification, including exercise, diet, and decreased smoking and alcohol intake:
This statement is accurate. Lifestyle modifications are essential components of hypertension management and are recommended as the first step in treatment. These modifications include regular physical activity, adopting a heart-healthy diet such as the DASH (Dietary Approaches to Stop Hypertension) diet, reducing sodium intake, limiting alcohol consumption, and quitting smoking. These changes can help lower blood pressure and reduce the risk of cardiovascular events.

B) Use of diuretic, beta-blocker, or ACE inhibitor to supplement lifestyle changes:
This statement is also accurate. If lifestyle modifications alone are insufficient to achieve blood pressure control, pharmacotherapy may be initiated. The choice of antihypertensive medications depends on various factors, including the individual's comorbidities, medication tolerance, and response to treatment. Diuretics, beta-blockers, and ACE inhibitors are commonly used as first-line agents in the management of hypertension, either as monotherapy or in combination with other drugs.

C) All of the above:
This statement is correct. The stepped-care approach to hypertension management involves a combination of lifestyle modifications and pharmacotherapy. Lifestyle changes are typically recommended as the initial step, followed by the addition of antihypertensive medications if necessary to achieve target blood pressure goals. Therefore, both lifestyle modifications and pharmacological interventions are integral components of the stepped-care approach.

D) A combination of antihypertensive drug classes to achieve desired control:
While this statement is true, it does not encompass all aspects of the stepped-care approach. The use of combination therapy with multiple antihypertensive drug classes may be necessary in some cases to achieve optimal blood pressure control. However, it is only one component of the broader treatment strategy, which also includes lifestyle modifications as the foundation of therapy. Therefore, while combination therapy is important, it does not fully represent the stepped-care approach on its own.

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Correct Answer is C

Explanation

A) Milk:
Milk is not known to interact significantly with verapamil. Therefore, there's no need for the client to avoid consuming milk while taking this medication.

B) Orange juice:
Orange juice does not typically interact with verapamil. However, calcium-containing foods and beverages, including orange juice, may reduce the absorption of verapamil when taken simultaneously. While the interaction is not severe, it's advisable for clients to separate the administration of verapamil from calcium-rich foods and beverages to optimize absorption.

C) Grapefruit juice:
This is the correct answer. Grapefruit juice contains compounds that inhibit the activity of cytochrome P450 enzymes, particularly CYP3A4, which are involved in the metabolism of many medications, including verapamil. Consuming grapefruit juice while taking verapamil can lead to elevated blood levels of the medication, increasing the risk of side effects and toxicity. Therefore, clients should avoid grapefruit juice while on verapamil therapy.

D) Coffee:
Coffee does not typically interact with verapamil. However, caffeine-containing beverages like coffee may exacerbate certain side effects of verapamil, such as dizziness or palpitations, due to their stimulant effects. Clients may be advised to limit caffeine intake or consume coffee in moderation while taking verapamil.

A. Respiratory rate 18/min B. Oxygen saturation 95% C. Heart rate 46/min D. Blood pressure 160/94 mm Hg

Correct Answer is C

Explanation

A) Respiratory rate 18/min:
A respiratory rate of 18/min is within the normal range for adults and is not a contraindication for administering atenolol. This finding does not warrant withholding the medication.

B) Oxygen saturation 95%:
An oxygen saturation of 95% is within the normal range and does not indicate any acute respiratory compromise. It is not a contraindication for administering atenolol.

C) Heart rate 46/min:
A heart rate of 46/min is below the normal range (typically 60-100 beats per minute for adults). Atenolol is a beta-blocker that primarily acts to reduce heart rate and blood pressure. Administering atenolol to a client with bradycardia (heart rate less than 60/min) can further decrease heart rate and may lead to symptomatic bradycardia or heart block. Therefore, the nurse should withhold atenolol in this case and notify the healthcare provider.

D) Blood pressure 160/94 mm Hg:
A blood pressure of 160/94 mm Hg indicates hypertension (elevated blood pressure). While atenolol is often prescribed for the management of hypertension, this blood pressure reading alone does not warrant withholding the medication. However, the client's bradycardia (heart rate 46/min)’is a more immediate concern that requires action."

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The stepped-care approach to the treatment of hypertension includes

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is providing teaching to a client who has hypertension and a new prescription for verapamil. Which of the following beverages should the nurse tell the client to avoid while taking this medication?

Correct Answer is C

Explanation

A nurse is assessing a clie”t prior to administering atenolol. Which of the following findings should prompt the nurse to withhold the medication?

Correct Answer is C

Explanation

A nurse caring for a client”who has hypertension and asks the nurse about a prescription for propranolol. The nurse should inform the client that this medication is contraindicated in clients who have a history of which of the following conditions?

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A nurse is assessing a client who has had diarrhea for several days. Which of the following findings should the nurse expect?

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