Review Practice Exercise 1

Drugs Used to Treat Hypertension > Pharmacology

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Practice Exercise 1

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Total Questions : 3

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Question 1:

A patient’s blood pressure (BP) is 130/84. The healthcare provider plans to suggest nonpharmacologic methods for the patient. Which should the nurse include in teaching? Select all that apply

A. Stress-reduction techniques B. Starting an exercise program C. Salt restriction D. Smoking cessation E. Diet with increased protein

Answer and Explanation

Choice A:

Stress-reduction techniques: Stress activates the sympathetic nervous system, increasing heart rate and blood pressure. Relaxation methods such as meditation, yoga, or deep-breathing exercises help lower stress and support BP control.

Choice B:

Starting an exercise program: Regular physical activity (e.g., brisk walking 30 minutes daily) improves vascular tone, promotes weight control, and reduces systolic and diastolic pressures.

Choice C:

Salt restriction: High sodium intake leads to water retention and increased blood volume. Limiting salt to less than 2 grams per day helps decrease BP and improve cardiac workload.

Choice D:

Smoking cessation: Nicotine causes vasoconstriction and increases heart rate and BP. Quitting smoking improves endothelial function and overall cardiovascular health.Rationale for incorrect answer

Choice E:

Diet with increased protein: Increasing protein intake does not directly reduce BP and may burden the kidneys if excessive. The focus should be on a balanced, heart-healthy diet such as the DASH plan rich in fruits, vegetables, and low-fat dairy.

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Question 2:

Scenario

A patient arrived at an outpatient clinic for a follow-up visit to determine adequate hypertension control. The patient had recently been started on an ACE inhibitor and a thiazide diuretic after following lifestyle modifications for 10 years.
The patient in the scenario asks the nurse about the difference between primary and secondary hypertension. Which statement by the nurse accurately answers the question?

A. “Primary hypertension accounts for 90% of all clinical cases of high blood pressure and is readily treatable.” B. “It does not matter whether you have primary or secondary hypertension; your treatment plan will be the same.” C. “Primary hypertension causes target organ damage and secondary hypertension causes fast heart rate, as well as high blood pressure.” D. “Primary hypertension is curable, and secondary hypertension is only controllable.”

Answer and Explanation

Choice A:

“Primary hypertension accounts for 90% of all clinical cases of high blood pressure and is readily treatable.”This statement accurately reflects that primary (essential) hypertension makes up about 90–95% of all cases. Although it has no specific cause, it is often effectively managed through lifestyle modifications and antihypertensive medications such as ACE inhibitors and thiazide diuretics. While not curable, it is readily controllable to prevent complications like stroke, heart failure, and renal disease.Rationales for incorrect answers:

Choice B:

“It does not matter whether you have primary or secondary hypertension; your treatment plan will be the same.”This statement is inaccurate because secondary hypertension requires addressing the underlying cause (e.g., removing an adrenal tumor or treating kidney disease). In contrast, primary hypertension focuses on lifestyle modification and pharmacologic management to control blood pressure.

Choice C:

“Primary hypertension causes target organ damage and secondary hypertension causes fast heart rate, as well as high blood pressure.”Both types can lead to target organ damage (heart, kidneys, brain, eyes) if uncontrolled. However, tachycardia is not a defining feature of secondary hypertension. This statement reflects a misunderstanding of pathophysiology.

Choice D:

“Primary hypertension is curable, and secondary hypertension is only controllable.”The opposite is true. Primary hypertension is not curable but can be controlled. Secondary hypertension, on the other hand, may be curable if the underlying cause (such as renal artery stenosis or endocrine disorder) is corrected.

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Question 3:

The nurse reviewing the assessments and interventions for the patient in the scenario who is concerned about starting on antihypertensive medications. Which statement by the nurse would be an appropriate response? Select all that apply

A. “It is important that you monitor your blood pressure regularly and keep a record of it for follow up.” B. “While you are taking these medications it will be necessary for your healthcare provider to listen for bowel sounds.” C. “Your healthcare provider recommends that we review your diet history.” D. “The primary healthcare provider will have you come back for periodic laboratory checks to determine any changes in kidney function.” E. “It is recommended that you continue to engage in physical activity and maintain this over the course of a lifetime.”

Answer and Explanation

Choice A:

“It is important that you monitor your blood pressure regularly and keep a record of it for follow up.”Regular blood pressure monitoring allows both the patient and healthcare provider to assess how well antihypertensive therapy is controlling hypertension. Keeping a written or electronic record helps track trends, evaluate medication effectiveness, and identify when dosage adjustments or additional therapies are needed.

Choice B:

“While you are taking these medications it will be necessary for your healthcare provider to listen for bowel sounds.”Listening for bowel sounds is unrelated to antihypertensive therapy. This assessment is typically indicated for patients with gastrointestinal conditions or those receiving medications affecting bowel motility, not for hypertension management.

Choice C:

“Your healthcare provider recommends that we review your diet history.”Reviewing the diet history helps determine sodium, fat, and alcohol intake, all of which can influence blood pressure control. Diet modification—such as reducing sodium and following the DASH diet—is a key component of hypertension management and may reduce the need for higher medication doses.

Choice D:

“The primary healthcare provider will have you come back for periodic laboratory checks to determine any changes in kidney function.”Many antihypertensive agents, especially ACE inhibitors, ARBs, and diuretics, can affect renal function and electrolyte balance. Periodic monitoring of serum creatinine and potassium levels ensures early detection of nephrotoxicity or hyperkalemia, allowing timely intervention.

Choice E:

“It is recommended that you continue to engage in physical activity and maintain this over the course of a lifetime.”Regular physical activity improves cardiovascular health, enhances the effectiveness of antihypertensive medications, and supports weight management. Consistency over time is vital to sustain blood pressure control and reduce cardiovascular risk.Rationales for incorrect answers:

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Practice Exercise 1

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