chapter 40: Hypertension

Question 1

Because primary hypertension has no identifiable cause, treatment is based on interfering with the physiological mechanisms that regulate blood pressure. Thiazide diuretics treat hypertension because they:

1. Increase renin secretion
2. Decrease the production of aldosterone
3. Deplete body sodium and reduce fluid volume
4. Decrease blood viscosity

Answer 1

3. Deplete body sodium and reduce fluid volume

Question 2

Because of its action on various body systems, the patient taking a thiazide or loop diuretic may also need to receive the following supplement:

1. Potassium
2. Calcium
3. Magnesium
4. Phosphates

Answer 2

1. Potassium

Question 3

All patients with hypertension benefit from diuretic therapy, but those who benefit the most are:

1. Those with orthostatic hypertension
2. African Americans
3. Those with stable angina
4. Diabetics

Answer 3

2. African Americans

Question 4

Beta blockers treat hypertension because they:

1. Reduce peripheral resistance
2. Vasoconstrict coronary arteries
3. Reduce norepinephrine
4. Reduce angiotensin II production

Answer 4

1. Reduce peripheral resistance

Question 5

Which of the following disease processes could be made worse by taking a nonselective beta blocker?

1. Asthma
2. Diabetes
3. Both might worsen
4. Beta blockade does not affect these disorders

Answer 5

3. Both might worsen

Question 6

Disease states in addition to hypertension in which beta blockade is a compelling indication for the use of beta blockers include:

1. Heart failure
2. Angina
3. Myocardial infarction
4. Dyslipidemia

Answer 6

3. Myocardial infarction

Question 7

Angiotensin-converting enzyme (ACE) inhibitors treat hypertension because they:

1. Reduce sodium and water retention
2. Decrease vasoconstriction
3. Increase vasodilation
4. All of the above

Answer 7

4. All of the above

Question 8

Compelling indications for an ACE inhibitor as treatment for hypertension based on clinical trials includes:

1. Pregnancy
2. Renal parenchymal disease
3. Stable angina
4. Dyslipidemia

Answer 8

2. Renal parenchymal disease

Question 9

An ACE inhibitor and what other class of drug may reduce proteinuria in patients with diabetes better than either drug alone?

1. Beta blockers
2. Diuretics
3. Nondihydropyridine calcium channel blockers
4. Angiotensin II receptor blockers

Answer 9

3. Nondihydropyridine calcium channel blockers

Question 10

If not chosen as the first drug in hypertension treatment, which drug class should be added as a second step because it will enhance the effects of most other agents?

1. ACE inhibitors
2. Beta blockers
3. Calcium channel blockers
4. Diuretics

Answer 10

4. Diuretics

Question 11

Treatment costs are important for patients with hypertension. Which of the following statements about cost is NOT true?

1. Hypertension is a chronic disease where patients may be taking drugs for a long time.
2. Most patients will require more than one drug to treat the hypertension.
3. The cost includes the price of any routine or special laboratory tests that a specific drug may require.
4. Few antihypertensive drugs come in generic formulations.

Answer 11

4. Few antihypertensive drugs come in generic formulations.

Question 12

Caffeine, exercise, and smoking should be avoided for at least how many minutes before blood pressure measurement?

1. 15
2. 30
3. 60
4. 90

Answer 12

2. 30

Question 13

Blood pressure checks in children:

1. Should occur with their annual physical examinations after 6 years of age
2. Require a blood pressure cuff that is one-third the diameter of the child’s arm
3. Should be done during every health-care visit after 3 years of age
4. Require additional laboratory tests such as serum creatinine

Answer 13

3. Should be done during every health-care visit after 3 years of age

Question 14

Lack of adherence to blood pressure management is very common. Reasons for this lack of adherence include:

1. Lifestyle changes are difficult to achieve and maintain.
2. Adverse drug reactions are common and often fall into the categories more associated with nonadherence.
3. Costs of drugs and monitoring with laboratory tests can be expensive.
4. All of the above

Answer 14

4. All of the above

Question 15

Lifestyle modifications for patients with prehypertension or hypertension include:

1. Diet and increase exercise to achieve a BMI greater than 25.
2. Drink 4 ounces of red wine at least once per week.
3. Adopt the dietary approaches to stop hypertension (DASH) diet.
4. Increase potassium intake.

Answer 15

3. Adopt the dietary approaches to stop hypertension (DASH) diet.

Question 16

Which diuretic agents typically do not need potassium supplementation?

1. The loop diuretics
2. The thiazide diuretics
3. The aldosterone inhibitors
4. They all need supplementation

Answer 16

3. The aldosterone inhibitors

Question 17

Aldactone family medications are frequently used when the hypertensive patient also has:

1. Hyperkalemia
2. Advancing liver dysfunction
3. The need for birth control
4. Rheumatoid arthritis

Answer 17

2. Advancing liver dysfunction

Question 18

Hypertensive African Americans are typically listed as not being as responsive to which drug groups?

1. ACE inhibitors
2. Calcium channel blockers
3. Diuretics
4. Bidil (hydralazine family of medications)

Answer 18

1. ACE inhibitors

Question 19

What educational points concerning fluid intake must be covered with diuretic prescriptions?

1. Fluid should be restricted when on them.
2. Fluids should contain at least one salty item daily.
3. Fluid intake should remain near normal for optimal performance.
4. Avoidance of potassium-rich fluids is encouraged.

Answer 19

3. Fluid intake should remain near normal for optimal performance.

Question 20

What is a common side effect concern with hypertensive medications and all individuals, but especially the elderly?

1. Risk of falls
2. Triggering of a hypertensive crisis
3. Erectile priapism
4. Risk for bladder cancer development

Answer 20

1. Risk of falls