A patient has had blood pressures of 150/95 and 148/90 mm Hg on two separate office visits. The patient reports a blood pressure of 145/92 mm Hg taken in an ambulatory setting. The patient’s diagnostic tests are all normal. The nurse will expect this patient’s provider to order

An adrenergic neuron blocker

A beta blocker

Counseling on lifestyle changes

An ACE inhibitor

Answer and Explanation

The Correct Answer is C

Choice A reason: Adrenergic neuron blockers, like guanethidine, reduce blood pressure by inhibiting norepinephrine release. They are not first-line for stage 1 hypertension (140-159/90-99 mm Hg). Their side effects, like orthostatic hypotension, make them less suitable. Lifestyle changes are preferred initially for this patient’s mild elevation and normal diagnostic tests, making this choice inappropriate.

Choice B reason: Beta blockers, like atenolol, reduce heart rate and cardiac output, lowering blood pressure. They are not first-line for stage 1 hypertension without compelling indications (e.g., heart failure). Guidelines recommend lifestyle modifications first for this patient’s blood pressure range, as they effectively reduce risk without medication side effects, making this choice less suitable.

Choice C reason: For stage 1 hypertension (140-159/90-99 mm Hg) with normal diagnostic tests, guidelines recommend lifestyle changes, such as diet, exercise, and weight loss, as first-line treatment. These reduce blood pressure by improving vascular health and reducing cardiac strain, offering a low-risk approach to manage mild hypertension effectively, making this the correct choice.

Choice D reason: ACE inhibitors, like lisinopril, block angiotensin II formation, reducing blood pressure. They are effective but not first-line for stage 1 hypertension without comorbidities. Lifestyle changes are prioritized to avoid medication side effects like cough or hyperkalemia, making this choice less appropriate for initial management in this patient.

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Correct Answer is B

Explanation

Choice A reason: Increasing aspirin dosage without medical guidance risks toxicity, including gastrointestinal bleeding and ulceration, as aspirin inhibits COX enzymes, reducing prostaglandin production. Prostaglandins mediate pain and inflammation, but excessive inhibition can damage the stomach lining. This approach is unsafe and not recommended for managing menstrual cramps effectively, as it may exacerbate adverse effects without ensuring better pain relief.

Choice B reason: First-generation NSAIDs, like ibuprofen, are more effective for menstrual cramps due to their stronger inhibition of COX-1 and COX-2 enzymes, which reduce prostaglandin synthesis responsible for uterine contractions and pain. Unlike aspirin, ibuprofen offers better pain relief with a more favorable dosing profile, making it a suitable alternative for dysmenorrhea management in most patients.

Choice C reason: Acetaminophen lacks significant anti-inflammatory effects, as it primarily inhibits COX enzymes in the central nervous system, not peripherally. It reduces pain and fever but does not effectively target prostaglandin-mediated inflammation in menstrual cramps. Therefore, it is less effective than NSAIDs like ibuprofen for dysmenorrhea, making it an inappropriate substitute in this context.

Choice D reason: Avoiding COX inhibitors due to Reye’s syndrome risk is unwarranted here, as Reye’s syndrome is primarily associated with aspirin use in children with viral infections. Menstrual cramps are unrelated to this condition, and COX inhibitors like NSAIDs are standard treatment. This choice is overly restrictive and not clinically justified for managing dysmenorrhea.

A. Renal artery ligation stenosis B. Bronchial asthma C. Diabetes mellitus D. Coronary artery disease

Correct Answer is B

Explanation

Choice A reason: Renal artery ligation stenosis is affected by beta-blockers’ renin reduction, but asthma’s bronchoconstriction risk is more immediate. Respiratory effects are critical, so this is incorrect.

Choice B reason: Nonselective beta-blockers can cause bronchospasm in asthma by blocking beta-2 receptors. This is a major concern, making it the correct disease to prioritize.

Choice C reason: Diabetes mellitus may mask hypoglycemia with beta-blockers, but asthma’s acute airway risk is more severe. Respiratory issues take precedence, so this is incorrect.

Choice D reason: Coronary artery disease benefits from beta-blockers’ cardiac effects. Asthma’s bronchoconstriction risk is more concerning, so this is incorrect for the primary concern.

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A patient has had blood pressures of 150/95 and 148/90 mm Hg on two separate office visits. The patient reports a blood pressure of 145/92 mm Hg taken in an ambulatory setting. The patient’s diagnostic tests are all normal. The nurse will expect this patient’s provider to order

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A patient tells the nurse that she takes aspirin for menstrual cramps, but she does not feel that it works well. What will the nurse suggest?

Correct Answer is B

Explanation

A patient with hypertension is prescribed a nonselective beta-blocker. The nurse reviewing this patient’s chart before administering the medication will be most concerned about which other disease process?

Correct Answer is B

Explanation

A patient has had blood pressures of 150/95 and 148/90 mm Hg on two separate office visits. The patient reports a blood pressure of 145/92 mm Hg taken in an ambulatory setting. The patient’s diagnostic tests are all normal. The nurse will expect this patient’s provider to order

When administering a central nervous system depressant, the nurse should closely observe for drug toxicity in which patient?

Name the following arterial blood gas (ABG) values: pH 7.47, PaCO2 32, HCO3- 23

Insulin glargine is prescribed for a hospitalized patient who has diabetes. When will the nurse expect to administer this drug?

Name the imbalance using the following Arterial Blood Gas (ABG) values: pH 7.31, PaCO2 41, HCO3- 20

Name the imbalance using the following Arterial Blood Gas (ABG) values: pH 7.48, PaCO2 44, HCO3- 29

Which of the following cells increase acid in the stomach? (Select all that apply)