A patient in a hypertensive crisis is prescribed hydralazine. What is the primary action of hydralazine in treating hypertensive crisis?

Inhibits the renin-angiotensin-aldosterone system

Promotes sodium and water retention

increases heart rate to improve cardiac output

Directly causes arterial vasodilation to decrease blood pressure

Answer and Explanation

The Correct Answer is D

A. Inhibits the renin-angiotensin-aldosterone system: Hydralazine does not act on the RAAS pathway and does not block angiotensin-converting enzyme or angiotensin receptors. Medications such as ACE inhibitors or ARBs are responsible for this mechanism. Hydralazine works peripherally on vascular smooth muscle.

B. Promotes sodium and water retention: Sodium and water retention can occur as a compensatory adverse effect rather than a therapeutic action of hydralazine. This response is related to reflex activation of the sympathetic nervous system and RAAS. It does not explain the drug’s blood pressure–lowering effect.

C. Increases heart rate to improve cardiac output: Reflex tachycardia may occur secondary to vasodilation, but it is not the intended or primary mechanism of action. Increasing heart rate can increase myocardial oxygen demand and is often an undesirable effect. This action does not directly reduce blood pressure.

D. Directly causes arterial vasodilation to decrease blood pressure: Hydralazine relaxes arterial smooth muscle, leading to decreased systemic vascular resistance. This arterial vasodilation lowers afterload and rapidly reduces blood pressure in hypertensive crises. The effect is direct and does not rely on hormonal pathways.

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Free Nursing Study Resources

Correct Answer is C

Explanation

A. "Go to the emergency room and your provider will meet you there.":Black stools can be a sign of gastrointestinal bleeding, but in the absence of pain, cramping, or other symptoms, emergency evaluation is not necessary. This response may cause unnecessary anxiety.

B. "Come to the office and we will check things out.":Routine office evaluation is not required for black stools caused by iron supplements when the patient is otherwise asymptomatic.

C. "This is expected because of the way iron is broken down during digestion.":
Oral iron commonly causes dark or black stools due to oxidation of iron in the gastrointestinal tract. This is a harmless and expected side effect, and the patient can be reassured while continuing therapy.

D. "What else have you been eating?":While diet can affect stool color, in this context the most likely cause is iron supplementation. Asking about diet is not necessary unless additional symptoms suggest an alternative cause.

A. Instruct the patient to avoid weight-bearing exercises to reduce fracture risk. B. Encourage the patient to increase calcium and vitamin intake while taking omeprazole C. Recommend stopping omeprazole after 16 weeks of treatment to prevent bone loss D. Advise the patient to increase caffeine intake to stimulate bone formation.

Correct Answer is B

Explanation

A. Instruct the patient to avoid weight-bearing exercises to reduce fracture risk:Weight-bearing exercises help maintain bone density and reduce osteoporosis risk. Avoiding these activities can accelerate bone loss, especially in older adults, and is not recommended for patients concerned about osteoporosis.

B. Encourage the patient to increase calcium and vitamin D intake while taking omeprazole:Long-term proton pump inhibitor use can reduce calcium absorption, increasing the risk of osteoporosis and fractures. Adequate calcium and vitamin D intake supports bone health and helps counteract this risk while continuing necessary GERD treatment.

C. Recommend stopping omeprazole after 16 weeks of treatment to prevent bone loss:Discontinuing omeprazole without healthcare provider guidance may lead to uncontrolled GERD symptoms and complications. Treatment duration should be determined by the provider based on symptom control and risk-benefit assessment.

D. Advise the patient to increase caffeine intake to stimulate bone formation:High caffeine intake is associated with decreased calcium absorption and increased bone loss. Increasing caffeine would worsen osteoporosis risk rather than protect bone health.

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A patient in a hypertensive crisis is prescribed hydralazine. What is the primary action of hydralazine in treating hypertensive crisis?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is speaking on the phone to a client on the phone who is pregnant and taking iron supplements for iron-deficiency anemia. The client reports that her stools are black but she has no abdominal pain or cramping. Which of the following responses by the nurse is appropriate?

Correct Answer is C

Explanation

A 68-year-old female patient has been prescribed omeprazole for chronic gastroesophageal reflux disease (GERD). She is concerned about her risk for bone loss. Which nursing intervention is most appropriate to minimize the risk of osteoporosis related to long-term omeprazole use?

Correct Answer is B

Explanation

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