The nurse is administering antihypertensive drugs to older adult patients. The nurse knows that which adverse effect is of most concern for these patients?

Dry mouth

Hypotension

Restlessness

Constipation

Answer and Explanation

The Correct Answer is B

Older adults taking antihypertensive medications are at increased risk for hypotension, particularly orthostatic (postural) hypotension, due to age-related physiological changes and altered drug metabolism. These changes make them more sensitive to blood pressure–lowering effects, which can lead to dangerous complications such as falls, syncope, and injury.

Rationale for correct answer:

B. Hypotension:
Hypotension, especially orthostatic hypotension, is the most concerning adverse effect in older adults receiving antihypertensive therapy. Aging reduces baroreceptor sensitivity, making it harder for the cardiovascular system to compensate for sudden position changes. This increases the risk of dizziness, fainting, and falls, which can result in fractures or head injuries. Nurses should monitor blood pressure regularly, particularly when clients move from lying to standing, and educate them to rise slowly.

Rationales for incorrect answers:

A. Dry mouth:
Although dry mouth can occur with some antihypertensive agents (e.g., clonidine), it is a minor discomfort compared to the safety risks associated with hypotension. It can be managed with oral fluids, sugar-free gum, or saliva substitutes.

C. Restlessness:
Restlessness is not a typical adverse effect of most antihypertensive medications. It may occur from anxiety or unrelated causes but is not the main concern in this population.

D. Constipation:
Constipation can occur with certain antihypertensives (e.g., verapamil), but it is not life-threatening and is manageable with dietary adjustments or stool softeners. It poses far less danger than hypotension and fall-related injuries.

Take-home points:
• Hypotension and orthostatic hypotension are the most serious risks of antihypertensive therapy in older adults.
• Falls and injuries are common complications due to impaired cardiovascular reflexes.
• Nurses should monitor blood pressure closely and instruct patients to change positions slowly to prevent dizziness and fainting.

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Correct Answer is A

Explanation

For clients with hypertension, lifestyle modifications remain essential even after starting on medication therapy. Pharmacologic treatment is often necessary when lifestyle measures alone are insufficient, but it does not replace them. Combining drug therapy with lifestyle changes such as diet modification, weight control, physical activity, and smoking cessation provides the best long-term control of blood pressure and prevention of complications such as stroke, myocardial infarction, and renal damage.

Rationale for correct answer:

A. “I figure that since I have started on these medications that I don’t have to follow those lifestyle modifications anymore.”
This statement demonstrates a misunderstanding of hypertension management. Antihypertensive drugs work best when combined with ongoing lifestyle modifications, including reduced sodium intake, regular exercise, limited alcohol consumption, and stress management. Discontinuing these habits can lead to poor blood pressure control and increased risk of cardiovascular complications despite medication adherence. The nurse should reinforce that lifestyle changes are a lifelong commitment, not a temporary measure.

Rationales for incorrect answers:

B. “I will walk every day at least 20 minutes.”
This reflects positive adherence to exercise recommendations. Regular physical activity, such as brisk walking for 20–30 minutes most days of the week, improves cardiovascular function and helps reduce blood pressure.

C. “I will weigh myself at the same time every day and report a weight gain of more than 2 pounds.”
Daily weight monitoring helps detect fluid retention, especially in clients taking diuretics or those with cardiovascular comorbidities. This is an appropriate and safe self-care behavior.

D. “I think that I can keep track of my blood pressure using a journal to record it.”
Keeping a blood pressure log demonstrates active self-monitoring, which allows both the patient and provider to evaluate treatment effectiveness and make necessary adjustments. This behavior supports effective long-term hypertension management.

Take-home points:
• Lifestyle modifications must continue even after antihypertensive therapy begins.
• Medication and healthy habits work synergistically to maintain optimal blood pressure control.
• Patient education should emphasize that long-term adherence to both pharmacologic and lifestyle measures prevents complications and promotes cardiovascular health.

A. The blood pressure will decrease faster. B. Lower doses of both drugs may be given with fewer adverse effects. C. There is less daily medication dosing. D. Combination therapy will treat the patient’s other medical conditions.

Correct Answer is B

Explanation

Atenolol (Tenormin) is a beta-adrenergic blocker that decreases heart rate, cardiac output, and renin release, while doxazosin (Cardura) is an alpha-adrenergic blocker that causes vasodilation by relaxing vascular smooth muscle. Combining these two antihypertensive agents targets different mechanisms involved in blood pressure regulation, allowing for synergistic blood pressure reduction while minimizing side effects associated with higher doses of a single medication.

Rationale for correct answer:

B. Lower doses of both drugs may be given with fewer adverse effects.
Combination therapy allows each drug to complement the other’s mechanism of action—atenolol reduces cardiac workload and renin secretion, while doxazosin reduces peripheral vascular resistance. This dual approach enables the use of lower doses of both drugs, enhancing efficacy and reducing the risk of dose-related adverse effects such as bradycardia (from beta blockers) or postural hypotension (from alpha blockers).

Rationales for incorrect answers:

A. The blood pressure will decrease faster.
The goal of combination therapy is safe and sustained blood pressure control, not a rapid decrease. A sudden drop in BP can lead to hypotension, dizziness, or syncope, especially in older adults.

C. There is less daily medication dosing.
Combination therapy often involves multiple doses or separate tablets, not necessarily fewer doses. The purpose is enhanced control, not dosing convenience.

D. Combination therapy will treat the patient’s other medical conditions.
Although atenolol may help with cardiac conditions like angina, combination therapy in this context is specifically aimed at improving blood pressure control, not managing unrelated diseases.

Take-home points:
• Combining antihypertensive drugs with different mechanisms enhances blood pressure control and limits side effects.
• Lower doses of each drug in combination therapy improve tolerability and adherence.
• The goal is balanced, sustained blood pressure reduction, not rapid or multi-condition treatment.

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The nurse is administering antihypertensive drugs to older adult patients. The nurse knows that which adverse effect is of most concern for these patients?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

After discussing lifestyle modifications with the patient who is hypertensive, the nurse will reinforce teaching after the patient makes which statement?

Correct Answer is A

Explanation

The client is taking atenolol (Tenormin) and doxazosin (Cardura). What is the rationale for combining two antihypertensive drugs?

Correct Answer is B

Explanation

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The nurse is administering antihypertensive drugs to older adult patients. The nurse knows that which adverse effect is of most concern for these patients?

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