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WorksheetsAntianginals + Antihypertensives
Total questions: 30
Worksheet time: 15mins
A patient on nitroglycerin reports dizziness and flushing after applying a new patch. The nurse should:
Remove the patch immediately
Reassure the patient this is common and self-limiting
Call the provider for a lower dose
Apply two patches to improve tolerance
Which concurrent medication requires the strongest contraindication with nitrates?
Metoprolol
Sildenafil
Furosemide
Diltiazem
When administering IV nitroglycerin, the nurse should:
Use an infusion pump and monitor BP closely
Give via IV push
Keep the line open with dextrose only
Titrate rapidly for quick effect
A patient develops tolerance to long-acting nitrates. Nursing intervention:
Schedule a daily nitrate-free period of at least 8 hours
Increase dose at night
Apply patches continuously
Administer extra caffeine
Which statement by a patient on isosorbide mononitrate requires further teaching?
“I will sit down if I feel dizzy.”
“If I miss a dose, I’ll double the next one.”
“I’ll avoid alcohol while taking this.”
“I’ll check my blood pressure daily.”
For beta-blocker therapy in angina, which effect is expected?
Increased HR and contractility
Reduced HR and myocardial oxygen demand
Increased cardiac output
Decreased filling time
Which sign warrants immediate intervention in a patient taking atenolol?
HR 58 bpm
BP 100/60 mm Hg
HR 40 bpm with dizziness
Mild fatigue
Calcium channel blockers treat angina by:
Blocking calcium to reduce myocardial contraction and cause vasodilation
Increasing calcium to strengthen the heartbeat
Promoting sodium retention
Increasing afterload
A patient on verapamil develops constipation. The nurse should:
Educate about increased fiber and fluids
Discontinue drug immediately
Add an NSAID for relief
Ignore unless severe
Which fruit should a patient on amlodipine avoid?
Grapefruit
Bananas
Apples
Oranges
A nurse expects which mechanism for clonidine in hypertension management?
Stimulates central α2 receptors, decreasing norepinephrine release
Blocks β2 receptors peripherally
Promotes renin secretion
Increases aldosterone
Which finding is most important after giving the first dose of an α1 blocker?
Orthostatic hypotension
Polyuria
Headache
Bradycardia
A patient on clonidine stops the medication abruptly. What’s the risk?
Bradycardia
Rebound hypertension
Hyperkalemia
Hypoglycemia
ACE inhibitors end with which suffix?
"-pril"
"-sartan"
"-lol"
"-dipine"
Which adverse effect is unique to ACE inhibitors?
Dry, nonproductive cough
Constipation
Reflex tachycardia
Sedation
A patient on lisinopril develops facial swelling and difficulty breathing. Priority action:
Stop drug; suspect angioedema
Give antihistamines and continue
Document and monitor
Reduce dose
Which statement indicates understanding of ACE inhibitors in diabetes?
“They raise my blood sugar.”
“They help protect my kidneys from damage.”
“They increase my potassium loss.”
“They are unsafe for me.”
ARBs differ from ACE inhibitors in that:
They block angiotensin II receptors directly
They prevent renin release
They increase bradykinin
They cause more cough
Common adverse effect of ARBs:
Chest pain and fatigue
Severe cough
Gynecomastia
Bradycardia
Which hypertensive is contraindicated in pregnancy?
Losartan
Hydralazine
Methyldopa
Labetalol
ACE inhibitors improve heart failure by:
Decreasing preload and afterload
Increasing SVR
Causing fluid retention
Stimulating aldosterone
A patient on hydralazine reports joint pain and rash. Possible cause?
Drug-induced lupus
Dehydration
Electrolyte imbalance
Allergic rhinitis
When giving hydralazine IV, monitor for:
Reflex tachycardia and hypotension
Bradycardia
Hypoglycemia
Hyperkalemia
Which patient education is vital for male patients on antihypertensives?
Possible impotence can affect compliance
"This drug enhances libido."
"Report any increased urination."
"You’ll need to take with milk."
Which combination increases risk for hyperkalemia?
ACE inhibitor with potassium supplements
Beta blocker with loop diuretic
CCB with nitrates
Alpha blocker with clonidine
Which antihypertensive has dual action similar to carvedilol?
Labetalol
Atenolol
Amlodipine
Clonidine
When combining a beta blocker and nitrate, the nurse should watch for:
Excessive hypotension or bradycardia
Hyperglycemia
Reflex hypertension
Peripheral edema only
Which patient teaching prevents orthostatic falls with antihypertensives?
Rise slowly and dangle legs before standing
Drink less water
Lie flat after each dose
Take dose only at night
For all antihypertensives, which statement reflects critical patient education?
“Do not stop medication abruptly, even if you feel well.”
“Skip doses if BP seems normal.”
“Take extra if BP is high.”
“You can drink alcohol to relax.”
Labetalol lowers BP primarily by
Causing sodium retention
Increasing renin
Stimulating β₂ receptors
Blocking β₁ and α₁ receptors to reduce HR and vasodilate
