A patient is admitted with essential hypertension. Which ...

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A patient is admitted with essential hypertension. Which concurrent health problem would produce the greatest risk of a cardiovascular event?
 
  a. Obesity
  b. Diabetes
  c. Hyperlipidemia
  d. Peripheral edema

Question 2

An elderly patient has hypertension, and the prescriber has ordered a combination of medications that have been shown to reduce mortality and morbidity in the elderly.
 
  Which combination of medications would the nurse anticipate being prescribed?
  a. An angiotensin-converting enzyme (ACE) inhibitor and a loop diuretic
  b. A beta blocker and a diuretic
  c. An alpha1 blocker and an alpha/beta blocker
  d. A centrally acting alpha2 blocker and a beta blocker

[Chou]

Answer to Question 1

ANS: B
Diabetes would pose the greatest risk of a cardiovascular event because of the damage to the endothelium of the vessels
Obesity would also be a risk factor, but not the greatest risk.
Hyperlipidemia would also be considered a risk factor, but not the greatest risk. Diabetes affects multiple systems in the body, including the vessels, heart, and kidneys.
Peripheral edema would not produce the greatest risk for a cardiovascular event.

Answer to Question 2

ANS: B
Although all antihypertensive drugs are effective in older adults, only beta blockers and diuretics have been shown in controlled trials to reduce morbidity and mortality.
Clinical trials have proven only that beta blockers and diuretics decrease morbidity and mortality with older adults. Beta blockers are cardioprotective since they decrease heart rate and contractility. Thiazide diuretics tend to be effective with older adults as aantihypertensive agent.
Alpha1 blockers and alpha/beta blockers can cause orthostatic hypotension.
Centrally acting alpha2 blockers can impair cognitive function.

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