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Managing hypertension

Piecing together the guidelines

doi: 10.1097/01.NURSE.0000459970.85709.bb
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INSTRUCTIONS Managing hypertension: Piecing together the guidelines

TEST INSTRUCTIONS

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PROVIDER ACCREDITATION

Lippincott Williams & Wilkins, publisher of Nursing2015 journal, will award 2.0 contact hours for this continuing nursing education activity.

Lippincott Williams & Wilkins is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation.

Lippincott Williams & Wilkins is also an approved provider of continuing nursing education by the District of Columbia and Florida #50-1223. This activity is also provider approved by the California Board of Registered Nursing, Provider Number CEP 11749 for 2.0 contact hours.

Your certificate is valid in all states. This activity has been assigned 1.0 pharmacology credits.

Managing hypertension: Piecing together the guidelines

GENERAL PURPOSE: To provide information on the current guidelines for the management of hypertension. LEARNING OBJECTIVES: After reading the article and taking this test, you should be able to: Identify recommendations from the JNC 8 guidelines on hypertension. Compare recommendations from the ASH/ISH with JNC 8 practice guidelines.

  1. From 2003 to 2010, the CDC estimated that less than half of U.adults had adequately controlled BP, defined as
    1. SBP < 140 mm Hg, DBP < 90 mm Hg.
    2. SBP < 150 mm Hg, DBP < 80 mm Hg.
    3. SBP < 160 mm Hg, DBP < 90 mm Hg.
  2. The JNC 8 guidelines recommend treating patients in the general population age . 60 to a goal of
    1. SBP < 130 mm Hg, DBP < 80 mm Hg.
    2. SBP < 140 mm Hg, DBP < 90 mm Hg.
    3. SBP < 150 mm Hg, DBP < 90 mm Hg.
  3. For patients in the general population ages 30 to 59, JNC 8 focuses on treating
    1. DBP.
    2. SBP.
    3. DBP and SBP.
  4. For patients age . 18 years with diabetes, JNC 8 recommends treating to a goal of
    1. SBP < 140 mm Hg, DBP < 80 mm Hg.
    2. SBP < 140 mm Hg, DBP < 90 mm Hg.
    3. SBP < 150 mm Hg, DBP < 80 mm Hg.
  5. Initial antihypertensive treatment in non-Black patients should include any of the following except
    1. an ACEI.
    2. a beta blocker.
    3. a CCB.
  6. JNC 8 recommends beginning antihypertensive treatment in the general Black population with a thiazide-type diuretic or
    1. an ACEI.
    2. a CCB.
    3. an ARB.
  7. Which therapy can improve kidney outcomes in hypertensive patients with CKD?
    1. an ACEI
    2. an aldosterone antagonist
    3. a CCB
  8. Due to possible hyperkalemia, an ACEI shouldn't be combined with which drug?
    1. an ARB
    2. a CCB
    3. a thiazide-type diuretic
  9. Which lifestyle change is identified in the article as part of hypertension management?
    1. drinking alcohol in moderation
    2. relaxation therapy
    3. weight control
  10. Unlike the JNC 8 guidelines, the ASH/ISH guidelines
    1. pay special attention to the treatment of Asian patients.
    2. have a limited discussion of lifestyle changes.
    3. address resistant hypertension.
  11. In the ASH/ISH guidelines, hypertension in adults age ≥ 80 is considered as an SBP greater than
    1. 130 mm Hg.
    2. 140 mm Hg.
    3. 150 mm Hg.
  12. Prehypertension is defined in the ASH/ISH guidelines as a DBP of
    1. 70 to 79 mm Hg.
    2. 80 to 89 mm Hg.
    3. 90 to 99 mm Hg.
  13. ASH/ISH recommends that patients with prehypertension be treated with
    1. a thiazide-type diuretic.
    2. a CCB.
    3. lifestyle modifications.
  14. Stage 2 hypertension in the ASH/ISH guidelines is defined as
    1. SBP ≥ 160 mm Hg or DBP ≥ 100 mm Hg.
    2. SBP ≥ 140 mm Hg or DBP ≥ 90 mm Hg.
    3. SBP ≥ 150 mm Hg or DBP ≥ 80 mm Hg.
  15. The ASH/ISH guidelines recommend monitoring the patient's urine for
    1. albumin.
    2. specific gravity.
    3. glucose.
  16. According to ASH/ISH guidelines, patients age ≥ 80 with BP > 140/90 should be treated if they also have
    1. obstructive sleep apnea.
    2. diabetes.
    3. aldosterone deficiency.
  17. ASH/ISH guidelines recommend that initial therapy in non-Black patients age < 60 includes
    1. a thiazide diuretic or CCB.
    2. a beta blocker or direct renin inhibitor.
    3. an ACEI or ARB.
  18. Under ASH/ISH guidelines, all patients with Stage 2 hypertension should receive
    1. a CCB or thiazide diuretic and an ACEI or ARB.
    2. a thiazide diuretic, spironolactone, and an ACEI or ARB.
    3. a beta- or alpha-blocker, an aldosterone antagonist, and a CCB or thiazide diuretic.
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