Exam #5 Hypertension

A nurse is caring for a client who has hypertension and diabetes mellitus. The client's blood pressure this morning was 150/92 mm Hg. He asks the nurse what his blood pressure should be. The nurse's most appropriate response is:

"Clients with diabetes should have a lower blood pressure goal. You should strive for 130/80 mm Hg."

The nurse and a dietitian are instructing the client on a low-sodium diet needed to lower the blood pressure. Which question, asked by the nurse, is most important?

"How do you prepare your food?"

A client is placed on a low-sodium (500 mg/day) diet. Which client statement indicates that the nurse's nutrition teaching plan has been effective?

"I chose broiled chicken with a baked potato for dinner."

When monitoring a patient who has hypertension and chronic kidney disease, the target pressure for this individual should be less than which blood pressure reading?

130/80 mm Hg

Officially, hypertension is diagnosed when the client demonstrates a systolic blood pressure greater than ______ mm Hg and a diastolic blood pressure greater than _____ mm Hg over a sustained period.

140, 90

A nurse is caring for a client with hypertension. The physician orders furosemide (lasix) 2 mg/kg to be given intravenously. The client weighs 24 kg. The medication comes in a single-use vial that contains 40 mg in 4 mL (10 mg/mL). How much will the nurse draw up for this client's dose?

4.8 mL

Which of the following client scenarios would be correct for the nurse to identify as a client with secondary hypertension?

A client diagnosed with kidney disease

The nurse is administering the morning mediations to a patient on the cardiac telemetry unit. Atenolol has been prescribed for this patient. Prior to administration, the nurse would tell the patient that the medication is which type of antihypertensive?

Beta blocker

A nurse is providing education about hypertension to a community group. One client reports that his doctor has diagnosed him with hypertension, but that he feels just fine. He asks, "What would happen if I did not treat my hypertension?" Which of the following are possible consequences of untreated hypertension? Choose all that apply.

CAD, MI, Stroke

The treatment goal for those with stage 2 hypertension (hypertension with compelling indications or complications) includes lifestyle modifications and multiple drug therapies. Thiazide diuretics are part of this treatment approach for most complications except for:

Chronic kidney disease

A nurse providing education about hypertension to a community group is discussing the high risk for cardiovascular complications. Which of the following are risk factors for cardiovascular problems in clients with hypertension? Choose all that apply.

Diabetes mellitus, Smoking, Phys. Inactivity

A client with newly diagnosed hypertension asks what she can do to decrease the risk for related cardiovascular problems. Which of the following risk factors is modifiable by the client?

Dyslipidemia

A patient with long-standing hypertension is admitted to the hospital with hypertensive urgency. The physician orders a chest x-ray, which reveals an enlarged heart. What diagnostic test does the nurse anticipate preparing the patient for to determine left ventricular enlargement?

Echocardiography

A client, newly prescribed a low-sodium diet due to hypertension, is asking for help with meal choices. The client provides four meal choices, which are favorites. Which selection would be best?

Green pepper stuffed with diced tomatoes and chicken

A nurse working in the clinic is seeing a client who has just been prescribed a new medication for hypertension. The client asks why hypertension is sometimes called the "silent killer." The nurse's correct response is which of the following?

Hypertension often causes no symptoms."

The staff educator is talking to a group of new emergency department nurses about hypertensive crises. The nurse educator is aware that hypertensive urgency differs from hypertensive emergency in what way?

Hypertensive emergencies are associated with evidence of target organ damage.

When treating hypertensive emergencies, the nurse identifies the most appropriate route of administration for antihypertensive agents as being which of the following?

Hypertensive emergencies are associated with evidence of target organ damage.

Which of the following would be inconsistent as a component of metabolic syndrome?

Hypotension

A nurse is educating about lifestyle modifications for a group of clients with newly diagnosed hypertension. While discussing dietary changes, which of the following points would the nurse emphasize?

It takes 2 to 3 months for the taste buds to adapt to decreased salt intake.

The nurse is caring for an 82-year-old male client who has come to the clinic for a yearly physical. When assessing the client, the nurse notes the blood pressure (BP) is 140/93. The nurse knows that in older clients what happens that may elevate the systolic BP?

Loss of arterial elasticity

A patient is taking amiloride (Midamor) and lisinopril (Zestril) for the treatment of hypertension. What laboratory studies should the nurse monitor while the patient is taking these two medications together?

Potassium level

A patient comes to the walk-in clinic. While assessing the patient's vital signs, the nurse assesses the patient's blood pressure at 128/89 mm Hg. According to JNC7, how would this patient's blood pressure be classified?

Prehypertensive

It is appropriate for the nurse to recommend smoking cessation for clients with hypertension because nicotine

Rebound

A patient is flying overseas for 1 week for business and packed antihypertensive medications in a suitcase. After arriving at the intended destination, the patient found that the luggage had been stolen. If the patient cannot take the medication, what condition becomes a concern?

Rebound hypertension

A patient is brought to the emergency department with complaints of a bad headache and an increase in blood pressure. The blood pressure reading obtained by the nurse is 260/180 mm Hg. What is the therapeutic goal for reduction of the mean blood pressure?

Reduce the blood pressure by 20% to 25% within the first hour of treatment.

The nurse is caring for a client newly diagnosed with secondary hypertension. Which condition contributes to the development of secondary hypertension?

Renal disease

The nurse is instructing a client who is newly prescribed an antihypertensive medication. Which nursing instruction is emphasized to maintain client safety?

Sit on the edge of the chair and rise slowly.

It is appropriate for the nurse to recommend smoking cessation for clients with hypertension because nicotine

Spironolactone

The nurse is caring for a client who is prescribed medication for the treatment of hypertension. The nurse recognizes that which medication conserves potassium?

Spironolactone

The nurse is employed in a physician's office and is caring for a client present for an annual exam. A blood pressure of 124/84 mm Hg is documented. Following revised guidelines for identifying hypertension, which educational pamphlet is help?

Stress reduction to lower prehypertensive state

The nursing student is part of a group of nursing students who are making a presentation on chronic hypertension. What is one subject the nursing student would need to include in the presentation as a possible consequence of untreated chronic hypertension?

Stroke

The nurse is caring for a client with hypertension. The nurse is correct to realize that a 24-hour urine is ordered to determine if the cause of hypertension is related to the dysfunction of which of the following?

The adrenal gland

A patient is being treated for hypertensive emergency. When treating this patient, the priority goal is to lower the mean blood pressure (BP) by which percentage in the first hour?

Up to 25%

Nurses should implement measures to relieve emotional stress for clients with hypertension because the reduction of stress

decreases the production of neurotransmitters that constrict peripheral arterioles

A blood pressure (BP) of 140/90 mm Hg is considered to be

hypertension

It is appropriate for the nurse to recommend smoking cessation for clients with hypertension because nicotine

increases the heart rate, constricts arterioles, and reduces the heart's ability to eject blood.

A systolic blood pressure of 135 mm Hg would be classified as

prehypertension.

According to the classification of hypertension diagnosed in older adults, hypertension that can be attributed to an underlying cause is termed

secondary

Hypertension that can be attributed to an underlying cause is termed

secondary hypertension.

The nurse is seeing a client for the first time and has just checked the client's blood pressure. The nurse would consider the client prehypertensive if:

systolic BP is between 120 and 139 mm Hg.