Med Surg Chapter 31

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. o 140, 90 o 130, 80 o 110, 60 o 120, 70

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? o 4.8 mL o 0.48 mL o 2.4 mL o 0.24 mL

4.8

A female client, aged 82, visits the clinic for a blood pressure (BP) check. Her hypertension is not well controlled, and a new blood pressure medicine is prescribed. What is important for the nurse to teach this client about her blood pressure medicine? o Take the medicine on an empty stomach. o There are no adverse effects from blood pressure medicine. o A possible adverse effect of blood pressure medicine is dizziness when you stand. o A severe drop in blood pressure is possible.

A possible adverse effect of blood pressure medicine is dizziness when you stand.

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 not modifiable by the client? o Dyslipidemia o Age o Inactivity o Obesity

Age

When treating hypertensive emergencies, the nurse identifies the most appropriate route of administration for antihypertensive agents as being which of the following? o Continuous IV infusion o Sublingual o Intramuscular o Oral

Continuous IV infusion

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? o The patient's blood pressure (BP) is always higher in a hypertensive emergency. o Close hemodynamic monitoring is required during treatment of hypertensive emergencies. o Hypertensive urgency is treated with rest and tranquilizers to lower BP. o Hypertensive emergencies are associated with evidence of target organ damage.

Hypertensive emergencies are associated with evidence of target organ damage.

Which of the following would be inconsistent as a component of metabolic syndrome? o Hypotension o Hypertension o Elevated triglyceride levels o Abdominal obesity

Hypotension

The nurse understands that client education related to antihypertensive medication should include which of the following? o Inform client that recommended lifestyle changes are not necessary o Inform client if a dosage of medication is missed, to double the next scheduled dose o Inform client to avoid over-the-counter cold and sinus medications o Inform client to discontinue antihypertensives once blood pressure is normal

Inform client to avoid over-the-counter cold and sinus medications.

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? o Loss of arterial elasticity o Decrease in blood volume o Increase in calcium intake o Decrease in cardiac output

Loss of arterial elasticity

The nurse teaches the client which guideline regarding lifestyle modification for hypertension? o Reduce smoking to no more than four cigarettes per day o Limit aerobic physical activity to 15 minutes, three times per week o Stop alcohol intake o Maintain adequate dietary intake of potassium

Maintain adequate dietary intake of potassium

The nurse teaches the client which guideline regarding lifestyle modification for hypertension? o Stop alcohol intake o Reduce smoking to no more than four cigarettes per day o Maintain adequate dietary intake of potassium o Limit aerobic physical activity to 15 minutes, three times per week

Maintain adequate dietary intake of potassium.

A 77-year-old client has newly diagnosed stage 2 hypertension. The physician has prescribed a thiazide and an angio-converting enzyme inhibitor. About what is the nurse most concerned? o Postural hypertension and resulting injury o Rebound hypertension o Sexual dysfunction o Postural hypotension and resulting injury

Postural hypotension and resulting injury

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? o Hypertensive o Normal o Slightly hypertensive o Prehypertensive

Prehypertensive

The nurse is instructing a client who is newly prescribed an antihypertensive medication. Which nursing instruction is emphasized to maintain client safety? o Sit on the edge of the chair and rise slowly. o Do not operate a motor vehicle. o Use a pillbox to store daily medication. o Take the medication at the same time daily.

Sit on the edge of the chair and rise slowly.

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. Gallbladder disease Smoking Diabetes mellitus Physical inactivity Frequent upper respiratory infections

Smoking Diabetes mellitus Physical inactivity

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

Spironolactone

Mr. Faulkner is a 69-year-old man who has enjoyed generally good health for his entire adult life. As a result, he has been surprised to receive a new diagnosis of hypertension after a series of visits to his primary care provider. The nurse who is working with Mr. Faulkner should recognize which of the following aspects of aging and hypertension? o The diagnostic criteria for hypertension in adults over 65 differ from those for younger adults. o The incidence and prevalence of hypertension increase with age. o Blood pressure remains stable throughout adulthood but tends to be assessed more often by health care providers of older adults. o Older adults are less vulnerable to the pathophysiological effects of hypertension than are younger adults.

The incidence and prevalence of hypertension increase with age.

The nurse observes a certified nursing assistant (CNA) obtaining a blood pressure reading with a cuff that is too small for the patient. The nurse informs the CNA that using a cuff that is too small can affect the reading results in what way? o The results will be falsely decreased. o The results will be falsely elevated. o It will give an accurate reading. o It will be significantly different with each reading.

The results will be falsely elevated.

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? o 35% o Up to 25% o 45% o 40%

Up to 25%

A client who was recently diagnosed with prehypertension is to meet with a dietitian and return for a follow-up with the cardiologist in 6 months. What would this client's treatment likely include? o nonpharmacological interventions o pharmacological interventions o procedural interventions o observation only

non-pharmacological interventions