PrepU ML Quiz Ch.31
A nurse is teaching a client who is newly diagnosed with hypertension and diabetes mellitus. What will the nurse specify about this client's target blood pressure? A. 145/95 or lower B. 125/85 or lower C. 130/80 or lower D. 150/95 or lower
C
According to the DASH diet, how many servings of vegetables should a person consume each day? A. 2 or fewer B. 2 or 3 C. 4 or 5 D. 7 or 8
C
A blood pressure (BP) of 140/90 mm Hg is considered to be A. hypertension. B. prehypertension. C. a hypertensive emergency. D. normal.
A
An older adult client visits the clinic for a blood pressure (BP) check. The client's hypertension is not well controlled, and a new blood pressure medicine is prescribed. What is important for the nurse to teach this client about the blood pressure medicine? A. A possible adverse effect of blood pressure medicine is dizziness when you stand. B. Take the medicine on an empty stomach. C. A severe drop in blood pressure is possible. D. There are no adverse effects from blood pressure medicine.
A
The nurse is discussing aging and the incidence of hypertension with an older adult. What lifestyle change will lower blood pressure for the older adult? A. Sleep four hours each night. B. Add salt to foods for taste. C. Keep weight stable. D. Exercise once a week.
C
Which statements are true when the nurse is measuring blood pressure (BP)? Select all that apply. A. Using a BP cuff that is too small will give a higher BP measurement. B. The client should sit quietly while BP is being measured. C. The client's BP should be measured 1 hour before consuming alcohol. D. Using a BP cuff that is too large will give a higher BP measurement. E. The client's arm should be positioned at the level of the heart.
A, B, E
A client is taking amiloride and lisinopril for the treatment of hypertension. What laboratory studies should the nurse monitor while the client is taking these two medications together? A. Potassium level B. Calcium level C. Sodium level D. Magnesium level
A
A nurse is educating about lifestyle modifications for a group of clients with newly diagnosed hypertension. While discussing dietary changes, which point would the nurse emphasize? A. It takes 2 to 3 months for the taste buds to adapt to decreased salt intake. B. There is usually no need to change alcohol consumption for clients with hypertension. C. The taste buds never adapt to decreased salt intake. D. A person with hypertension should never consume alcohol.
A
Nurses should implement measures to relieve emotional stress for clients with hypertension because the reduction of stress A. decreases the production of neurotransmitters that constrict peripheral arterioles. B. increases the resistance that the heart must overcome to eject blood. C. increases the production of neurotransmitters that constrict peripheral arterioles. D. increases blood volume and improves the potential for greater cardiac output.
A
The nurse is planning the care of a patient admitted to the hospital with hypertension. What objective will help to meet the needs of this patient? A. Lowering and controlling the blood pressure without adverse effects and without undue cost B. Instructing the patient to enter a weight loss program and begin an exercise regimen C. Scheduling the patient for all follow-up visits and making phone calls to the home to ensure adherence D. Making sure that the patient adheres to the therapeutic medication regimen
A
When measuring blood pressure in each arm of a healthy adult, the nurse recognizes that the pressures A. differ no more than 5 mm Hg between arms. B. may vary, with the higher pressure found in the left arm. C. may vary 10 mm Hg or more between arms. D. must be equal in both arms.
A
Which describes a situation in which blood pressure is severely elevated and there is evidence of actual or probable target organ damage? A. Hypertensive emergency B. Hypertensive urgency C. Primary hypertension D. Secondary hypertension
A
Which finding indicates that hypertension is progressing to target organ damage? A. Retinal blood vessel damage B. Chest x-ray showing pneumonia C. Blood urea nitrogen concentration of 12 mg/dL D. Urine output of 60 mL over 2 hours
A
A client is taking 50 mg of oral spironolactone twice a day to assist with blood pressure control. While the nurse is performing the morning assessment, the client reports nausea, general muscle cramps, and weakness. The ECG strip shows a peaked, narrow T-wave, which is a change. What electrolyte imbalance does the nurse suspect? A. Hyponatremia B. Hyperkalemia C. Hypokalemia D. Hypernatremia
B
A 66-year-old client presents to the emergency department reporting severe headache and mild nausea for the past 6 hours. Upon assessment, the client's BP is 210/120 mm Hg. The client has a history of hypertension and takes 1.0 mg clonidine twice daily. Which question is most important for the nurse to ask the client next? A. "Did you take any medication for your headache?" B. "Are you having chest pain or shortness of breath?" C. "Have you taken your prescribed clonidine today?" D. "Do you have a dry mouth or nasal congestion?"
C
A 77-year-old client presents to the local community center for a blood pressure (BP) screening; BP is recorded as 180/90 mm Hg. The client has a history of hypertension but currently is not taking the prescribed medications. Which question is most appropriate for the nurse to ask the client first? A. "Are you able to get to your pharmacy to pick up your medications?" B. "Are you having trouble paying for your medications?" C. "What medications are you prescribed?" D. "Why are you not taking your medications?"
D
The nurse is administering metoprolol to a client. What type of medication should the nurse educate the client about? A. Angiotensin-converting enzyme (ACE) inhibitor B. Diuretic C. Vasodilator D. Beta blocker
D
The nurse is teaching a client about chronic untreated hypertension. What complication will the nurse explain to the client? A. right-sided heart failure B. stroke C. peripheral edema D. pulmonary insufficiency
B
A 35-year-old client has been diagnosed with hypertension. The client is a stock broker, smokes daily, and has diabetes. During a follow-up appointment, the client states that regular visits to the doctor just to check blood pressure (BP) are cumbersome and time consuming. As the nurse, which aspect of client teaching would you recommend? A. Purchasing a self-monitoring BP cuff B. Administering glycemic control C. Advising smoking cessation D. Discussing methods for stress reduction
A
A client comes to the emergency department complaining of visual changes and severe headache and denies past medical history. The nurse measures the client's blood pressure at 210/120 mm Hg. What question will the nurse ask to explore the hypertension situation? A. "Do you have hypertension in your family?" B. "What have you eaten in the last 24 hours?" C. "Did you try an over-the-counter medication?" D. "Do you smoke cigarettes?"
A
A client has just been diagnosed with prehypertension. What would the nurse instruct this client to do to restore blood pressure below hypertensive levels? A. Decrease sodium intake B. Increase iodine intake C. Avoid over-the-counter decongestants D. Increase fluid intake
A
A client is admitted to the intensive care unit (ICU) with a diagnosis of hypertension emergency/crisis. The client's blood pressure (BP) is 200/130 mm Hg. The nurse is preparing to administer IV nitroprusside. Upon assessment, which finding requires immediate intervention by the nurse? A. Numbness and weakness in the left arm B. Urine output of 40 mL over the past hour C. Chest pain score of 3 (on a scale of 1 to 10) D. Nausea and severe headache
A
A client is brought to the emergency department with reports 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? A. Reduce the blood pressure by 20% to 25% within the first hour of treatment. B. Reduce the blood pressure by 50% within the first hour of treatment. C. Rapidly reduce the blood pressure so the client will not suffer a stroke. D. Reduce the blood pressure to about 140/80 mm Hg.
A
A client who is newly diagnosed with hypertension is going to be starting antihypertensive medicine. What is one of the main things the client and the client's spouse should watch for? A. dizziness B. persistent cough C. tremor D. blurred vision
A
Primary or essential hypertension accounts for about 95% of all hypertension diagnoses with an unknown etiology. Secondary hypertension accompanies specific conditions that create hypertension as a result of tissue damage. Which condition contributes to secondary hypertension? A. arterial vasoconstriction B. hepatic function C. acid-base imbalance D. calcium deficit
A
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? A. The adrenal gland B. The thymus C. The thyroid gland D. The pituitary gland
A
The nurse is creating a community teaching demonstration focusing on the cause of blood pressure. When completing the visual aid, which body structures represent the mechanism of blood pressure? A. Heart and blood vessels B. Kidneys and autonomic nervous system C. Lung and arteries D. Brain and sympathetic nervous system
A
The nurse is teaching a client who is experiencing dizziness to rise slowly from a sitting or lying position. What is the rationale for the teaching? A. Gradual changes in position provide time for the heart to increase rate of contraction to resupply oxygen to the brain. B. Gradual changes in position help reduce the blood pressure to resupply oxygen to the brain. C. Gradual changes in position help reduce the heart's work to resupply oxygen to the brain. D. Gradual changes in position provide time for the heart to reduce its rate of contraction to resupply oxygen to the brain.
A
When administering benazepril with spironolactone, the nurse should be aware that which electrolyte imbalance may occur? A. Hyperkalemia B. Hypercalcemia C. Hypocalcemia D. Hypokalemia
A
When measuring the blood pressure in each arm of a healthy adult client, the nurse recognizes that which statement is true? A. Pressures should not differ more than 5 mm Hg between arms. B. Pressures may vary 10 mm Hg or more between arms. C. Pressures must be equal in both arms. D. Pressures may vary, with the higher pressure found in the left arm.
A
Which diuretic medication conserves potassium? A. Spironolactone B. Furosemide C. Chlorthalidone D. Chlorothiazide
A
The nurse is performing an assessment on a patient to determine the effects of hypertension on the heart and blood vessels. What specific assessment data will assist in determining this complication? (Select all that apply.) A. Character of apical and peripheral pulses B. Heart rhythm C. Heart rate D. Respiratory rate E. Lung sounds
A, B, C
A nurse is providing education to a client about monitoring blood pressure readings at home. What reminders will the nurse review with the client? Select all that apply. A. Be sure the forearm is well supported at heart level while taking blood pressure B. Ensure at least 5 minutes of quiet rest before measurements. C. Sit with both feet on the ground during the measurement. D. Avoid talking during the measurement. E. Avoid smoking cigarettes for 1 hour prior to taking blood pressure.
A, B, C, D
A nurse providing education about hypertension to a community group is discussing the high risk for cardiovascular complications. What are risk factors for cardiovascular problems in clients with hypertension? Select all that apply. A. Physical inactivity B. Smoking C. Frequent upper respiratory infections D. Diabetes mellitus E. Gallbladder disease
A, B, D
The nurse is conducting a service project for a local elderly community group on the topic of hypertension. The nurse will relay that which risk factors and cardiovascular problems are related to hypertension? Select all that apply. A. Age ≥65 in women B. Overweight/obesity C. Decreased low-density lipoprotein (LDL) levels D. Smoking E. Elevated high-density lipoprotein (HDL) cholesterol
A, B, D
What risk factors would cause the nurse to become concerned that the client may have atherosclerotic heart disease? Select all that apply. A. family history of early cardiovascular events B. hypertension C. lowered triglyceride levels D. active lifestyle E. obesity F. diabetes
A, B, E, F
A nurse is assisting with checking blood pressures at a local health care fair. To which client would the nurse pay particular attention? A. A 16-year-old girl B. An Asian adult man C. A 40-year-old African-American man D. A 50-year-old Caucasian woman
C
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? A. procedural interventions B. nonpharmacological interventions C. observation only D. pharmacological interventions
B
An older adult client has newly diagnosed stage 2 hypertension. The health care provider has prescribed Chlorothiazide and Benazepril. What will the nurse monitor this client for? A. Postural hypertension and resulting injury B. Postural hypotension and resulting injury C. Rebound hypertension D. Sexual dysfunction
B
As recommended follow-up for a client initially diagnosed with prehypertension, the client should get his or her blood pressure rechecked within which time frame? A. Evaluate within 1 month B. Recheck in 1 year C. Recheck in 2 years D. Confirm within 2 months
B
It is important for the nurse to encourage the client to rise slowly from a sitting or lying position because gradual changes in position A. help reduce the work required by the heart to resupply oxygen to the brain. B. provide time for the heart to increase the rate of contraction to resupply oxygen to the brain. C. help reduce the blood pressure to resupply oxygen to the brain. D. provide time for the heart to reduce the rate of contraction to resupply oxygen to the brain.
B
The nurse is evaluating the types of medications prescribed for a client's hypertension. Which of the following medication classifications establishes an action on vasoconstrictive hormones in the blood stream? A. Beta-blocker B. ACE inhibitor C. Loop diuretic D. Calcium channel blocker
B
Which client statement indicates a good understanding of the nutritional modifications needed to manage hypertension? A. "I should eliminate caffeine from my diet to lower my blood pressure." B. "Limiting my salt intake to 2 grams per day will improve my blood pressure." C. "If I include less fat in my diet, I'll lower my blood pressure." D. "A glass of red wine each day will lower my blood pressure."
B
Which describes a situation in which blood pressure is severely elevated and there is evidence of actual or probable target organ damage? A. Secondary hypertension B. Hypertensive emergency C. Hypertensive urgency D. Primary hypertension
B
A nurse is providing education about hypertension to a community group. What are possible consequences of untreated hypertension? Select all that apply. A. Pancreatitis B. Myocardial infarction C. Stroke D. Coronary artery disease E. Tension pneumothorax
B, C, D
A client has severe coronary artery disease (CAD) and hypertension. Which medication order should the nurse consult with the health care provider about that is contraindicated for a client with severe CAD? A. Bumetanide B. Methyldopa C. Clonidine D. Amiloride
C
A client in a clinic setting has just been diagnosed with hypertension. When the client asks what the end goal is for treatment, what is the nurse's best response? A. To stop smoking and increase physical activity to 30 minutes/day most days of the week B. To lose weight, achieve a body mass index of 24 or less, and to eat a diet rich in fruits and vegetables C. To prevent complications/death by achieving and maintaining a blood pressure of 140/90 or less D. To prevent complications/death by achieving and maintaining a blood pressure of 145/95 or less
C
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? A. "I can still eat a ham-and-cheese sandwich with potato chips for lunch." B. "I'm glad I can still have chicken bouillon." C. "I chose broiled chicken with a baked potato for dinner." D. "I chose a tossed salad with sardines and oil and vinegar dressing for lunch."
C
A client, newly admitted to the nursing unit, has a primary diagnosis of renal failure. When assessing the client, the nurse notes a blood pressure (BP) of 180/100. The nurse knows that this is what kind of hypertension? A. Malignant B. Essential C. Secondary D. Primary
C
A diabetic client visits a walk-in clinic and asks the nurse to take a blood pressure (BP) reading. The measurements are 150/90 mm Hg. Which of the following would the nurse expect as the treatment to normalize the client's BP? A. Low-fat diet B. Smoking cessation programs C. Drug therapy D. Daily exercise
C
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. When the client asks the nurse what his or her blood pressure should be, what is the nurse's most appropriate response? A. "The current recommendation is for everyone to have blood pressure of 140/90 mm Hg or lower." B. "Your blood pressure is fine. Just keep doing what you're doing." C. "Clients with diabetes should have a lower blood pressure goal. You should strive for 130/80 mm Hg." D. "The lower the better. Blood pressure of 120/80 mm Hg is best for everyone."
C
A nurse is teaching a client with severe hypertension about the damage this condition can cause to the body. What system/organs will the nurse note are particularly targeted for damage due to severe hypertension? A. Musculoskeletal B. Gastrointestinal C. Sensory D. Integumentary
C
Papilledema is a fairly common symptom of elevated blood pressure. The best way to detect this condition is through: A. using a sphygmomanometer. B. an MRI. C. ophthalmic examination. D. laboratory tests.
C
The nurse is explaining the DASH diet to a client diagnosed with hypertension. The client inquires about how many servings of fruit per day can be consumed on the diet. What is the nurse's best response? A. 2 or fewer servings per day B. 2 or 3 servings per day C. 4 or 5 servings per day D. 7 or 8 servings per day
C
The nurse teaches the client which guidelines regarding lifestyle modifications for hypertension? A. Stop alcohol intake B. Reduce smoking to no more than four cigarettes per day C. Maintain adequate dietary intake of fruits and vegetables D. Limit aerobic physical activity to 15 minutes, three times per week
C
Which term describes a situation in which blood pressure is very elevated but there is no evidence of impending or progressive target organ damage? A. Secondary hypertension B. Hypertensive emergency C. Hypertensive urgency D. Primary hypertension
C
A nurse is providing education about hypertension to a community group. What are possible consequences of untreated hypertension? Select all that apply. A. Tension pneumothorax B. Pancreatitis C. Stroke D. Coronary artery disease E. Myocardial infarction
C, D, E
A client is being seen at the clinic on a monthly basis for assessment of blood pressure. The client has been checking blood pressure at home as well and has reported a systolic pressure of 158 and a diastolic pressure of 64. What does the nurse suspect this client is experiencing? A. Hypertensive urgency B. Primary hypertension C. Secondary hypertension D. Isolated systolic hypertension
D
A client with high blood pressure is receiving an antihypertensive drug. When developing a client teaching plan to minimize orthostatic hypotension, which instruction should the nurse include? A. "Avoid drinking alcohol and straining at stool, and eat a low-protein snack at night." B. "Rest between demanding activities, eat plenty of fruits and vegetables, and drink 6 to 8 cups of fluid daily." C. "Wear elastic stockings, change positions quickly, and hold onto a stationary object when rising." D. "Flex your calf muscles, avoid alcohol, and change positions slowly."
D
A nurse is educating a client about monitoring blood pressure readings at home. What will the nurse be sure to emphasize? A. "Be sure the forearm is well supported above heart level while taking blood pressure." B. ."Sit with legs crossed when taking your blood pressure." C. "Avoid smoking cigarettes for 8 hours prior to taking blood pressure." D. "Sit quietly for 5 minutes prior to taking blood pressure."
D
A patient arrives at the clinic for a follow-up visit for treatment of hypertension. The nurse obtains a blood pressure reading of 180/110 but finds no evidence of impending or progressive organ damage when performing the assessment on the patient. What situation does the nurse understand this patient is experiencing? A. Hypertensive emergency B. Secondary hypertension C. Primary hypertension D. Hypertensive urgency
D
The nurse is assessing a patient with severe hypertension. When performing a focused assessment of the eyes, what does the nurse understand may be observed related to the hypertension? A. Cataracts B. Retinal detachment C. Glaucoma D. Papilledema
D
The nurse is assessing the blood pressure for a patient who has hypertension and the nurse does not hear an auscultatory gap. What outcome may be documented in this circumstance? A. A low diastolic reading B. A high systolic pressure reading C. A normal reading D. A high diastolic or low systolic reading
D
The nurse is caring for a client prescribed bumetanide for the treatment of stage 2 hypertension. Which finding indicates the client is experiencing an adverse effect of the medication? A. Blood glucose value of 160 mg/dL B. Urine output of 90 mL 1 hour after medication administration C. Electrocardiogram (EGG) tracing demonstrating peaked T waves D. Serum potassium value of 3.0 mEq/L
D
The nurse is caring for a client with essential hypertension. The nurse reviews lab work and assesses kidney function. Which action of the kidney would the nurse evaluate as the body's attempt to regulate high blood pressure? A. The kidney retains sodium and excretes water. B. The kidney retains sodium and water. C. The kidney retains water and excretes sodium. D. The kidney excretes sodium and water.
D
The nurse is completing a cardiac assessment on a client. The patient has a blood pressure (BP) reading of 126/78. What would the nurse would identify this blood pressure reading as? A.Stage 2 hypertension B. Normal C. Stage 1 hypertension D. Elevated
D
The nurse is instructing a student on the proper technique for measuring blood pressure (BP). Which student action indicates a need for further teaching? A. Palpates the systolic pressure before auscultating blood pressure B. Wraps the blood pressure cuff firmly around the arm C. Centers the blood pressure cuff bladder directly over the brachial artery D. Positions the arm at waist level
D
The physician is ordering a test for the hypertensive client that will be able to evaluate whether the client has experienced heart damage. Which diagnostic test would the nurse anticipate to determine heart damage? A. Chest radiograph B. Blood chemistry C. Fluorescein angiography D. Multiple gated acquisition scan (MUGA)
D
Which condition contributes to secondary hypertension? A. Calcium deficit B. Hepatic function C. Acid-based imbalance D. Arterial vasoconstriction
D
Which diagnostic method is recommended to determine whether left ventricular hypertrophy has occurred? A. Electrocardiography B. Blood chemistry C. Blood urea nitrogen D. Echocardiography
D
Which of the following client scenarios would be correct for the nurse to identify as a client with secondary hypertension? A. A client with excessive alcohol intake B. A client experiencing depression C. A client of advanced age D. A client diagnosed with kidney disease
D
Which of the following is the nurse most correct to recognize as a direct effect of client hypertension? A. Anemia resulting from bone marrow suppression B. Emphysema related to poor gas exchange C. Hyperglycemia resulting from insulin receptor resistance D. Renal dysfunction resulting from atherosclerosis
D
Which of the following is the nurse most correct to recognize as a direct effect of client hypertension? A. Emphysema related to poor gas exchange B. Anemia resulting from bone marrow suppression C. Hyperglycemia resulting from insulin receptor resistance D. Renal dysfunction resulting from atherosclerosis
D