decisions Ch. 13 HTN

A nurse is educating a client about monitoring blood pressure readings at home. What will the nurse be sure to emphasize? A. "Sit with legs crossed when taking your blood pressure." B. "Sit quietly for 5 minutes prior to taking blood pressure." C. "Be sure the forearm is well supported above heart level while taking blood pressure." D. "Avoid smoking cigarettes for 8 hours prior to taking blood pressure."

B. "Sit quietly for 5 minutes prior to taking blood pressure."

The nurse is administering medications on a medical-surgical unit. A client is ordered to receive 40 mg oral nadolol for the treatment of hypertension. Before administering the medication, the nurse should A. check the client's urine output. B. check the client's heart rate. C. weigh the client. D. check the client's serum K+ level.

B. check the client's heart rate.

Which term is refers to hypertension in which blood pressure that is controlled with therapy becomes uncontrolled (abnormally high) when the therapy is discontinued?

Rebound

The nurse is working on a busy cardiac unit caring for four hypertensive clients. Which client description would the nurse assess first because the client is at an increased risk for malignant hypertension? A. A client with anorexia and history of no healthcare insurance B. A client with liver dysfunction who drinks alcohol daily C. A client with chronic asthma who uses a corticosteroid inhaler D. A schizophrenic residing at an assisted living facility

A. A client with anorexia and history of no healthcare insurance malignant hypertension can occur in individuals who fail to maintain follow-up or comply with medical therapy

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. Clonidine B. Amiloride C. Bumetanide D. Methyldopa

A. Clonidine

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. Secondary hypertension C. Primary hypertension D. Hypertensive urgency

A. Hypertensive emergency

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. Nausea and severe headache C. Urine output of 40 mL over the past hour D. Chest pain score of 3 (on a scale of 1 to 10)

A. Numbness and weakness in the left arm

Which term describes high blood pressure from an identified cause, such as renal disease? A. Secondary hypertension B. Rebound hypertension C. Primary hypertension D. Hypertensive emergency

A. Secondary hypertension

The nurse is caring for a client with a blood pressure of 210/100 mm Hg in the emergency room. What is the most appropriate route of administration for antihypertensive agents? A. continuous IV infusion B. intramuscular C. oral D. sublingual

A. continuous IV infusion

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: A. systolic BP is between 120 and 139 mm Hg. B. diastolic BP is between 70 and 79 mm Hg. C. diastolic BP is 100 mm Hg. D. systolic BP is above 180 mm Hg.

A. systolic BP is between 120 and 139 mm Hg.

What lifestyle factors will the nurse discuss with the client who has a blood pressure of 130/88? Select all that apply. A. weight reduction B. the DASH diet C. physical activity D. alcohol moderation E. dietary sodium

All the above

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. "Your blood pressure is fine. Just keep doing what you're doing." B. "Clients with diabetes should have a lower blood pressure goal. You should strive for 130/80 mm Hg." C. "The lower the better. Blood pressure of 120/80 mm Hg is best for everyone." D. "The current recommendation is for everyone to have blood pressure of 140/90 mm Hg or lower."

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

The nurse is caring for an older adult 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? A. Increase in calcium intake B. Loss of arterial elasticity C. Decrease in blood volume D. Decrease in cardiac output

B. Loss of arterial elasticity

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. Sexual dysfunction D. Rebound hypertension

B. Postural hypotension and resulting injury

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." What is the best response by the nurse? A. "Hypertension often causes no pain." B. "Hypertension is difficult to diagnose." C. "Hypertension often causes no symptoms." D. "Hypertension often kills early in the disease process."

C. "Hypertension often causes no symptoms."

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

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. Normal B. Stage 2 hypertension C. Elevated D. Stage 1 hypertension

C. Elevated

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 50% within the first hour of treatment. B. Rapidly reduce the blood pressure so the client will not suffer a stroke. C. Reduce the blood pressure by 20% to 25% within the first hour of treatment. D. Reduce the blood pressure to about 140/80 mm Hg.

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

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. Primary B. Essential C. Secondary D. Malignant

C. Secondary

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

C. Spironolactone

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. blurred vision B. tremor C. dizziness D. persistent cough

C. dizziness

A blood pressure (BP) of 140/90 mm Hg is considered to be A. normal. B. a hypertensive emergency. C. hypertension. D. prehypertension.

C. hypertension.

Papilledema is a fairly common symptom of elevated blood pressure. The best way to detect this condition is through: A. an MRI. B. laboratory tests. C. ophthalmic examination. D. using a sphygmomanometer.

C. ophthalmic examination.

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

D. Sit on the edge of the chair and rise slowly.

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. 150/95 or lower D. 130/80 or lower

D. 130/80 or lower

A patient is being treated for hypertensive emergency. When treating this patient, the priority goal is to lower the mean blood pressure (BP) by up to which percentage in the first hour? A. 35% B. 45% C. 40% D. 25%

D. 25%

Which of the following is the nurse most correct to recognize as a direct effect of client hypertension? A. Hyperglycemia resulting from insulin receptor resistance B. Emphysema related to poor gas exchange C. Anemia resulting from bone marrow suppression D. Renal dysfunction resulting from atherosclerosis

D. Renal dysfunction resulting from atherosclerosis

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 water and excretes sodium. B. The kidney retains sodium and water. C. The kidney retains sodium and excretes water. D. The kidney excretes sodium and water.

D. The kidney excretes sodium and water.

Nurses should implement measures to relieve emotional stress for clients with hypertension because the reduction of stress A. increases blood volume and improves the potential for greater cardiac output. B. increases the production of neurotransmitters that constrict peripheral arterioles. C. increases the resistance that the heart must overcome to eject blood. D. decreases the production of neurotransmitters that constrict peripheral arterioles.

D. decreases the production of neurotransmitters that constrict peripheral arterioles.

It is appropriate for the nurse to recommend smoking cessation for clients with hypertension because nicotine A. decreases the heart rate, constricts arterioles, and reduces the heart's ability to eject blood. B. decreases circulating blood volume. C. increases the heart rate, constricts arterioles, and increases the heart's ability to eject blood. D. increases the heart rate, constricts arterioles, and reduces the heart's ability to eject blood.

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

Hypertension that can be attributed to an underlying cause is termed A. essential hypertension. B. primary hypertension. C. isolated systolic hypertension. D. secondary hypertension.

D. secondary hypertension.

The nurse is caring for a client who has had 25 mg of oral hydrochlorothiazide added to the medication regimen for the treatment of hypertension. Which instruction should the nurse give the client?

Increase the amount of fruits and vegetables you eat."