PrepU Chapter 31

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 A client with excessive alcohol intake A client experiencing depression A client of advanced age

A client diagnosed with kidney disease

A community health nurse is screening for hypertension. Which of the following clients would the nurse focus on most intensively? A Hispanic teenager A middle-aged African-American man A 45-year-old Asian woman A postmenopausal Caucasian woman

A middle-aged African-American man

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? Vasodilator Diuretic Angiotensin-converting enzyme (ACE) inhibitor Beta blocker

Beta blocker

The nurse is caring for an elderly client with a diagnosis of hypertension, who is taking several antihypertensive medications. Which safety precaution is the nurse most likely to reinforce? Being sure to keep follow-up appointments Walking as far as the client is able every day Changing positions slowly related to possible hypotension Eating extra potassium due to loss of potassium related to medications

Changing positions slowly related to possible hypotension

You are the triage nurse in a walk-in clinic when a diabetic client visits the clinic and asks you to take her blood pressure (BP). The measurements are 150/90 mm Hg. Which of the following would the nurse expect as the treatment to normalize the client's BP? Daily exercise Smoking cessation programs Drug therapy Low-fat diet

Drug therapy

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? Postural hypertension and resulting injury Postural hypotension and resulting injury Rebound hypertension Sexual dysfunction

Postural hypotension and resulting injury

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? Malignant Primary Secondary Essential

Secondary

According to the DASH diet, how many servings of vegetables should a person consume per day? 7 or 8 2 or 3 4 or 5 2 or fewer

4 or 5

A nurse is teaching a client who is newly diagnosed with hypertension and diabetes mellitus. For a client without diabetes mellitus, the target blood pressure is 140/90 or lower. Because this client has diabetes mellitus, the target blood pressure will be which of the following? 130/80 or lower 145/95 or lower 150/95 or lower 125/85 or lower

130/80 or lower

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 Isolated systolic hypertension Angina Left ventricular hypertrophy

Rebound hypertension

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. Stroke Tension pneumothorax Coronary artery disease Pancreatitis Myocardial infarction

Coronary artery disease Myocardial infarction Stroke

A nurse is teaching a 38-year-old man with newly diagnosed hypertension who asks if there is any harm in stopping his antihypertensive medication if he decides to discontinue it. The correct reply addresses the consequence of stopping antihypertensive medications abruptly. Which of the following statements from the nurse would be appropriate? "Postural hypotension can occur." "Rebound hypertension can occur." "Postural hypertension can occur." "Rebound hypotension can occur."

"Rebound hypertension can occur."

A nurse educator is providing information about hypertension to a small group of clients. A participant asks what she can do to decrease her blood pressure and thus her risk for heart problems. The nurse describes modifiable and nonmodifiable risk factors. Which of the following risk factors can the client modify? Family history of cardiovascular disease Age (older than 55 years for men, 65 years for women) Dyslipidemia Ethnicity

Dyslipidemia

Which of the following diagnostic tests may reveal an enlarged left ventricle? Computed tomographic scan Echocardiography Positron emission tomography (PET) scan Fluorescein angiography

Echocardiography

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? Kidneys and autonomic nervous system Lung and arteries Brain and sympathetic nervous system Heart and blood vessels

Heart and blood vessels

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

Hypotension

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

Loss of arterial elasticity

A 77-year-old client has newly diagnosed stage 2 hypertension for which the physician has prescribed a thiazide and an angio-converting enzyme inhibitor. The nurse is concerned about the client's risk for postural hypotension because of these medications, as well as for what other reason? Older adults have impaired cardiovascular reflexes. Older adults require large doses of these medications to control their blood pressure. These medications often cause rebound hypertension. Older adults have trouble remembering to measure their blood pressure at home.

Older adults have impaired cardiovascular reflexes.

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

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

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? Right-sided heart failure Pulmonary insufficiency Peripheral edema Stroke

Stroke

During the physical assessment of a client with hypertension, what would you expect to be the most obvious finding? Hypotension in either one or both systolic or diastolic measurements. Client is underweight. Client is anemic. Sustained increase of either one or both systolic or diastolic measurements.

Sustained increase of either one or both systolic or diastolic measurements.

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% 45% 35% 40%

Up to 25%

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? persistent cough tremor dizziness blurred vision

dizziness

Which client statement indicates a good understanding of the nutritional modifications needed to manage hypertension? "I should eliminate caffeine from my diet to lower my blood pressure." "A glass of red wine each day will lower my blood pressure." "If I include less fat in my diet, I'll lower my blood pressure." "Limiting my salt intake to 2 grams per day will improve my blood pressure."

"Limiting my salt intake to 2 grams per day will improve my blood pressure."

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

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

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

140, 90

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

Continuous IV infusion

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 Stress test Cardiac catheterization Tilt-table test

Echocardiography

Which diagnostic method is recommended to determine whether left ventricular hypertrophy has occurred? Blood chemistry Echocardiography Electrocardiography Blood urea nitrogen

Echocardiography

A nurse is teaching about lifestyle modifications to a group of clients with known hypertension. Which of the following statements would the nurse include in the education session? Limit alcohol consumption to no more that 3 drinks per day. Maintain a waist circumference of 45 inches (114 cm) (men) and 40 inches (102 cm) (women) or less. Engage in aerobic activity at least 30 minutes/day most days of the week. Maintain a body mass index between 30 and 35.

Engage in aerobic activity at least 30 minutes/day most days of the week.

Which describes a situation in which blood pressure is severely elevated and there is evidence of actual or probable target organ damage? Primary hypertension Secondary hypertension Hypertensive urgency Hypertensive emergency

Hypertensive emergency

A client experiences orthostatic hypotension while receiving furosemide (Lasix) to treat hypertension. How should the nurse intervene? Instruct the client to sit for several minutes before standing. Administer a vasodilator as ordered. Insert an indwelling urinary catheter as ordered. Administer I.V. fluids as ordered.

Instruct the client to sit for several minutes before standing.

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? Urine output of 40 mL over the past hour Chest pain score of 3 (on a scale of 1 to 10) Numbness and weakness in the left arm Nausea and severe headache

Numbness and weakness in the left arm

When measuring the blood pressure in each arm of a healthy adult client, the nurse recognizes that which statement is true? Pressures may vary 10 mm Hg or more between arms. Pressures must be equal in both arms. Pressures may vary, with the higher pressure found in the left arm. Pressures should not differ more than 5 mm Hg between arms.

Pressures should not differ more than 5 mm Hg between Pressures should not differ more than 5 mm Hg between arms.

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? Discussing methods for stress reduction Administering glycemic control Purchasing a self-monitoring BP cuff Advising smoking cessation

Purchasing a self-monitoring BP cuff

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 Essential Secondary Primary

Rebound

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

Renal dysfunction resulting from atherosclerosis

Which finding indicates that hypertension is progressing to target organ damage? Retinal blood vessel damage Blood urea nitrogen concentration of 12 mg/dL Chest x-ray showing pneumonia Urine output of 60 mL over 2 hours

Retinal blood vessel damage

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

Sit on the edge of the chair and rise slowly.

Which diuretic medication conserves potassium? Chlorothiazide Furosemide Chlorthalidone Spironolactone

Spironolactone

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 The thymus The pituitary gland The thyroid gland

The adrenal gland

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. increases the resistance that the heart must overcome to eject blood. increases the production of neurotransmitters that constrict peripheral arterioles. increases blood volume and improves the potential for greater cardiac output.

decreases the production of neurotransmitters that constrict peripheral arterioles.

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

hypertension.

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

inform client to avoid over-the-counter cold and sinus medications

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? procedural interventions observation only nonpharmacological interventions pharmacological interventions

nonpharmacological interventions

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

ophthalmic examination.

A diastolic blood pressure of 90 mm Hg is classified as normal. prehypertension. stage 1 hypertension. stage 2 hypertension.

stage 1 hypertension.

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 Frequent upper respiratory infections Physical inactivity Gallbladder disease Smoking

Smoking Diabetes mellitus Physical inactivity

A client with high blood pressure is receiving an antihypertensive drug. The nurse knows that antihypertensive drugs commonly cause fatigue and dizziness, especially on rising. When developing a client teaching plan to minimize orthostatic hypotension, which instruction should the nurse include? "Flex your calf muscles, avoid alcohol, and change positions slowly." "Rest between demanding activities, eat plenty of fruits and vegetables, and drink 6 to 8 cups of fluid daily." "Avoid drinking alcohol and straining at stool, and eat a low-protein snack at night." "Wear elastic stockings, change positions quickly, and hold onto a stationary object when rising."

"Flex your calf muscles, avoid alcohol, and change positions slowly."

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'm glad I can still have chicken bouillon." "I chose a tossed salad with sardines and oil and vinegar dressing for lunch." "I chose broiled chicken with a baked potato for dinner." "I can still eat a ham-and-cheese sandwich with potato chips for lunch."

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

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? Take the medicine on an empty stomach. A possible adverse effect of blood pressure medicine is dizziness when you stand. There are no adverse effects from blood pressure medicine. A severe drop in blood pressure is possible.

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

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? 0.24 mL 2.4 mL 0.48 mL 4.8 mL

4.8 mL

A nurse is discussing with a nursing student how to accurately measure blood pressure. Which of the following points does the nurse emphasize? The size of the cuff does not matter as long as it fits snugly around the arm. A cuff that is too small will give a false low blood pressure. A cuff that is too large will give a false high blood pressure. A cuff that is too small will give a false high blood pressure.

A cuff that is too small will give a false high blood pressure.

A client is being seen at the clinic for a routine physical when the nurse notes the client's blood pressure is 150/97. The client is considered to be a healthy, well-nourished young adult. What type of hypertension does this client have? Essential (primary) Secondary Pathologic Malignant

Essential (primary)

A nurse educator is teaching a small group of clients about hypertension and dietary changes that will assist in lowering blood pressure readings. The nurse is specifically discussing the (Dietary Approaches to Stop Hypertension (DASH) diet and teaches the clients that the food group with the largest number of servings per day is which of the following? Fruits Vegetables Low-fat or fat-free dairy foods Grains and grain products

Grains and grain products

The nurse is caring for a client with hypertension who is experiencing complications. What diagnostic test evaluates the efficiency or inefficiency of the heart to pump blood? Echocardiography Multiple gated acquisition (MUGA) scan Chest radiography Computed tomography scan

Multiple gated acquisition (MUGA) scan

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? Postural hypertension and resulting injury Sexual dysfunction Rebound hypertension Postural hypotension and resulting injury

Postural hypotension and resulting injury

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? Magnesium level Calcium level Potassium level Sodium level

Potassium level

A systolic blood pressure of 135 mm Hg would be classified as normal. prehypertension. stage 1 hypertension. stage 2 hypertension.

prehypertension.

According to the classification of hypertension diagnosed in older adults, hypertension that can be attributed to an underlying cause is termed isolated systolic. essential. secondary. primary.

secondary.