Hypertension

Normal BP

< 120/80

Stage II hypertension

> or = 160/100

Prehypertension

121/81 - 139/89

Stage I hypertension

141/91 - 159/99

A nurse is reviewing the health record of a client who is starting propranolol (Inderal) to treat hypertension. Which of the following conditions is a contraindication for taking propranolol? a. asthma b. diabetes c. angina d. tachycardia

a. asthma blockage of beta 2 receptors in the lungs cause bronchoconstriction b. use cautiously in DM patients because it can mask the signs of hypoglycemia c. Rx to treat angina d. Rx to treat tachycardia

A nurse is caring for a client who has a new diagnosis of hypertension and a new prescription for spironolactone (Aldactone) 25 mg/day. Which of the following statements by the client indicates a need for further teaching. a. I should eat a lot of fruits and vegetables, especially bananas and potatoes b. I will report any changes in heart rate or rhythm c. I should use a salt substitute that is low in potassium d. I will continue to take this medication even if I am feeling better

a. bananas and potatoes contain potassium and could put the patient at risk for hyperkalemia

A nurse is caring for a client with a history of hypertension who is treated with metoprolol (Lopressor), hydrochlorothiazide (Hydrodiuril), and captopril (Capoten). The client's current blood pressure is 120/80 with a heart rate of 48. Which of the following is the best action by the nurse? a. Administer the captopril and the hydrochlorothiazide, hold the metoprolol, and notify the physician. b. Administer all medications and notify the physician. c. Administer the metroprolol and the hydrochlorothiazide, hold the captopril, and notify the physician. d. Withhold all medications and notify the physician.

a. hold the metoprolol, call provider Metoprolol is a beta-blocker and causes a decreased heart rate. Neither the captopril nor the hydrochlorothiazide causes a decreased heart rate

A nurse is teaching a client who is starting verapamil (Calan) to control hypertension. Which of the following should the nurse include in the teaching? a. increase the amount of dietary fiber b. drink grapefruit juice to increase vitamin C c. decrease the amount of calcium d. withhold food for 1 hr after the medication is taken

a. increase fiber to prevent constipation b. grapefruit juice can lead to toxicity c. calcium is not important here d. take with food to prevent GI upset

A nurse is providing discharge teaching for a client who has a prescription for furosemide (Laxix) 40 mg PO daily. What time of the day should the nurse encourage the client to take this medication? a. morning b. immediately after lunch c. immediately before dinner d. bedtime

a. morning all others could disrupt the clients sleep

A client with hypertension is being treated with metoprolol (Lopressor), hydrochlorothiazide, and carpool (Capoten. Other scheduled medications include decussate (Colace) and a multivitamin. The client's current BP is 124/86 and pulse is 48. Which scheduled medications doses should the nurse administer. select all a. metoprolol b. captopril c. hydrochlorothiazide d. docusate e. multivitamin

b, c, d & e a. metoprolol causes bradycardia

A nurse is planning to administer a first dose of captopril (Capoten) to a hospitalized client who has hypertension. Which of the following medications can intensify early adverse effects of captopril? (select all) a. simvastatin (Zocor) b. hydrochlorothiazide c. phenytoin (Dilantin) d. clonidine (Catapres) e. aliskiren (Tekturna)

b. hydrochlorothiazide may intensify orthostatic hypotension d. clonidine may intensify orthostatic hypotension e. alizarine may intensify orthostatic hypotension simvastatin and phenytoin do not interact with captopril

The nurse concludes that an important outcome of care for a female client with hypertension has been met when the client is able to a. return to usual ADLs b. identify actions to counteract two modifiable risk factors c. lower BP by 10% d. d/c lifestyle modifications

b. identify actions to counteract two modifiable risk factors a. ADLs not an issue c. may or may not be significant enough d. contraindicated...just wrong...lol

The nurse is aware that reduction of stress is an important part of controlling hypertension. The nurse encourages the client with hypertension to reduce stress in which of the following ways? a. Repressing anger. b. Weekly visits to a massage therapist. c. Working from home. d. Eating food when angry.

b. massage

A nurse is screening a client for hypertension. Which of the following actions by the client increases his risk for hypertension? (select all) a. drinking 8 oz of nonfat milk daily b. eating popcorn at the movie theater c. walking 1 mile daily at 12 min/mile pace d. consuming 36 oz of beer daily e. getting a massage once a week

b. popcorn d. alcohol all others reduce the risk for hypertension

A nurse is teaching a family with several members at risk for hypertension about measures that can be taken to help prevent hypertension. The nurse includes which of the following in the teaching? (Select all that apply.) a. Increase sodium intake. b. Stop smoking. c. Eat a diet rich in fruits and vegetables. d. Engage in isometric exercises. e. Reduce cholesterol intake.

b. smoking c. fruits and veggies e. reduce cholesterol Exercise is encouraged but it should be aerobic exercise as isometric exercise does not improve cardiac health.

A nurse is caring for a client who is admitted to the emergency department with a BP of 266/147 mm Hg. The client reports a headache and states that she is seeing double. The client states that she ran out of her diltazem (Cardizem) 3 days ago, and she has not been able to purchase more. Which of the following nursing interventions should the nurse expect to perform first? a. administer acetaminophen for headache. b. provide teaching in regard to the importance of not abruptly stoping an antihypertensive c. obtain IV access and prepare to administer an IV antihypertensive d. call social services for a referral for financial assistance in obtaining her medications

c. IV antihypertensive

The nurse assesses which of the following clients as being at highest risk for hypertension? a. The Caucasian middle-aged adult who smokes. b. The Caucasian woman with central obesity who drinks 2-3 drinks per day. c. The African American woman who enjoys traditional cultural foods and is above a healthy weight. d. The female adolescent African American.

c. The African American woman who enjoys traditional cultural foods and is above a healthy weight.

The nurse is obtaining a blood pressure for a client with primary hypertension. The nurse ensures accuracy of the blood pressure by avoiding which of the following? a. Using a cuff that covers 80% of the limb. b. Placing the arm in a supportive position, bare-armed, and at the level of the heart. c. Taking the blood pressure within ten minutes of the client ingesting caffeine. d. Measuring the blood pressure after the client has rested for five minutes.

c. caffeine

A nurse in an acute care facility is infusing IV nitroprusside for a client who is in hypertensive crisis. For which of the following adverse reactions should the nurse monitor this client? a. intestinal ileus b. neutropenia c. delirium d. hyperthermia

c. delirium and other mental status changes may occur in thiocyanate toxicity

A nurse in an urgent care clinic is obtaining a history from a client who has type 2 DM and a recent diagnosis of hypertension. This is the second time in two week that the client experienced hypoglycemia. Which of the following data should the nurse report to the provider? a. takes psyllium hydrophilic muccilloid (Metamucil) b. drinks skim milk daily c. takes metoprolol (Lopressor) d. drinks grapefruit juice daily

c. metoprolol (Lopressor) masks the effects of hypoglycemia

A nurse is caring for a client who is starting captopril (Capoten) for hypertension. For which of the following adverse effects should the nurse monitor the client? a. hypokalemia b. hypernatremia c. neutropenia d. anemia

c. neutropenia is a serious adverse effect that can occur in clients taking an ACE inhibitor. a. hyperkalemia = ACE inhibitor b. hypernatremia is not a risk factor d. anemia is not a risk factor

The nurse caring for a diabetic client with chronic renal failure classifies the client's hypertension as: a. Malignant. b. Primary. c. Secondary. d. Genetic.

c. secondary

Which of the following nursing diagnoses would the nurse select for the client who has been treated for hypertension and continues to have high blood pressure? a. Ineffective Coping. b. Anxiety. c. Grieving. d. Noncompliance with Treatment Regimen.

d. noncompliance