CH 27

The nurse in an oncology clinic notes that the client being treated has hypertension. What tumor is a predisposing condition for secondary hypertension? A) Pheochromocytoma B) Wilms' tumor C) Astrocytoma D) Lymphoma

A

The nurse is caring for a client with accelerated hypertension. Which body system would the nurse assess to identify early signs of blood pressure progression? A) Eyes B) Kidney C) Heart D) Musculoskeletal system

A

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 schizophrenic residing at an assisted living facility D) A client with chronic asthma who uses a corticosteroid inhaler

A

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

B

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) Blood chemistry B) Multiple gated acquisition scan (MUGA) C) Chest radiograph D) Fluorescein angiography

B

The nurse is caring for a client with long-standing hypertension. As a client advocate, which instruction is most helpful in preventing further complications?A) Maintain a healthy diet of fruits and vegetables. B) Focus on exercise at least twice a week. C) Obtain a regular appointment with eye doctor. D) Avoid use of caffeinated beverages.

C

The nurse is obtaining a healthy history from a client with blood pressure of 146/88 mm Hg. The client states that lifestyle changes have not been effective in lowering the blood pressure. Which medication classification does the nurse anticipate first? A) ACE inhibitors B) Beta-blocker C) Thiazide diuretic D) Calcium channel blocker

C

The nurse obtains a blood pressure of 136/86 mm Hg on morning assessment of a client with history of hypertension. Which pressure is of most concern when considering ventricular relaxation? A) Central aortic pressure B) Systolic pressure C) Diastolic pressure D) Central venous pressure

C

Which of the following nursing diagnosis is the nurse most correct to choose when caring for a client with long-standing hypertension? A) Impaired Gas Exchange B) Activity Intolerance C) Ineffective Tissue Perfusion D) Risk for Decreased Cardiac Output

C

A client, newly prescribed a low-sodium diet due to hypertension, is asking for help with meal choices. The client provides four meal choices, which are favorites. Which selection would be best? A) Toasted cheese sandwich on whole wheat toast with tomato soup B) Creamed chipped beef over toast with mashed potatoes C) Hot dog with ketchup and relish on whole wheat bun D) Green pepper stuffed with diced tomatoes and chicken

D

The nurse is caring for a client who is newly diagnosed with hypertension. The client states, "I do not understand what is causing my blood pressure to continue to rise." Which information does the nurse recognize as the key structure in regulating arterial blood pressure? A) Heart B) Lung C) Brain D) Kidney

D

Which ethnic background would the nurse screen for hypertension at an early age? A) Asian population B) Japanese population C) Mexican population D) African American population

D

You are caring for a client diagnosed with secondary hypertension. What would be a predisposing condition for this diagnosis? A) Use of valium B) Hypoaldosteronism C) Pancreatic disease D) Use of oral contraceptives

D

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

D

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

What is blood pressure? A) The force produced by the volume of blood in arterial walls B) The force produced by the volume of blood in the venous system C) The measurement of cardiac output D) The peripheral resistance of the cardiac output

A

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

A

You are part of a group of nursing students who are making a presentation on chronic hypertension. What is one subject you would need to include in your presentation as a possible consequence of untreated chronic hypertension? A) Peripheral edema B) Right-sided heart failure C) Stroke D) Pulmonary insufficiency

C

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

A

A nurse is assessing the blood pressure of a large adult client diagnosed with primary hypertension. To ensure an accurate blood pressure reading, the nurse follows which standard of care? Select all that apply. A) Use the large adult blood pressure cuff. B) Place the cuff midway between the acromion and olecranon process. C) Vary the blood pressure reading sites every other day. D) Obtain supine, sitting, and standing readings daily. E) Document the results immediately after the reading is completed.

A, B, E

The nurse is volunteering at a community blood pressure screening. A client, never diagnosed with hypertension, presents with a blood pressure of 158/90 mm Hg. Which assessment questions, asked by the nurse, are appropriate? Select all that apply. A) "Have you recently drunk a caffeinated beverage?" B) "Did you have a beer after work?" C) "Do you smoke?" D) "Do you have a friend accompanying you?" E) "Are you married and with children?"

A, C

The nurse is screening a client at a health fair for hypertension. Which assessment data, provided by the client, would prompt the nurse to stress physician involvement? Select all that apply. A) Fatigue B) Constipation C) Headache D) Insomnia E) Dysuria F) Blurred vision

A,C, D, F

A client has just been diagnosed with prehypertension. What would the nurse instruct this client to do to restore his blood pressure below hypertensive levels? A) Increase iodine intake. B) Decrease sodium intake. C) Increase fluid intake. D) Avoid over-the-counter decongestants.

B

A female client, aged 82 years, 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? A) Take the medicine on an empty stomach. B) A possible adverse effect of blood pressure medicine is dizziness when you stand. C) There are no adverse effects from blood pressure medicine. D) A severe drop in blood pressure is possible.

B

The nurse and a dietitian are instructing the client on a low-sodium diet needed to lower the blood pressure. Which question, asked by the nurse, is most important? A) "Who eats meals with you?" B) "How do you prepare your food?" C) "Do you each three meals per day?" D) "Do you snack in the evening?"

B

The nurse is caring for a client who is ordered Hyperstat IV to decrease blood pressure. Which nursing consideration is a priority?A) Elevate the head of the bed. B) Use an automatic blood pressure recording machine. C) Place a Foley catheter to monitor urine output. D) Assess the client's deep tendon reflex.

B

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

B

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 thyroid gland B) The adrenal gland C) The pituitary gland D) The thymus

B

The nurse is caring for a client with malignant hypertension. What would be an appropriate nursing intervention for this client?A) Monitor the client's mental and emotional status every hour. B) Monitor the blood pressure (BP) every few minutes by applying an automatic BP recording machine. C) Monitor the client's blood sugar every hour. D) Monitor the client's temperature every few minutes.

B

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) Lung and arteries B) Heart and blood vessels C) Brain and sympathetic nervous system D) Kidneys and autonomic nervous system

B

The nurse is employed in a physician's office and is caring for a client present for an annual exam. A blood pressure of 124/84 mm Hg is documented. Following revised guidelines for identifying hypertension, which educational pamphlet is help? A) Increasing fluids for low blood pressure B) Stress reduction to lower prehypertensive state C) Use of beta-blockers for treatment of hypertension D) Diagnostic testing for determining cardiac functioning

B

The nurse is working on a clinical research study, obtaining data evaluating central aortic systolic pressure and brachial arm systolic pressure. The client notes difference in the readings. Which response by the nurse is most accurate? A) "The difference is due to machine calibration." B) "The difference is due to the location of pressure measurement." C) "The difference is due to the discomfort caused by the measurement procedure." D) "The difference is due to the constrictive force on the arteries when the measurement is taken."

B

Which of the following client scenarios would be correct for the nurse to identify as a client with secondary hypertension? A) A client experiencing depression B) A client diagnosed with kidney disease C) A client of advanced age D) A client with excessive alcohol intake

B

You are teaching a health class at the local YMCA. What body system would you explain regulates arterial blood pressure?A) Cardiovascular system B) Immune system C) Lymphatic system D) Autonomic nervous system

D