MED-SURG Exam 4 CH.31 PREP U
Which client statement indicates a good understanding of the nutritional modifications needed to manage hypertension?
"Limiting my salt intake to 2 grams per day will improve my blood pressure."
A nurse is teaching a client with newly diagnosed hypertension who asks if there is any harm in stopping antihypertensive medication. What is the nurse's best response?
"Rebound hypertension can occur."
A nurse is educating a client about monitoring blood pressure readings at home. What will the nurse be sure to emphasize?
"Sit quietly for 5 minutes prior to taking blood pressure."
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?
"Why are you not taking your medications?"
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?
130/80 or lower
According to the DASH diet, how many servings of vegetables should a person consume each day?
4 or 5
Which ethnic background would the nurse screen for hypertension at an early age?
African population
During a routine physical examination, the nurse assesses a blood pressure reading of 150/90 mm Hg. The patient's blood work indicates several abnormal results. The health care provider informs the nurse that he suspects that the patient has metabolic syndrome. The nurse knows that this diagnosis is associated with three classic signs/symptoms. Select all that apply.
Dyslipidemia and/or abdominal obesity A blood pressure reading greater than 130/85 mm Hg Insulin resistance
Which diagnostic method is recommended to determine whether left ventricular hypertrophy has occurred?
Echocardiography
A nurse is teaching about lifestyle modifications to a group of clients with known hypertension. Which statement would the nurse include in the education session?
Engage in aerobic activity at least 30 minutes/day most days of the week.
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)
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?
Hyperkalemia
The nurse is developing a teaching plan for a client diagnosed with hypertension. What would be important for the nurse to emphasize as part of the plan of care?
Limiting sodium intake in the diet
A client hospitalized for treatment of hypertension is being prepared for discharge. Which teaching topic should the nurse be sure to cover?
Maintaining a low-sodium diet
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.
Physical inactivity Diabetes mellitus Smoking
When measuring the blood pressure in each arm of a healthy adult client, the nurse recognizes that which statement is true?
Pressures should not differ more than 5 mm Hg between arms.
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
Which finding indicates that hypertension is progressing to target organ damage?
Retinal blood vessel damage
Which term describes high blood pressure from an identified cause, such as renal disease?
Secondary hypertension
Which diuretic medication conserves potassium?
Spironolactone
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?
Stress reduction to lower prehypertensive state
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?
The kidney excretes sodium and water.
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
check the client's heart rate.
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?
continuous IV infusion
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.
A blood pressure (BP) of 140/90 mm Hg is considered to be
hypertension.
It is appropriate for the nurse to recommend smoking cessation for clients with hypertension because nicotine
increases the heart rate, constricts arterioles, and reduces the heart's ability to eject blood.
The nurse encourages the client diagnosed with hypertension to rise slowly from a sitting or lying position because gradual changes in position
provide time for the heart to increase the rate of contraction to resupply oxygen to the brain.
The nurse is teaching a client about chronic untreated hypertension. What complication will the nurse explain to the client?
stroke
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?
"How do you prepare your food?"
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 chose broiled chicken with a baked potato for dinner."
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?
Heart and blood vessels
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?
Potassium level
Management of hypertension includes three of the following four goals, depending on the primary and secondary causes. Select all that apply.
Impairing the synthesis of norepinephrine. Modifying the rate of myocardial contraction. Decreasing renal absorption of sodium.
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?
Lowering and controlling the blood pressure without adverse effects and without undue cost
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?
Postural hypotension and resulting injury
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?
Purchasing a self-monitoring BP cuff
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?
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?
Secondary
The nurse is instructing a client who is newly prescribed an antihypertensive medication. Which nursing instruction is emphasized to maintain client safety?
Sit on the edge of the chair and rise slowly.
A nurse is providing education about hypertension to a community group. What are possible consequences of untreated hypertension? Select all that apply.
Stroke Myocardial infarction Coronary artery disease
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
Which statements are true when the nurse is measuring blood pressure (BP)? Select all that apply.
The client's arm should be positioned at the level of the heart. Using a BP cuff that is too small will give a higher BP measurement. The client should sit quietly while BP is being measured.
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?
dizziness
