PREP U: Chapter 13: Nursing Management: Patients With Hypertension

A client has been prescribed three medications for hypertension and the nurse measured a blood pressure of 180/80. Which question will the nurse ask the client first? "Have you stopped exercising?" "Are you still taking the medication?" "Are you following the low-sodium diet?" "How much stress are you experiencing?"

"Are you still taking the medication?"

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

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

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? "Take this medication before going to bed." "Increase the amount of fruits and vegetables you eat." "You may develop nasal congestion or depression while taking this medication." "You may drink alcohol while taking this medication."

"Increase the amount of fruits and vegetables you eat."

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." "Postural hypotension can occur." "Rebound hypotension can occur." "Postural hypertension can occur."

"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? "Avoid smoking cigarettes for 8 hours prior to taking blood pressure." "Sit quietly for 5 minutes prior to taking blood pressure." "Sit with legs crossed when taking your blood pressure." "Be sure the forearm is well supported above heart level while taking blood pressure."

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

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? 25% 35% 40% 45%

25%

A nurse is discussing with a nursing student how to accurately measure blood pressure. What statement by the student indicates an understanding of the education? A cuff that is too small will give a false high blood pressure. 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. 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 high blood pressure.

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

Echocardiography

A team of public health nurses are strategizing around a new initiative that will address screening, education, and management of hypertension in residents of the community. Which of the following facts surrounding hypertension should underlie the nurses' design of this health initiative? Many of the pathophysiological effects of hypertension are poorly understood in the health literature. Hypertension is difficult to identify in many of the individuals who are at highest risk of the problem. Hypertension tends to be inadequately managed in many of the people who have been diagnosed with the problem. Hypertension is among the health problems that are most difficult to treat successfully.

Hypertension tends to be inadequately managed in many of the people who have been diagnosed with the problem.

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

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

Postural hypotension and resulting injury

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

Renal dysfunction resulting from atherosclerosis

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

Spironolactone

A patient has come to the clinic for a follow-up assessment. Before taking the blood pressure, the nurse should determine if the patient has: Tried to rest quietly for 5 minutes before the reading is taken Refrained from smoking for at least 8 hours Been NPO for at least 2 hours Avoided drinking coffee for 12 hours before the visit

Tried to rest quietly for 5 minutes before the reading is taken

An 80-year-old man, newly diagnosed with primary hypertension, has just been started on a beta-blocker. The nurse knows that in addition to teaching the patient about his medication (i.e., side effects, purpose, and schedule), she should also focus her teaching on what? Limiting fluids in order to decrease vascular volume Maintaining a diet high in dairy to increase protein necessary to prevent organ damage Use of supportive devices such as hand rails and walkers to prevent falls stemming from postural hypotension Limiting exercise to avoid injury that can be caused by postural hypotension

Use of supportive devices such as hand rails and walkers to prevent falls stemming from postural hypotension

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 what? Thyroid gland Adrenal gland Pituitary gland Thymus

adrenal gland

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 sublingual intramuscular oral

continuous IV infusion

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

decreases the production of neurotransmitters that constrict peripheral arterioles.

When measuring blood pressure in each arm of a healthy adult, the nurse recognizes that the pressures must be equal in both arms. may vary 10 mm Hg or more between arms. differ no more than 5 mm Hg between arms. may vary, with the higher pressure found in the left arm.

differ no more than 5 mm Hg between arms.

The nurse is teaching a client about hypertension and the effects on the left ventricle. What diagnostic test will the nurse describe? computed tomographic (CT) scan echocardiography fluorescein angiography positron emission tomography (PET) scan

echocardiography

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? Secondary Pathologic Malignant Essential (primary)

essential (primary)

What risk factors would cause the nurse to become concerned that the client may have atherosclerotic heart disease? Select all that apply. hypertension diabetes obesity lowered triglyceride levels active lifestyle family history of early cardiovascular events

hypertension diabetes obesity family history of early cardiovascular events

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

hypertensive emergency

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? nonpharmacological interventions pharmacological interventions procedural interventions observation only

nonpharmacological interventions

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? Magnesium level Potassium level Calcium level Sodium level

potassium level

A patient newly diagnosed with hypertension asks the nurse what happens when uncontrolled hypertension is prolonged. The nurse explains that a patient with prolonged uncontrolled hypertension is at risk for developing what health problem? Renal failure Right ventricular hypertrophy Glaucoma Anemia

renal failure

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

retinal blood vessel damage

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? Primary Essential Secondary Malignant

secondary

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

secondary hypertension.

A nurse is teaching a client with severe hypertension about the damage this condition can cause to the body. What system/organs will the nurse note are particularly targeted for damage due to severe hypertension? Sensory Musculoskeletal Gastrointestinal Integumentary

sensory

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. Gallbladder disease Smoking Diabetes mellitus Physical inactivity Frequent upper respiratory infections

smoking diabetes mellitus physical inactivity

Mr. Faulkner is a 69-year-old man who has enjoyed generally good health for his entire adult life. As a result, he has been surprised to receive a new diagnosis of hypertension after a series of visits to his primary care provider. The nurse who is working with Mr. Faulkner should recognize which of the following aspects of aging and hypertension? The diagnostic criteria for hypertension in adults over 65 differ from those for younger adults. The incidence and prevalence of hypertension increase with age. Blood pressure remains stable throughout adulthood but tends to be assessed more often by health care providers of older adults. Older adults are less vulnerable to the pathophysiological effects of hypertension than are younger adults.

The incidence and prevalence of hypertension increase with age.

A patient has been diagnosed with prehypertension and has been encouraged to exercise regularly and begin a weight loss program. What other healthcare professional may be helpful for the client to see? Occupational therapist Dietician Pharmacist Social worker

dietician

The nurse is performing an assessment on a patient to determine the effects of hypertension on the heart and blood vessels. What specific assessment data will assist in determining this complication? (Select all that apply.) Heart rate Respiratory rate Heart rhythm Character of apical and peripheral pulses Lung sounds

heart rate heat rhythm character of apical and peripheral pulses