Prep U Hypertension

A client with newly diagnosed hypertension asks what to do to decrease the risk for related cardiovascular problems. Which risk factor is not modifiable by the client? Age Obesity Inactivity Dyslipidemia

Age

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

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 thyroid gland adrenal gland pituitary gland thymus

adrenal gland

A client with high blood pressure is receiving an antihypertensive drug. When developing a client teaching plan to minimize orthostatic hypotension, which instruction should the nurse include? "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." "Rest between demanding activities, eat plenty of fruits and vegetables, and drink 6 to 8 cups of fluid daily."

"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 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."

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

4 or 5

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.

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? Increase iodine intake. Decrease sodium intake. Increase fluid intake. Avoid over-the-counter decongestants.

Decrease sodium intake.

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 Hypokalemia Hypernatremia Hyponatremia

Hyperkalemia

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 experiences orthostatic hypotension while receiving furosemide to treat hypertension. How will the nurse intervene? Administer I.V. fluids as ordered. Administer an isosorbide as ordered. Insert an indwelling urinary catheter as ordered. Instruct the client to sit for several minutes before standing.

Instruct the client to sit for several minutes before standing.

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

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

Numbness and weakness in the left arm

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 Discussing methods for stress reduction Advising smoking cessation Administering glycemic control

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

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? Primary Essential Secondary Malignant

Secondary

Which term describes high blood pressure from an identified cause, such as renal disease? Primary hypertension Secondary hypertension Rebound hypertension Hypertensive emergency

Secondary hypertension

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.

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 persistent cough blurred vision tremor

dizziness

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. decreases the heart rate, constricts arterioles, and reduces the heart's ability to eject blood. increases the heart rate, constricts arterioles, and increases the heart's ability to eject blood. decreases circulating blood volume.

increases the heart rate, constricts arterioles, and reduces the heart's ability to eject blood.

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

secondary hypertension.

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

secondary.

The nurse is teaching a client about chronic untreated hypertension. What complication will the nurse explain to the client? peripheral edema right-sided heart failure stroke pulmonary insufficiency

stroke

The nurse understands that an overall goal of hypertension management is that the client maintains a normal blood pressure reading. there is no indication of target organ damage. there is no report of postural hypotension. there are no reports of sexual dysfunction.

there is no indication of target organ damage.

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

to avoid over-the-counter cold and sinus medications

A nurse is providing education about hypertension to a community group. What are possible consequences of untreated hypertension? Select all that apply. Coronary artery disease Myocardial infarction Pancreatitis Tension pneumothorax Stroke

Coronary artery disease Myocardial infarction Stroke

The nurse is discussing aging and the incidence of hypertension with an older adult. What lifestyle change will lower blood pressure for the older adult? Add salt to foods for taste. Exercise once a week. Keep weight stable. Sleep four hours each night.

Keep weight stable.

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

Renal dysfunction resulting from atherosclerosis

The nurse observes a certified nursing assistant (CNA) obtaining a blood pressure reading with a cuff that is too small for the patient. The nurse informs the CNA that using a cuff that is too small can affect the reading results in what way? The results will be falsely decreased. The results will be falsely elevated It will give an accurate reading. It will be significantly different with each reading.

The results will be falsely elevated

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

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

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

ophthalmic examination.

The public health nurse is presenting a workshop on hypertension for the Parent Teacher Organization of the local elementary school. A parent asks the nurse who is at risk for hypertension. What would be the nurse's best answer? "People at highest risk for hypertension include clients younger than 18 years." "People at highest risk for hypertension include those with diabetes." "People at highest risk for hypertension include Asians." "People at highest risk for hypertension include the immune-compromised."

"People at highest risk for hypertension include those with diabetes."

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? Cardiac catheterization Echocardiography Stress test Tilt-table test

Echocardiography

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? Toasted cheese sandwich on whole wheat toast with tomato soup Creamed chipped beef over toast with mashed potatoes Hot dog with ketchup and relish on whole wheat bun Green pepper stuffed with diced tomatoes and chicken

Green pepper stuffed with diced tomatoes and chicken

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

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

Heart and blood vessels

A nurse is educating about lifestyle modifications for a group of clients with newly diagnosed hypertension. While discussing dietary changes, which point would the nurse emphasize? It takes 2 to 3 months for the taste buds to adapt to decreased salt intake. The taste buds never adapt to decreased salt intake. There is usually no need to change alcohol consumption for clients with hypertension. A person with hypertension should never consume alcohol.

It takes 2 to 3 months for the taste buds to adapt to decreased salt intake.

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? Isolated systolic hypertension Rebound hypertension Angina Left ventricular hypertrophy

Rebound hypertension

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

Sit on the edge of the chair and rise slowly.

Which statements are true when the nurse is measuring blood pressure (BP)? Select all that apply. Using a BP cuff that is too small will give a higher BP measurement. The client's arm should be positioned at the level of the heart. Using a BP cuff that is too large will give a higher BP measurement. The client's BP should be measured 1 hour before consuming alcohol. The client should sit quietly while BP is being measured.

Using a BP cuff that is too small will give a higher BP measurement. The client's arm should be positioned at the level of the heart. The client should sit quietly while BP is being measured.

Which client statement indicates a good understanding of the nutritional modifications needed to manage hypertension? "A glass of red wine each day will lower my blood pressure." "I should eliminate caffeine from my diet to 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. 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."

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

A client diagnosed with kidney disease

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 Antihypertensive medication can cause hypotension, especially postural hypotension that may result in injury. Rebound hypertension occurs when antihypertensive medication is stopped abruptly. Sexual dysfunction may occur, especially with beta blockers, but other medications are available should this problem ensue. This is not immediately a priority concern. Antihypertensive medications do not usually cause postural hypertension.