CH 27
A client has been diagnosed as being prehypertensive. What should the nurse encourage this client to do to aid in preventing a progression to a hypertensive state? A. Avoid excessive potassium intake. B. Exercise on a regular basis. C. Eat less protein and more vegetables. D. Limit morning activity.
B
A client newly diagnosed with hypertension is discussing risk factors with the nurse. The nurse talks about lifestyle changes with the client and advises that the client should avoid tobacco use. What is the primary rationale behind that advice to the client? A. Quitting smoking will cause the client's hypertension to resolve. B. Tobacco use increases the client's concurrent risk of heart disease. C. Tobacco use is associated with a sedentary lifestyle. D. Tobacco use causes ventricular hypertrophy.
B
A client's medication regimen for the treatment of hypertension includes hydrochlorothiazide. Following administration of this medication, the nurse should anticipate what effect? A. Drowsiness or lethargy B. Increased urine output C. Decreased heart rate D. Mild agitation
B
A 55-year-old client comes to the clinic for a routine check-up. The client's BP is 159/100 mm Hg and the health care provider diagnoses hypertension after referring to previous readings. The client asks why it is important to treat hypertension, since the client denies any discomfort. What would be the nurse's best response? A. "Hypertension can cause you to develop dangerous blood clots in your legs that can migrate to your lungs." B. "Hypertension puts you at increased risk of type 1 diabetes and cancer in your age group." C. "Hypertension is the leading cause of death in people your age." D. "Hypertension greatly increases your risk of stroke and heart disease."
D
A nurse is teaching an client about the risk factors for hypertension. Which factors should the nurse explain as risk factors for primary hypertension? A. Obesity and high intake of sodium and saturated fat B. Diabetes and use of oral contraceptives C. Metabolic syndrome and smoking D. Renal disease and coarctation of the aorta
A
The nurse identifies a nursing diagnosis of Ineffective Health Maintenance related to nonadherence to therapeutic regimen in a client with hypertension who has not been taking their medication as prescribed. When planning this client's care, which outcome would be appropriate? A. Client takes medication as prescribed and reports any adverse effects. B. Client's BP remains consistently below 140/90 mm Hg. C. Client denies signs and symptoms of hypertensive urgency. D. Client is able to describe modifiable risk factors for hypertension.
A
The nurse is developing a nursing care plan for a client who is being treated for hypertension. Which outcome is most appropriate for the nurse to include? A. Client will reduce Na+ intake to less than 2 g daily. B. Client will have a stable BUN and serum creatinine levels. C. Client will abstain from fat intake and reduce calorie intake. D. Client will maintain a normal body weight.
A
The nurse is reviewing the medication administration record of a client who takes a variety of medications for the treatment of hypertension. What potential therapeutic benefits of antihypertensives should the nurse identify? Select all that apply. A. Increased venous return B. Decreased peripheral resistance C. Decreased blood volume D. Decreased strength and rate of myocardial contractions E. Decreased blood viscosity
B, C, D
A client newly diagnosed with hypertension asks the nurse what happens when uncontrolled hypertension is prolonged. The nurse explains that a client with prolonged, uncontrolled hypertension is at risk for developing which health problem? A. Chronic kidney disease B. Right ventricular hypertrophy C. Glaucoma D. Anemia
A
A client with primary hypertension reports dizziness with ambulation when taking the prescribed alpha-adrenergic blocker. When teaching this client, what should the nurse emphasize? A. Rising slowly from a lying or sitting position B. Increasing fluids to maintain BP C. Stopping medication if dizziness persists D. Taking medication first thing in the morning
A
A client with secondary hypertension has come into the clinic for a routine check-up. When comparing this client's diagnosis to primary hypertension, the nurse recognizes that secondary hypertension: A. has a specific cause. B. has a more gradual onset than primary hypertension. C. does not normally cause target organ damage. D. does not normally respond to antihypertensive drug therapy.
A
The nurse is monitoring blood pressure for a client with unstable readings. How often should the nurse check the client's blood pressure? A. Every 5 minutes B. Every 30 minutes C. Every 30 minutes until stable D. Every 2 minutes
A
The nurse is teaching a client about some of the health consequences of uncontrolled hypertension. What health problems should the nurse describe? Select all that apply. A. Transient ischemic attacks (TIAs) B. Cerebrovascular disease C. Retinal hemorrhage D. Venous insufficiency E. Right ventricular hypertrophy
A, B, C
The community health nurse cares for many clients who have hypertension. What nursing diagnosis is most common among clients who are being treated for this health problem? A. Deficient knowledge regarding the lifestyle modifications for management of hypertension B. Noncompliance with therapeutic regimen related to adverse effects of prescribed therapy C. Deficient knowledge regarding BP monitoring D. Noncompliance with treatment regimen related to medication costs
B
The nurse is caring for an older adult with a diagnosis of hypertension who is being treated with a diuretic and beta-blocker. Which item should the nurse integrate into the management of this client's hypertension? A. Ensure that the client receives a larger initial dose of antihypertensive medication due to impaired absorption. B. Pay close attention to hydration status because of increased sensitivity to extracellular volume depletion. C. Recognize that an older adult is less likely to adhere to the medication regimen than a younger client. D. Carefully assess for weight loss because of impaired kidney function resulting from normal aging.
B
The nurse is providing education to a client newly diagnosed with hypertension. Which outcome would be most appropriate for this client? A. Client will have no visual disturbances. B. Client will return demonstrate measuring a blood pressure. C. Client will state two side effects of not taking antihypertensives. D. Client will lose two pounds within two weeks.
B
The nursing lab instructor is teaching student nurses how to take blood pressure. To ensure accurate measurement, the lab instructor would teach the students to avoid which action? A. Measuring the BP after the client has been seated quietly for more than 5 minutes B. Taking the BP 10 minutes after nicotine or coffee ingestion C. Using a cuff with a bladder that encircles at least 80% of the limb D. Using a bare forearm supported at heart level on a firm surface
B
A 56-year-old client at a screening event has a blood pressure reading of 146/96 mm Hg. Upon hearing the reading, the client states, "My pressure has never been this high. Do you think my doctor will prescribe medication to reduce it?" What is the nurse's best response? A. "Yes. It is fortunate we caught this during your routine examination." B. "We will need to reevaluate your blood pressure because your age places you at high risk for hypertension." C. "A single elevated blood pressure does not confirm hypertension. Diagnosis requires multiple elevated readings." D. "You have no need to worry. Your pressure is probably elevated because you are being tested."
C
The nurse is assessing a client new to the clinic. Records brought to the clinic show that the client's hypertension has not improved. What contributing factor should the nurse first explore in an effort to identify the cause of the client's inadequate BP control? A. Progressive target organ damage B. Possibility of medication interactions C. Lack of adherence to prescribed drug therapy D. Possible heavy alcohol use or use of recreational drugs
C
A newly diagnosed client with hypertension is prescribed a thiazide diuretic. What client education should the nurse provide to this client? A. "Eat a banana every day because this medication causes moderate hyperkalemia." B. "Take over-the-counter potassium pills because this medication causes your kidneys to lose potassium." C. "This medication can cause low blood pressure and dizziness, especially when you get up suddenly." D. "This medication increases sodium levels in your blood, so cut down on your salt."
C
An older adult is newly diagnosed with primary hypertension and has just been started on a beta-blocker. Which topic should the nurse include in health education? A. Increasing fluids to avoid extracellular volume depletion from the diuretic effect of the beta-blocker B. Maintaining a diet high in dairy to increase protein necessary to prevent organ damage C. Use of strategies to prevent falls stemming from orthostatic hypotension D. Limiting exercise to avoid injury that can be caused by increased intracranial pressure
C
At a blood pressure screening, the nurse learns that a client has a family history of hypertension, high cholesterol, and elevated lipid levels. The client says reports smoking one pack of cigarettes daily and drinking "about a pack of beer" every day. The nurse notes which nonmodifiable risk factor for hypertension? A. Hyperlipidemia B. Excessive alcohol intake C. A family history of hypertension D. Closer adherence to medical regimen
C
The critical care nurse is caring for a client just admitted in a hypertensive emergency. The nurse should anticipate the administration of what medication? A. Warfarin B. Furosemide C. Sodium nitroprusside D. Ramipril
C
The nurse is caring for a client in the emergency department who was admitted for a hypertensive emergency. The nurse knows the goal of intravenous vasodilator therapy for a hypertensive emergency would be which outcome? A. Lower the blood pressure to reduce the onset of neurological changes B. Decrease the blood pressure to a normal level based on the client's age C. Decrease the systolic blood pressure by no more than 25% within the first hour D. Decrease the blood pressure to less than or equal to 120/80 as quickly as possible
C
The nurse is collaborating with the dietitian and a client with hypertension to plan dietary modifications. Which modifications should be the priority? A. Reduced intake of protein and carbohydrates B. Increased intake of calcium and vitamin D C. Reduced intake of fat and sodium D. Increased intake of potassium, vitamin B12 and vitamin D
C
The nurse is providing care for a client with a diagnosis of hypertension. The nurse should consequently assess the client for signs and symptoms of which other health problem? A. Migraines B. Atrial-septal defect C. Atherosclerosis D. Thrombocytopenia
C
The nurse is providing health education to an older adult client. What should the nurse teach the client about the relationship between hypertension and age? A. "Because of reduced smooth muscle tone in blood vessels, blood pressure tends to go down with age, not up." B. "Decreases in the strength of arteries and the presence of venous insufficiency cause hypertension in older adults." C. "Structural and functional changes in the cardiovascular system that occur with age contribute to an increase in blood pressure." D. "The neurologic system of older adults is less efficient at monitoring and regulating blood pressure."
C
A client with a hypertensive emergency is being treated in the intensive care unit. The nurse knows that which client is at risk for developing this type of emergency? A. A client who stops their antihypertensive medication abruptly B. A client with a diagnosis of primary hypertension C. A client with well-controlled hypertension D. A client with hypertension that was diagnosed 2 years ago
D
A client with newly diagnosed hypertension has come to the clinic for a follow-up visit. The client asks the nurse why the client has to come in so often. Which response by the nurse would be best? A. "To identify any of the early symptoms of a stroke" B. "To determine how your blood pressure changes throughout the day" C. "To see how often you should change your medication dose" D. "To make sure your health is stable"
D
A client's recently elevated BP has prompted the primary care provider to prescribe furosemide. The nurse should closely monitor which of the following levels? A. The client's oxygen saturation level B. The client's red blood cells, hematocrit, and hemoglobin C. The client's level of consciousness D. The client's potassium level
D
The nurse is planning the care of a client who has been diagnosed with hypertension, but who otherwise enjoys good health. When assessing the response to an antihypertensive drug regimen, which blood pressure would be the goal of treatment? A. 160/90 mm Hg or lower B. 100/80 mm Hg or lower C. Average of two BP readings of 150/80 mm Hg D. 130/80 mm Hg or lower
D
The nurse takes the client's blood pressure, and the reading is 161/101 mm Hg. The nurse knows this blood pressure would be classified as which type? A. Elevated B. Normal C. Stage 1 hypertensive D. Stage 2 hypertensive
D
