chapter 31 exam 3 testbank

officially, hypertension is diagnosed when the client demonstrates a systolic blood pressure greater than ___ mmHg and a diastolic blood pressure greater than ___ mmHg over a sustained period a. 140,90 b. 130, 80 c. 120, 70 d. 110, 60

a. 140,90

which adrenergic inhibitor acts directly on the blood vessels, producing vasodilation? a. Prazosin b. Reserpine c. Clonidine d. Propranolol

a. Prazosin

which condition contributes to secondary hypertension? a. arterial vasoconstriction b. acid-based imbalance c. calcium deficit d. hepatic function

a. arterial vasoconstriction

a blood pressure of 140/90 mmHg is considered to be a. hypertension b. prehypertension c. hypertensive emergency d. normal

a. hypertension

which describes a situation in which blood pressure is severely elevated and there is evidence of actual or probable target organ damage? a. hypertensive emergency b. hypertensive urgency c. secondary hypertension d. primary hypertension

a. hypertensive emergency

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

b. 4 or 5

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

b. decreases the production of neurotransmitters that constrict peripheral arterioles

which term describes a situation in which blood pressure is very elevated but there is no evidence of impending or progressive target organ damage? a. secondary hypertension b. hypertensive urgency c. hypertensive emergency d. primary hypertension

b. hypertensive urgency

the nurse understands that client education related to antihypertensive medication should include all instructions except a. to avoid over the counter cold, weight reduction, and sinus medications b. if a dosage of medication is missed, double up on the next one to catch up c. do not stop antihypertensive medication abruptly d. to avoid hot baths, exercise, and alcohol within 3 hours of taking vasodilators

b. if a dosage of medication is missed, double up on the next one to catch up

the nurse is caring for a client who has had 25mh of oral hydrochlorothiazide added to the medication regimen for the treatment of hypertension. which instruction should the nurse give the client? a. take this medication before going to bed b. increase the amount of fruits and vegetables you eat c. you may drink alcohol while taking this medication d. you may develop dry mouth or nasal congestion while taking this medication

b. increase the amount of fruits and vegetables you eat

it is important for the nurse to encourage the client to rise slowly from a sitting or lying position because gradual changes in position a. provide time for the heart to reduce the rate of contraction to resupply oxygen to the brain b. provide time for the heart to increase the rate of contraction to resupply oxygen to the brain c. help reduce the work required by the heart to resupply oxygen to the brain d. help reduce the blood pressure to resupply oxygen to the brain

b. provide time for the heart to increase the rate of contraction to resupply oxygen to the brain

approximately what percentage of adults in the united states have hypertension? a. 20 b. 40 c. 30 d. 50

c. 30

which diagnostic method is recommended to determine whether left ventricular hypertrophy has occurred? a.electrocardiography b. blood urea nitrogen c. echocardiography d. blood chemistry

c. echocardiography

a 66 year old client presents to the ER reporting severe headache and mild nausea for the past 6 hours. upon assessment, the clients BP is 210/120 mmHg. the client has a history of hypertension and takes 1.0mg clonidine twice daily. which question is most important for the nurse to ask the client next? a. do you have a dry mouth or nasal congestion? b. did you take any medication for your headache? c. have you taken your prescribed clonidine today? d. are you having chest pain or shortness of breath?

c. have you taken your prescribed clonidine today?

the nurse teaching the client which guidelines regarding lifestyle modifications for hypertension? a. limit aerobic physical activity to 15 minutes, three times per week b. reduce smoking to no more than 4 cigarettes per day c. maintain adequate dietary intake of fruits and vegetables d. stop alcohol intake

c. maintain adequate dietary intake of fruits and vegetables

the nurse is teaching a client diagnosed with hypertension about the DASH diet. how many servings of meat, fish, and poultry should the client consume per day? a. 2 or 3 b. 7 or 8 c. 4 or 5 d. 2 or fewer

d. 2 or fewer

the nurse is administering medications on a medical-surgical unit. a client is ordered to receive 40mg oral nadolol for the treatment of hypertension. before administering the medication, the nurse should a. check the clients urine output b. check the clients serum K c. weigh the client d. check the clients heart rate

d. check the clients heart rate

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

d. differ no more than 5mmHg between arms

the nurse is caring for a client newly diagnosed with hypertension. which statement by the client indicates the need for further teaching? a. i think im going to sign up for a yoga class twice a week to help reduce my stress b. when getting up from bed, i will sit for a short period before standing up c. i will consult a dietician to help get my weight under control d. if i take my blood pressure and it is normal, i dont have to take my blood pressure pills

d. if i take my blood pressure and it is normal, i dont have to take my blood pressure pills

the nurse teaches the client which guideline regarding lifestyle modification for hypertension? a. limit aerobic physical activity to 15 minutes, three times per week b. reduce smoking to no more than 4 cigarettes per day c. stop alcohol intake d. maintain adequate dietary intake of potassium

d. maintain adequate dietary intake of potassium

is it appropriate for the nurse to recommend smoking cessation for clients with hypertension because nicotine a. increases the heart rate, constricts arterioles, and reduces the heart's ability to eject blood b. decreases the heart rate, constricts arterioles, and reduces the hearts ability to eject blood c. decreases circulating blood volume d. increases the heart rate, constricts arterioles, and increases the hearts ability to eject blood

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

which term is refers to hypertension in which blood pressure that is controlled with therapy becomes uncontrolled (abnormally high) when the therapy is discontinued? a. rebound b. primary c. essential d. secondary

a. rebound

the nurse is caring for a client newly diagnosed with secondary hypertension. which condition contributes to the development of secondary hypertension? a. renal disease b. acid-based imbalance c. hepatic function d. calcium deficit

a. renal disease

which finding indicates that hypertension is progressing to target organ damage? a. retinal blood vessel damage b. chest x-ray showing pneumonia c. BUN concentration of 12mg/dL d. urine output of 60mL/2 hr

a. retinal blood vessel damage

which conditions indicates target organ damage from untreated/undertreated hypertension? SATA a. retinal damage b. heart failure c. diabetes d. stroke e. hyperlipidemia

a. retinal damage b. heart failure d. stroke target organ damage includes the heart, kidney, brain and eyes

the nurse is caring for a client prescribed bumetanide for the treatment of stage 2 hypertension. which finding indicates the client is experiencing an adverse effect of the medication? a. serum potassium of 3 b. ECG tracing demonstrating peaked T waves c. urine output of 90mL 1 hour after medication administration d. blood glucose of 160

a. serum potassium of 3

the nurse is conducting a service project for a local elderly community group on the topic of hypertension. the nurse will relay which risk factors and cardiovascular problems are related to hypertension? SATA a. smoking b. elevated HDL cholesterol c. age > 65 in women d. decreased LDL levels e. overweight/obesity

a. smoking c. age > 65 in women e. overweight/obesity

a 35 year old 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 are cumbersome and time consuming. as the nurse which aspect of client teaching would you recommend? a. advising smoking cessation b. purchasing a self monitoring BP cuff c. administering glycemic control d. discussing methods for stress reduction

b. purchasing a self monitoring BP cuff

a recommended follow-up for a client initially diagnosed with prehypertension, the client should get his or her blood pressure rechecked within which time frame? a. confirm within 2 months b. recheck in 1 year c. recheck in 2 years d. evaluate within 1 month

b. recheck in 1 year

which term describes high blood pressure from an identified cause, such as renal disease? a. hypertensive emergency b. secondary hypertension c. primary hypertension d. rebound hypertension

b. secondary hypertension

choose the statements that correctly match the hypertensive medication with its side effects SATA a. with ACE inhibitors, assess for bradycardia b. cough is a common side effect of adrenergic inhibitors c. with thiazide diuretics, monitor serum potassium concentration d. direct vasodilators may cause headache and tachycardia e. beta-blockers may cause sedation

c. with thiazide diuretics, monitor serum potassium concentration d. direct vasodilators may cause headache and tachycardia

which statements are true when the nurse is measuring BP? SATA a. the clients arm should be positioned at the level of the heart. b. using a BP cuff that is too small will give a higher BP measurement c. the client should sit quietly while BP is measured d. using a BP cuff that is too large will give a higher BP reading e. the clients BP should be measured 1 hour before consuming alcohol

a. the clients arm should be positioned at the level of the heart. b. using a BP cuff that is too small will give a higher BP measurement c. the client should sit quietly while BP is measured

a 55 year old newly diagnosed with HTN returns for a follow up appointment after several months of treatment with metoprolol. during initial assessment, the nurse records the BP as 180/90 mmHg. the client states that the medication is not taken as prescribed. which is the best response by the nurse? a. the medication you were prescribed may cause sexual dysfunction, are you experiencing this side effect? b. your hypertension must be treated with medications, you need to take your metoprolol every day c. be certain to discuss your noncompliance with your medication regimen with the physician d. it is very important for you to take your medication as prescribed, or you could experience a stroke

a. the medication you were prescribed may cause sexual dysfunction, are you experiencing this side effect? all other statements are true BUT they are not therapeutic and would not give a reason why they are not taking the medication as prescribed

a client is admitted to teh ICU with a diagnosis of hypertensive emergency/crisis. the clients BP is 200/130 mmHg. the nurse is preparing to administer IV nitroprusside. upon assessment, which finding requires immediate intervention by the nurse? a. chest pain score of 3 (on scale of 1-10) b. nausea and severe headache c. numbness and weakness in the left arm d. urine output of 40mL over past hour

c. numbness and weakness in the left arm

according to the classifications of hypertension diagnosed in older adults, hypertension that can be attributed to an underlying cause is termed a. primary b. isolated systolic c. essential d. secondary

d. secondary

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

d. there is no indication of target organ damage

a systolic blood pressure of 135mmHg would be classified as a. stage 1 hypertension b. stage 2 hypertension c. prehypertension d. normal

c. prehypertension

which diuretic medication conserves potassium a. chlorthalidone b. chlorothiazide c. spironolactone d. furosemide

c. spironolactone

a diastolic blood pressure of 90 mmHg is classified as a. prehypertension b. normal c. stage 1 hypertension d. stage 2 hypertension

c. stage 1 hypertension

a 77 year old presents to the local community center for a BP screening: recorded as 180/90 mmHg. the client has a history of hypertension but currently is not taking prescribed medications. which question is most appropriate for the nurse to ask the client first? a. what medications are you prescribed? b. are you able to get to your pharmacy to pick up your medications? c. why are you not taking your medications? d. are you having trouble paying for your medications?

c. why are you not taking your medications? all other responses are appropriate, but we are trying to find out WHY they arent taking it, they need to tell us and not assume it is due to one specific thing