Hypertension ATI practice questions

A nurse is caring for a client who has hypertension and develop epistaxis. Which of the following actions should the nurse take? 1. move the client into high fowler's position. 2. tilt the client's head backward. 3. apply pressure on the nares. 4. place ice to the bridge of the client's nose. 5. instruct the client to blow his nose.

- apply pressure to the nares - place ice on the bridge of the client's nose. - move the client into high fowler's position.

A nurse is assisting with obtaining an electrocardiogram (ECG) for a client who has atrial fibrillation. Which of the following actions should the nurse take? 1. instruct the client not to talk during the test. 2. inspect the electrode pads 3. keep the client NPO after midnight. 4. administer an analgesic prior to the procedure. 5. wash the skin with plain water before placing the electrodes.

- inspect the electrode pads. (The gel is necessary to promote electrical conduction between the skin and the electrodes; therefore, the nurse should inspect the electrode pads to check that the gel is present) - instruct the client not to talk during the test. (The nurse should instruct the client to lie quietly and not to talk or move to prevent the recording of artifact)

A nurse is teaching a client who has hypertension and a new prescription for a low sodium diet. Which of the follow teaching methods uses the cognitive domain of learning? SATA 1. review strategies to reduce sodium intake. 2. ask the client how they are feeling about starting a low sodium diet. 3. encourage the client to share their thoughts in a support group. 4. discuss the physiology of hypertension with the client. 5. observe the client choose low sodium foods.

- observe the client choose low sodium foods. (Observing the client choose low sodium foods utilizes the application, understanding, and thinking processes associated with the cognitive domain of learning) - review strategies to reduce sodium intake. (Reviewing strategies to reduce sodium intake with the client utilizes the understanding and thinking processes associated with the cognitive domain of learning.) - discuss the physiology of hypertension with client. Discussing the physiology of hypertension with the client utilizes understanding and thinking processes associated with the cognitive domain of learning).

A nurse case manage for an employer sponsored health insurance plan is implementing a program to control costs associated with hypertension. Which interventions should the nurse implement to help with cost control on a tertiary prevention level? 1. medication adherence program 2. promoting meditation for all employees 3. education about the risks of hypertension 4. walking program for employees who have hypertension 5. blood pressure screening events for all employees

- tertiary prevention aims to limit further complications for a client who has a condition. ANSWERS 1. medication adherence program 2. walking program for employees who have hypertension.

A nurse is teaching a class about documenting bp. The nurse should include to document which of the following information? 1. a client's position when the bp was obtained. 2. the site where the bp was obtained. 3. the frequency in which a blood pressure is taken. 4. interventions implemented in response to a client's bp 5. a client's response to interventions implemented.

- the site where the bp was taken. - interventions implemented in response to a client's bp - a client's position when the bp was obtained. - a client's response to interventions implemented.

What is paralytic ileus?

A paralytic ileus in a postoperative client is indicated by the absence of bowel sounds, abdominal distention, and the client passing no stool or flatus. It is often caused by bowel handling during surgery and opioid analgesic use.

A nurse is reviewing the lab results for a client who has a history of atherosclerosis and notes elevated cholesterol levels. Which of the following statements by the client indicates the nurse should plan follow up teaching on a low cholesterol diet? 1. I flavor my meat with lemon juice. 2. I eat two eggs for breakfast each morning. 3. I cook my food with canola oil. 4. I take on omega 3 supplement daily.

I eat two eggs for breakfast each morning - Clients should limit egg yolks to two to three per week.

A nurse is providing teaching about a heart healthy diet to a group of clients with hypertension. Which of the following statements by one of the clients indicates a need for further teaching? 1. I may eat 10 ounces of lean protein each day. 2. fresh fruits make a good snack option. 3. i will replace table salt with dried herbs 4. I may thicken gravies with cornstarch as I cook.

I may eat 10 ounce of lean protein a day. (Lean meats should be limited to 5 to 6 oz per day. This statement by a client requires additional teaching)

A nurse is providing teaching about the Mediterranean diet to a client newly who has a new diagnosis of hypertension. Which of the following statements by the client indicates a need for further teaching? 1. I will limit my intake of red meat to twice daily 2. I can have dairy in moderate portions daily 3. I can have fish two times a week 4. I can drink wine in moderation

I will limit my intake of red meat to twice daily. (This statement by the client indicates a need for further teaching. Following the Mediterranean diet, red meat should be limited to two times monthly.)

A nurse is performing an ECG on a client who is experiencing chest pain. Which of the following statements should the nurse make? 1. you might feel a slight tingling while the test is being done. 2. the test will be complete in 30 to 60 minutes. 3. I will need to apply electrodes to your chest and extremities 4. the radioactivity from the dye lasts only a few hours

I will need to apply electrodes to your chest and extremities ( The nurse should inform the client that she will apply small electrodes to the client's chest and extremities before conducting the test. These electrodes transmit electrical current and allow for the recording of the heart's electrical activity.)

A nurse is reviewing the lab results of a male adult client who is at risk for peripheral arterial disease from athersclerosis. The nurse should identify that which of the following results place the client at risk? 1. triglycerides 130 mg/dL 2. blood glucose 92 mg/dL 3. LDL 172 mg/dL 4. HDL 84 mg/dL

LDL 172 mg/dL (The nurse should identify that an LDL of 172 mg/dL places the client at risk for peripheral arterial disease from atherosclerosis. The expected reference range for an adult is less than 130 mg/dL)

A nurse is giving a presentation to a community group about preventing atherosclerosis. Which of the following should the nurse include as a modifiable risk factor for this disorder? 1. obesity 2. hypercholesterolemia 3. smoking 4. genetic predisposition 5. hypertension

Obesity, smoking, hypertension, and hypercholesterolemia

A nurse is reviewing the medical record of a client who has hypertension and a new prescription for metoprolol. Which of the following findings should the nurse investigate further? 1. diet controlled type 2 diabetes mellitus. 2. a history of left sided heart failure. 3. a concurrent prescription for tadalafil. 4. recently treated bilateral pneumonia.

a history of left sided heart failure - The nurse should further investigate the client's history of heart failure. Although metoprolol can be used to treat heart failure, it can also cause heart failure, so this medication should be used with great caution with a client who has a history of heart failure. The nurse should teach the client to watch for signs of increasing left-sided heart failure, such as shortness of breath and weight gain indicating fluid retention, and report these findings to the provider

A nurse is providing discharge teaching to a client who has PAD. Which of the following instructions should the nurse include in the teaching? 1. apply a heating pad on a low setting to help relieve leg pain. 2. adjust the thermostat so that the environment is warm. 3. wear antiembolic stocking during the day. 4. rest with the legs above heart level.

adjust the thermostat so the environment is warm. (The client's instructions should include keeping the environment warm to prevent vasoconstriction. Wearing gloves, warm clothes, and socks will help prevent vasoconstriction.)

The nurse is preparing to obtain an electronic bp measurement on a client. Which of the following actions should the nurse plan to take? 1. place the bp cuff 5 cm (2 inches) above the client's antecubital space. 2. elevate the client's arm above the level of the heart. 3. align the artery indicator on the bp cuff with the client's brachial artery. 4. select a cuff that covers 50% of the client's upper arm.

align the artery indicator on the bp cuff with the client's brachial artery. - The nurse should align the artery indicator on the blood pressure cuff with the client's brachial artery to obtain an accurate measurement

A nurse caring for a client who has hypertension and asks the nurse about a prescription for propranolol. The nurse should inform the client that this medication is contraindicated in clients who have a history of which of the following conditions? 1. asthma 2. glaucoma 3. depression 4. migraines

asthma (Propranolol, a beta-blocker, is contraindicated in clients who have asthma because it can cause bronchospasms. Propranolol blocks the sympathetic stimulation, which prevents smooth muscle relaxation)

A nurse in a provider's office is reviewing the lab results of a client who take furosemide for hypertension. The nurse notes that the client's potassium level is 3.3 mEq/dL. The nurse should monitor the client for which of the following? 1. cardiac dysrhythmias 2. hypoglycemia 3. seizures 4. neurogenic shock

cardiac dysrhythmias

A nurse is planning a presentation on health promotion activities for clients who have hypertension. Which of the following should the nurse utilize as a resource for this information? 1. clinical practice guidelines for the management for high bp 2. standards of care for monitoring clients who have a history of bp elevation. 3. acute care facility protocol for clients who are experiencing a hypertensive crisis. 4. a critical pathway for clients who have had a stroke.

clinical practice guidelines for the management of high bp. (Clinical practice guidelines are evidence-based guidelines that provide information on medical management and health promotion activities for specific disease processes.)

A nurse is talking with a client who is about to undergo radionuclide imaging. The nurse should explain the procedure will help do which of the following? 1. evaluate the heart's functional capacity. 2. identify heart rhythm disturbances. 3. determine the size of the chambers of the heart. 4. detect damage to the heart muscle.

detect damage to the heart muscle - Radionuclide imaging uses radioisotopes such as thallium to evaluate coronary artery perfusion and detect areas of myocardial ischemia and infarction)

A nurse is preforming a bp screening for a client who has a family history of hypertension. Which of the following concepts is the nurse demonstrating? 1. health promotion 2. health education 3. disease prevention 4. holistic health

disease prevention (The nurse is demonstrating the concept of disease prevention by performing a blood pressure screening for the client who has a family history of hypertension. Through early detection of hypertension, an associated illness such as a stroke might be prevented)

A nurse is teaching a middle aged client about hypertension. Which of the following information should the nurse include in the teaching? 1. Reaching your goal bp will occur within 2 months. 2. Diuretics are the first type of medication to control hypertension. 3. limit your alcohol consumption to three drinks a day. 4. plan to lower saturated fats to 10 percent of your daily calorie intake

diuretics are the first type of medication to control hypertension. (The nurse should include in the teaching that diuretic medication is the first type of medication to control hypertension, by decreasing blood volume and lowering blood pressure)

A nurse is providing teaching to a client who has hypertension and a new prescription for captopril. Which of the following instructions should the nurse provide? 1. do not use salt substitutes while taking this med. 2. take the med with food. 3. count your pulse rate before taking the med. 4. expect to gain weight while taking this med.

do not use a salt substitute with this med.

A nurse is caring for an older adult client. The nurse informs the client that straining while defecating can cause which of the following? 1. dilated pupils 2. dysrhythmias 3. diarrhea 4. gastric ulcer

dysrhythmias - Dysrhythmias can result from straining while defecating. Pressure can be exerted with the Valsalva maneuver, when the client contracts the abdominal muscles and holds their breath while bearing down. When the client exhales, there is a sudden release of intraabdominal pressure against the closed airway, which can result in cardiac dysrhythmias and elevated blood pressure

A nurse is providing teaching to a client who has a family history of hypertension. The nurse should inform the client that his blood pressure of 124/79 mm Hg places him in which of the following categories? 1. within the expected range 2. elevated 3. stage 1 hypertension 4. stage 2 hypertension

elevated (A blood pressure of 124/79 mm Hg places this client in the elevated, or prehypertension, category. An elevated blood pressure, or prehypertension, is indicated by a systolic pressure between 120 and 129 mm Hg and a diastolic pressure of less than 80 mm Hg)

A charge nurse is teaching a group of nurses about agonists and antagonists. The nurse should include in the teaching that which of the following agonist meds binds to receptors and causes activation that affects the cardiovascular system? 1. insulin 2. epinephrine 3. morphine 4. norethindrone

epinephrine (The nurse should include that epinephrine is an agonist that activates the receptors that affect the cardiovascular system in clients who are at risk for cardiac collapse.)

A nurse is preparing an in-service about the various supplements clients might use. Which of the following herbal supplements should the nurse include as potentially increasing the anticoagulant effects of aspirin and other oral anticoagulants? 1. valerian 2. feverfew 3. milk thistle 4. saw palmetto

feverfew - feverfew can increase the risk of bleeding due to the suppression of platelet aggregation.

The nurse should inform the client that she will apply small electrodes to the client's chest and extremities before conducting the test. These electrodes transmit electrical current and allow for the recording of the heart's electrical activity. 1. the fourth heart sound 2. a friction rub 3. the third heart sound 4. a split second heart sound

fourth heart sound (S4 is an extra sound that is heard late in diastole just before S1. It occurs due to resistance to blood flow in an enlarged ventricle.)

A nurse is providing teaching to a client who has hypertension and a new prescription for verapamil. Which of the following beverages should the nurse tell the client to avoid while taking this medication? 1. milk 2. orange juice 3. coffee 4. grapefruit juice

grapefruit juice

A nurse is caring for a client 4 hr following a cardiac cath. Which of the following actions should the nurse take? 1. have the client lie flat in bed. 2. keep the affected leg slightly flexed. 3. elevate the head of the bed 45 degrees. 4. keep the client NPO for 4 hrs.

have the client lie flat in bed. (The nurse should have the client on lie flat in bed. Clients who had manual or mechanical pressure after catheter removal require 6 hr of bed rest. Those who had a closure device or patch only need 2 hr of bed rest)

A nurse on a med-surg unit is caring for four clients who are 24 to 36 hours post-op. Which of the following surgical procedures places the client at risk for deep vein thrombosis? 1. myringotomy 2. laparoscopic appendectomy 3. hip arthroplasty 4. cataract extraction

hip arthroplasty - Clients who are postoperative following orthopedic procedures of the lower extremities and clients who were placed in the lithotomy position for a procedure, such as for gynecological or urological surgeries, are at a higher risk of developing deep-vein thrombosis postoperatively.

A charge nurse is teaching a group of nurses about clients who report using garlic, ginger, and ginkgo biloba. The charge nurse should identify which of the following as an adverse effect of these supplements? 1. decreased effects of antirejection meds 2. decreased effects of antianxiety meds 3. increased effects of oral anticoagulants 4. increased effects of antidepressant meds

increased effects of oral anticoagulants. - The nurse should include that garlic, ginger, and ginkgo biloba can all interfere with the effects of oral anticoagulants and thus increase the risk of bleeding

A nurse is caring for a client who has peripheral arterial disease (PAD). Which of the following symptoms should a nurse expect to find in the early stage of the disease? 1. intermittent claudication 2. dependent rubor 3. rest pain 4. foot ulcers

intermittent claudication - Intermittent claudication is ischemic pain that is precipitated by exercise, resolves with rest, and is reproducible. The pain associated with claudication arises when cellular oxygen demand exceeds supply. It occurs early in the disease course, and is typically the initial reason clients who have PAD seek medical attention.)

A nurse is preparing a client who is schedule for an echo the following day. Which of the following instructions should the nurse include about the test? 1. it might cause slight discomfort in the chest area. 2. it takes about 5 to 10 minutes. 3. it requires lying quietly on one side. 4. it is best to have no food or beverages the day of the test.

it requires lying quietly on one side. - For an echocardiogram, the client lies quietly on the left side with slight head elevation

A nurse is assessing a male client who has advanced peripheral artery disease (PAD). Which of the following findings should the nurse expect? 1. thin, pliable toe nails 2. leg pain at rest 3. hairy legs 4. flushed warm legs

leg pain at rest (In the initial stages of PAD, clients might experience intermittent claudication. As the disease progresses, the client will experience pain even at rest due to ischemia of the distal extremities. The client might describe this pain as a persistent burning or aching pain that often awakens the client at night.)

A nurse is measuring a client for knee high anti embolic stockings to help prevent venous stasis. Which of the following actions should the nurse take? 1. measure from heel to the gluteal fold 2. measure the length of the feet. 3. measure form the heel to the popliteal space. 4. measure the ankle circumference.

measure from the heel to the popliteal space. - If the stocking is too short, if could impair circulation at its upper end. If it is too long, it can bunch together, which would cause pressure and irritate the skin. Measuring the length from the feet to the popliteal space helps the nurse identify the right size stockings for the client's legs.

A nurse is reviewing blood pressure classifications with a group of nurses at an in-service meeting. Which of the following should the nurse include as a risk factor for the development of hypertension? 1. high density lipoprotein (HDL) level of 70 mg/dL 2. a diet high in potassium 3. obstructive sleep apnea (OSA) 4. taking benazepril

obstructive sleep apnea (OSA) (The nurse should include OSA as a risk factor in the development of hypertension. OSA is a condition in which the client's airway becomes blocked by the relaxation of the tongue and muscles of the oropharynx, effectively obstructing the airway. The obstructed airway results in surges in the both the systolic and diastolic pressure during sleep and, in some clients, through the waking hours even when breathing is normal.)

A nurse is caring for a client who has hypertension and has a potassium level of 6.8 mEq/dL. Which of the following actions should the nurse take? 1. suggest the client use a salt substitute. 2. obtain a 12 lead ECG. 3. advise the client to add citrus juice and bananas into her diet. 4. obtain a blood sample for a serum sodium level.

obtain a 12 lead ECG. (This client's potassium level is above the expected reference range of 3.5-5.0 mEq/L and is at risk for dysrhythmias as well as cardiac arrest. Therefore, the nurse should obtain a 12-lead ECG to monitor for cardiac changes)

Which of the following actions should the nurse include as secondary prevention of hypertension? 1. provider prescribing antihypertensive med 2. blood pressure follow up visits every 6 months 3. obtain blood cholesterol levels 4. eating a low fat diet

obtain blood cholesterol levels (Obtaining blood cholesterol levels would be a secondary prevention intervention aimed at screening at risk community members. Secondary prevention will focus on further illness or injury)

A nurse is planning care for a client following a cardiac cath accessed through the femoral artery. Which of the following actions should the nurse plan to take? 1. instruct the client to perform ROM exercises to the lower extremities. 2. perform neurovascular checks with vitals. 3. ambulate the client 1 hr following the procedure. 4. restrict the client's fluid intake.

perform neurovascular checks with vitals. (The nurse should assess color, temperature, and pulse in the affected extremity and monitor the client for neurovascular changes that can indicate a stroke, such as slurred speech and visual disturbances)

A nurse is teaching a client's partner about how to obtain a bp reading. Which of the following actions by the partner indicates a need to further teaching? 1. wraps the bp cuff snugly around the client's arm 2. places the client's arm above the level of the client's heart. 3. checks the instrument gauge to ensure the reading starts at zero. 4. centers the cuff bladder over the client's brachial artery.

places the client's arm above the level of the client's heart.

A nurse is reviewing the serum laboratory findings for a client who has hypertension and is prescribed hydrochlorothiazide. Which of the following findings should the nurse report to the provider? 1. sodium 136 mEq/L 2. potassium 2.3 mEq/L 3. chloride 99 mEq/L 4. calcium 10 mg/dL

potassium 2.3 mEq/L - A serum potassium below 3 mEq/L is a critical laboratory value. The nurse should report this finding to the provider immediately and monitor the client for dysrhythmias.

A nurse is caring for a young client who has somatic symptom disorder and is being evaluated for chest pain. The client's lab results are all within normal expected reference ranges, the ECG is unremarkable, and the client has no identified cardiac risk factors. Which of the following actions should the nurse take? 1. inform the client that the pain is not real. 2. provide reassurance to the client. 3. encourage the client to request invasive cardiac testing. 4. refer the client for flooding therapy.

provide reassurance to the client.

The nurse is evaluating a client who had a cardiac cauterization with a left antecubital insertion site. Which of the following pulses should the nurse palpate? 1. brachial pulse in left arm 2. brachial pulse in right arm 3. radial pulse in left arm 4. radial pulse in right arm

radial pulse in left arm - Palpating the client's pulse distal to the insertion site is essential for evaluating possible thrombophlebitis and vessel occlusion. The left radial pulse should be strong and essentially equal to the right radial pulse

A nurse is assessing a client who is taking lisinopril to treat hypertension. Which of the following findings is a priority to report? 1. dry cough 2. swelling of the tongue 3. nausea 4. nasal congestion

swelling of the tongue. (When using the urgent vs non-urgent approach to client care, the nurse determines that the priority finding is swelling of the tongue, which is a manifestation of angioedema. The nurse should withhold the medication and notify the provider immediately if the client reports swelling of the tongue or throat. Other manifestations include giant wheals and edema of the tongue, glottis, and pharynx. Severe reactions are treated with subcutaneous epinephrine. If angioedema develops, ACE inhibitors are discontinued.)

A nurse is providing teaching to a client who has hypertension and a new prescription for hydrochlorothiazide. Which of the following instructions should the nurse provide? 1. weigh weekly to monitor therapeutic effect. 2. take the medication on an empty somtach. 3. take the medication early in the day. 4. muscle pain is an expected adverse effect.

take the medication early in the day. (The nurse should instruct the client to take hydrochlorothiazide early in the day to avoid nocturia)

A nurse is establishing health promotion goals for a female client who smokes cigarettes, has hypertension, and has a BMI of 26. Which of the following goals should the nurse include? 1. the client will list foods that are high in calcium, which should be avoided. 2. the client will walk for 30 min 5 days a week. 3. the client will increase caloric intake by 200 cal per day. 4. the client will replace cigarettes with smokeless tobacco products.

the client will walk for 30 mins 5 days a week.

A nurse is caring for a client who has a new diagnosis of essential hypertension. The nurse should monitor the client for which of the following findings that is consistent with this diagnosis? 1. vertigo 2. uremia 3. blurred vision 4. dyspnea

vertigo (The nurse should monitor the client for findings such as vertigo, headache, facial flushing, and fainting. These manifestations are consistent with a new diagnosis of essential hypertension.)

A nurse is caring for a client who sustained blood loss. Which of the following is a manifestation of hypovolemia? 1. decreased heart rate 2. dyspnea 3. increased blood pressure 4. weak pulse

weak pulse - A decreased volume of circulating blood and less pressure within the vessels results in weak peripheral pulses (rated as +1), which can be described as thready.

A nurse is caring for a client who has hypertension and is afraid to take his bp med. Which of the following nursing statements is an example of the therapeutic communication response of reflection? 1. you seem upset about taking your blood pressure med. 2. why do you feel afraid to take your med? 3. you won't get better until you take your medication? 4. did your symptoms occur before or after you took the med?

you seem upset about taking your bp med. (This statement is a reflective comment that describes the patient's feelings. A reflective comment repeats what a patient has said or describes the person's feelings.)

A nurse is providing discharge instructions to a client following a cardiac cathetherization. Which of the following information should the nurse include? 1. you can resume regular exercise as soon as tomorrow. 2. the dressing should be changed within 12 hours of the procedure. 3. you will notice a small hematoma at the incision site. 4. pain medication will not be necessary.

you will notice a small hematoma at the incision site. (Bruising and a small hematoma at the incision site are expected.)