Medical-Surgical Nursing

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The nurse is caring for a client newly diagnosed with hypertension. Which statement by the client indicates the need for further teaching? "If I take my blood pressure and it is normal. I don't have to take my blood pressure pills" "I will consult a dietician to help get my weight under control" "I think i'm going to sign up for a yoga class twice a week to help reduce my stress" "When getting up from bed, I will sit for a short period before standing"

"If I take my blood pressure and it is normal. I don't have to take my blood pressure pills"

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" "Be sure the forearm is well supported above heart level while taking blood pressure" "sit with legs crossed when taking your blood pressure" "Sit quietly for 5 minutes prior to taking blood pressure"

"Sit quietly for 5 minutes prior to taking 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 fluid intake. Decrease sodium intake. Increase iodine intake. Avoid over-the-counter decongestants.

Decrease sodium intake.

The most common affective or mood disorder of old age is __________, often related to chronic illnesses or pain

Depression

The actual percentage of long term nursing home residents has doubled over the last 25 years due to increased longevity and management of chronic illnesses True or false

False

The leading cause of death in older adults in the United States is ___________ disease

Heart

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

Hypertensive Emergency

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? Exercise once a week. Keep weight stable. Sleep four hours each night. Add salt to foods for taste.

Keep weight stable.

When measuring the blood pressure in each arm of a healthy adult client, the nurse recognizes that which statement is true? Pressures may vary, with the higher pressure found in the left arm. Pressures should not differ more than 5 mm Hg between arms. Pressures may vary 10 mm Hg or more between arms. Pressures must be equal in both arms.

Pressures should not differ more than 5 mm Hg between arms.

If neglect or abuse of any kind---including physical, emotional, sexual, neglect or financial abuse---is suspected, the local adult __________________ services agency must be notified.

Protective

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 50% within the first hour of treatment. Reduce the blood pressure by 20% to 25% within the first hour of treatment. Rapidly reduce the blood pressure so the client will not suffer a stroke. Reduce the blood pressure to about 140/80 mm Hg.

Reduce the blood pressure by 20% to 25% within the first hour of treatment.

Hypertension that can be attributed to an underlying cause is termed

Secondary Hypertension

Older adults are less likely than younger people to acknowledge or seek treatment for mental health symptoms True or false

True

most Americans 75 years of age and older remain functionally independent regardless of how they perceive their health true or false

True

Nursing interventions for __________ are aimed at promoting patient functioning and independence for as long as possible

dementia

Chronic Conditions, many of which are preventable or treatable, are the major cause of _________ and pain among older adults

disability

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? blurred vision dizziness tremor persistent cough

dizziness

Significant declines in intelligence, learning and memory are inversely proportional to increases in age true or false

false

Age-related degeneration is the primary cause of vision loss in adults older than 40 years of age true or false

true

A 77-year-old client presents to the local community center for a blood pressure (BP) screening; BP is recorded as 180/90 mm Hg. The client has a history of hypertension but currently is not taking the prescribed medications. Which question is most appropriate for the nurse to ask the client first? "what medications are you prescribed" "Are you having trouble paying for your medications" "Can you tell me the reasons you aren't taking your medications" "Are you able to get to your pharmacy to pick up your medications"

"Can you tell me the reasons you aren't taking your medications"

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? 35% 45% 40% 25%

25%

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

A client diagnosed with kidney disease

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 low blood pressure. A cuff that is too large will give a false high blood pressure. A cuff that is too small 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.

An older adult client visits the clinic for a blood pressure check. The client's hypertension is not well controlled, and a new blood pressure medicine is prescribed. What is important for the nurse to teach this client about blood pressure medicine? A possible adverse effect of blood pressure medicine is dizziness when you stand. Take the medicine on an empty stomach. There are no adverse effects from blood pressure medicine. A severe drop in blood pressure is possible.

A possible adverse effect of blood pressure medicine is dizziness when you stand.


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