1. The clinic nurse is teaching the client at risk for developing arteriosclerosis.
The nurse should teach the client that the dietary therapy to decrease homo-
cysteine levels includes eating foods rich in which nutrient?
A. Monosaturated fats
B. B complex Vitamins
C. Vitamin C
D. Calcium
ANSWER: B
A. Monosaturated fats are included in a healthy diet but have not been found to affect the
homocysteine levels.
B. Homocysteine interferes with the elasticity of the endothelial layer in blood vessels.
Foods rich in B-complex vitamins, especially folic acid, have been found to lower serum
homoeystelne levels.
C. Vitamin C is included in a healthy diet and enhances immune system functions but has
not been found to affect the homocysteine levels.
D. Calcium is important for bone health but has not been found to affect the homocysteinc
levels.
2. The client’s BP is being taken at a screening clinic. Which client statement to
the nurse demonstrates awareness of having a risk factor for hypertension?
A. “My doctor told me my body mass index is 23 and my blood pressure is 118/70.”
B. “I usually have a glass of wine to unwind when I come home from work.”
C. “I plan to get my blood pressure checked more often, as I am African American.”
D. “I have colds during the winter, so I plan to get the influenza vaccine every year.”
ANSWER: C
A. A BMI of 25 or higher is considered a risk factor for hypertension. A BMI of 23 is normal.
A BP of 118/70 is within normal range for an adult.
B. Excessive alcohol intake is a risk factor for hypertension; consuming two glasses of
wine daily increases the risk for hypertension.
C. Being African American is a known risk factor for hypertension. Starting to have the BP
taken more often demonstrates awareness of having a risk factor for hypertension.
, D. Having frequent colds and taking the influenza vaccine does not increase the risk for
hypertension. Medications for treating colds, if taken frequently, can increase the risk for
hypertension.
3. The nurse has prepared medications for a 75-year-old client with
hypertension. The nurse notes that the client has an elevated serum potassium
level. Which medication is most important for the nurse to address with the
HCP before administration?
ANSWER: A
A. Hyperkalemia can occur as a side effect to lisinopril (Prinivil, Zestril), an ACE inhibitor.
The HCP should be notified prior to administration. The drug or dose may need to be
changed; 40 mg is the maximum daily dose for an elderly client.
B. Metoprolol (Lopressor), a beta adrenergic blocker, can increase serum creatinine and
BUN levels and cause hypoglycemia. There is no information in the stem about these
levels.
C. Atorvastatin (Lipitor), an antilipidemic agent, lowers LDL levels; it has no effect on serum
potassium levels.
D. Sertraline (Zoloft), an SSRI, is used in treating anxiety or depression. 15 has no effect on
serum potassium levels. It may produce hyponatremia in older adults.
,4. The nurse completes discharge teaching for the client with chronic stage 2
hypertension. Which statement by the client indicates that teaching was
effective?
A. “I will limit my intake of potassium by eating bananas only once a week.”
B. “1 will start a rigorous exercise program to lose this excess weight.”
C. “I will call my doctor immediately if I have sudden vision changes.”
D. “I will strive to maintain my body mass index (BMI) at 32.”
ANSWER: C
A. Reduced intake of dietary potassium is a contributory factor associated with malignant
hypertension and should not be limited unless serum potassium levels are elevated.
Sodium, not potassium, should be limited with hypertension.
B. Clients with hypertension are advised to gradually increase to regular physical activity,
and should avoid sudden rigorous exercise programs.
C. Teaching is effective if the client states to call the HCP immediately if experiencing
vision changes. Sudden vision changes may be associated with stroke, a complication
of hypertension.
D. A BMI of 32 is obese. Obesity is a contributing factor of hypertension and is defined as a
BMI greater than 30.
5. The nurse is taking the BP on multiple clients. Which reading warrants the
nurse notifying the HCP because the client’s MAP is abnormal?
A. 94/60 mm Hg
B. 98/36 mm Hg
C. 110/50 mm Hg
D. 140/78 mm Hg
ANSWER: B
, 6 . The nurse is assessing the client. At which area should the nurse place the
stethoscope to best auscultate the client’s murmur associated with mitral
regurgitation?
A. Line A
B. Line B
C. Line C
D. Line D
ANSWER: D
A. Line A points to the aortic valve and would be associated with aortic stenosis, not mitral
regurgitation.
B. Line B points to the pulmonic valve and is not the valve to assess for mitral regurgitation.
C. Line C points to the tricuspid valve and is not the valve to assess for mitral regurgitation.
The nurse should teach the client that the dietary therapy to decrease homo-
cysteine levels includes eating foods rich in which nutrient?
A. Monosaturated fats
B. B complex Vitamins
C. Vitamin C
D. Calcium
ANSWER: B
A. Monosaturated fats are included in a healthy diet but have not been found to affect the
homocysteine levels.
B. Homocysteine interferes with the elasticity of the endothelial layer in blood vessels.
Foods rich in B-complex vitamins, especially folic acid, have been found to lower serum
homoeystelne levels.
C. Vitamin C is included in a healthy diet and enhances immune system functions but has
not been found to affect the homocysteine levels.
D. Calcium is important for bone health but has not been found to affect the homocysteinc
levels.
2. The client’s BP is being taken at a screening clinic. Which client statement to
the nurse demonstrates awareness of having a risk factor for hypertension?
A. “My doctor told me my body mass index is 23 and my blood pressure is 118/70.”
B. “I usually have a glass of wine to unwind when I come home from work.”
C. “I plan to get my blood pressure checked more often, as I am African American.”
D. “I have colds during the winter, so I plan to get the influenza vaccine every year.”
ANSWER: C
A. A BMI of 25 or higher is considered a risk factor for hypertension. A BMI of 23 is normal.
A BP of 118/70 is within normal range for an adult.
B. Excessive alcohol intake is a risk factor for hypertension; consuming two glasses of
wine daily increases the risk for hypertension.
C. Being African American is a known risk factor for hypertension. Starting to have the BP
taken more often demonstrates awareness of having a risk factor for hypertension.
, D. Having frequent colds and taking the influenza vaccine does not increase the risk for
hypertension. Medications for treating colds, if taken frequently, can increase the risk for
hypertension.
3. The nurse has prepared medications for a 75-year-old client with
hypertension. The nurse notes that the client has an elevated serum potassium
level. Which medication is most important for the nurse to address with the
HCP before administration?
ANSWER: A
A. Hyperkalemia can occur as a side effect to lisinopril (Prinivil, Zestril), an ACE inhibitor.
The HCP should be notified prior to administration. The drug or dose may need to be
changed; 40 mg is the maximum daily dose for an elderly client.
B. Metoprolol (Lopressor), a beta adrenergic blocker, can increase serum creatinine and
BUN levels and cause hypoglycemia. There is no information in the stem about these
levels.
C. Atorvastatin (Lipitor), an antilipidemic agent, lowers LDL levels; it has no effect on serum
potassium levels.
D. Sertraline (Zoloft), an SSRI, is used in treating anxiety or depression. 15 has no effect on
serum potassium levels. It may produce hyponatremia in older adults.
,4. The nurse completes discharge teaching for the client with chronic stage 2
hypertension. Which statement by the client indicates that teaching was
effective?
A. “I will limit my intake of potassium by eating bananas only once a week.”
B. “1 will start a rigorous exercise program to lose this excess weight.”
C. “I will call my doctor immediately if I have sudden vision changes.”
D. “I will strive to maintain my body mass index (BMI) at 32.”
ANSWER: C
A. Reduced intake of dietary potassium is a contributory factor associated with malignant
hypertension and should not be limited unless serum potassium levels are elevated.
Sodium, not potassium, should be limited with hypertension.
B. Clients with hypertension are advised to gradually increase to regular physical activity,
and should avoid sudden rigorous exercise programs.
C. Teaching is effective if the client states to call the HCP immediately if experiencing
vision changes. Sudden vision changes may be associated with stroke, a complication
of hypertension.
D. A BMI of 32 is obese. Obesity is a contributing factor of hypertension and is defined as a
BMI greater than 30.
5. The nurse is taking the BP on multiple clients. Which reading warrants the
nurse notifying the HCP because the client’s MAP is abnormal?
A. 94/60 mm Hg
B. 98/36 mm Hg
C. 110/50 mm Hg
D. 140/78 mm Hg
ANSWER: B
, 6 . The nurse is assessing the client. At which area should the nurse place the
stethoscope to best auscultate the client’s murmur associated with mitral
regurgitation?
A. Line A
B. Line B
C. Line C
D. Line D
ANSWER: D
A. Line A points to the aortic valve and would be associated with aortic stenosis, not mitral
regurgitation.
B. Line B points to the pulmonic valve and is not the valve to assess for mitral regurgitation.
C. Line C points to the tricuspid valve and is not the valve to assess for mitral regurgitation.
