Med_Surg_Chapter_31

MED-SURG Chapter 31: Assessment and Management of Patients With Hypertension Question A client is placed on a low-sodium (500 mg/day) diet. Which client statement indicates that the nurse's nutrition teaching plan has been effective? • "I chose broiled chicken with a baked potato for dinner." Question A client hospitalized for treatment of hypertension is being prepared for discharge. Which teaching topic should the nurse should be sure to cover? • Maintaining a low-sodium diet Question Which client statement indicates a good understanding of the nutritional modifications needed to manage hypertension? • "Limiting my salt intake to 2 grams per day will improve my blood pressure." Question Which diuretic medication conserves potassium? • Spironolactone Question A blood pressure (BP) of 140/90 mm Hg is considered to be • hypertension. Question A client with newly diagnosed hypertension asks what she can do to decrease the risk for related cardiovascular problems. Which of the following risk factors is not modifiable by the client? • Age Question A nurse is teaching about lifestyle modifications to a group of clients with known hypertension. Which of the following statements would the nurse include in the education session? • Engage in aerobic activity at least 30 minutes/day most days of the week. Question A nurse is educating a client about monitoring blood pressure readings at home. Which of the following will the nurse be sure to emphasize? • "Sit quietly for 5 minutes prior to taking blood pressure." Question A nurse is teaching a 38-year-old man with newly diagnosed hypertension who asks if there is any harm in stopping his antihypertensive medication if he decides to discontinue it. The correct reply addresses the consequence of stopping antihypertensive medications abruptly. Which of the following statements from the nurse would be appropriate? • "Rebound hypertension can occur." Question A nurse providing education about hypertension to a community group is discussing the high risk for cardiovascular complications. Which of the following are risk factors for cardiovascular problems in clients with hypertension? Choose all that apply. • Smoking • Diabetes mellitus • Physical inactivity Question The nurse is explaining the DASH diet to a patient diagnosed with hypertension. The patients inquires about how many servings of fruit per day can be consumed on the diet. The nurse would be correct in stating which of the following? • 4 or 5 Question A patient is being treated for hypertensive emergency. When treating this patient, the priority goal is to lower the mean blood pressure (BP) by which percentage in the first hour? • Up to 25% Question The nurse is creating a community teaching demonstration focusing on the cause of blood pressure. When completing the visual aid, which body structures represent the mechanism of blood pressure? • Heart and blood vessels Question Which of the following is the nurse most correct to recognize as a direct effect of client hypertension? • Renal dysfunction resulting from atherosclerosis Question The nurse is instructing a client who is newly prescribed an antihypertensive medication. Which nursing instruction is emphasized to maintain client safety? • Sit on the edge of the chair and rise slowly. Question The nurse is caring for a client who is prescribed medication for the treatment of hypertension. The nurse recognizes that which medication conserves potassium? • Spironolactone Question The nurse is caring for a patient with systolic blood pressure of 135 mm Hg. This finding would be classified as • prehypertension. Question The nurse understands that client education related to antihypertensive medication should include which of the following? • inform client to avoid over-the-counter cold and sinus medications Question A client is admitted to the intensive care unit (ICU) with a diagnosis of hypertension emergency/crisis. The client’s blood pressure (BP) is 200/130 mm Hg. The nurse is preparing to administer IV nitroprusside. Upon assessment, which finding requires immediate intervention by the nurse? • Numbness and weakness in the left arm Question A patient is taking amiloride (Midamor) and lisinopril (Zestril) for the treatment of hypertension. What laboratory studies should the nurse monitor while the patient is taking these two medications together? • Potassium level Question A client with high blood pressure is receiving an antihypertensive drug. The nurse knows that antihypertensive drugs commonly cause fatigue and dizziness, especially on rising. When developing a client teaching plan to minimize orthostatic hypotension, which instruction should the nurse include? • "Flex your calf muscles, avoid alcohol, and change positions slowly." Question According to the classification of hypertension diagnosed in older adults, hypertension that can be attributed to an underlying cause is termed • secondary. Question Nurses should implement measures to relieve emotional stress for clients with hypertension because the reduction of stress • decreases the production of neurotransmitters that constrict peripheral arterioles. Question Which describes a situation in which blood pressure is severely elevated and there is evidence of actual or probable target organ damage? • Hypertensive emergency Question A nurse is caring for a client with hypertension. The physician orders furosemide (lasix) 2 mg/kg to be given intravenously. The client weighs 24 kg. The medication comes in a single-use vial that contains 40 mg in 4 mL (10 mg/mL). How much will the nurse draw up for this client's dose? • 4.8 mL Question A 77-year-old client has newly diagnosed stage 2 hypertension. The physician has prescribed a thiazide and an angio-converting enzyme inhibitor. About what is the nurse most concerned? • Postural hypotension and resulting injury Question A nursing class is practicing measurement of blood pressure. One otherwise healthy participant, 46 years old, is 138/90. This man requires follow-up. In which classification of hypertension is he according to the JNC 7 (Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood pressure) recommendation? • Stage 1 Question A nurse is providing education to a client about monitoring blood pressure readings at home. The nurse will review all the following items except: • Avoid smoking cigarettes for 1 hour prior to taking blood pressure. Question Which of the following diagnostic tests may reveal an enlarged left ventricle? • Echocardiography Question The nurse is caring for an 82-year-old male client who has come to the clinic for a yearly physical. When assessing the client, the nurse notes the blood pressure (BP) is 140/93. The nurse knows that in older clients what happens that may elevate the systolic BP? • Loss of arterial elasticity Question A client, newly admitted to the nursing unit, has a primary diagnosis of renal failure. When assessing the client, the nurse notes a blood pressure (BP) of 180/100. The nurse knows that this is what kind of hypertension? • Secondary Question The nursing student is part of a group of nursing students who are making a presentation on chronic hypertension. What is one subject the nursing student would need to include in the presentation as a possible consequence of untreated chronic hypertension? • Stroke Question A client is being seen at the clinic for a routine physical when the nurse notes the client's blood pressure is 150/97. The client is considered to be a healthy, well-nourished young adult. What type of hypertension does this client have? • Essential (primary) Question Which of the following would be inconsistent as a component of metabolic syndrome? • Hypotension Question 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? • dizziness Question Papilledema is a fairly common symptom of elevated blood pressure. The best way to detect this condition is through: • ophthalmic examination. Question The nurse is caring for a client with hypertension. The nurse is correct to realize that a 24-hour urine is ordered to determine if the cause of hypertension is related to the dysfunction of which of the following? • The adrenal gland Question When measuring the blood pressure in each arm of a healthy adult client, the nurse recognizes that which statement is true? • Pressures should not differ more than 5 mm Hg between arms. Question The nurse is administering medications on a medical-surgical unit. A client is ordered to receive 40 mg oral nadolol for the treatment of hypertension. Before administering the medication, the nurse should • check the client’s heart rate. Question Aging is positively correlated to the incidence of hypertension. This is due to three of the following four structural or functional changes. Which choice is not considered a cause? • Increased ability to exert diastolic pressure Question It is appropriate for the nurse to recommend smoking cessation for clients with hypertension because nicotine • increases the heart rate, constricts arterioles, and reduces the heart's ability to eject blood. Question A nurse educator is providing information about hypertension to a small group of clients. A participant asks what she can do to decrease her blood pressure and thus her risk for heart problems. The nurse describes modifiable and nonmodifiable risk factors. Which of the following risk factors can the client modify? • Dyslipidemia Question A nurse is teaching a client who is newly diagnosed with hypertension and diabetes mellitus. For a client without diabetes mellitus, the target blood pressure is 140/90 or lower. Because this client has diabetes mellitus, the target blood pressure will be which of the following? • 130/80 or lower Question When treating hypertensive emergencies, the nurse identifies the most appropriate route of administration for antihypertensive agents as being which of the following? • Continuous IV infusion Question The nurse is performing an assessment on a patient to determine the effects of hypertension on the heart and blood vessels. What specific assessment data will assist in determining this complication? (Select all that apply.) • Heart rate • Heart rhythm • Character of apical and peripheral pulses Question A client with high blood pressure is receiving an antihypertensive drug. The nurse knows that antihypertensive drugs commonly cause fatigue and dizziness, especially on rising. When developing a client teaching plan to minimize orthostatic hypotension, which instruction should the nurse include? • "Flex your calf muscles, avoid alcohol, and change positions slowly." Question 2 See full question 14s Which client statement indicates a good understanding of the nutritional modifications needed to manage hypertension? • "Limiting my salt intake to 2 grams per day will improve my blood pressure." Question 3 See full question 23s Which adrenergic inhibitor acts directly on the blood vessels, producing vasodilation? • Prazosin Question A nurse is educating a client about monitoring blood pressure readings at home. Which of the following will the nurse be sure to emphasize? • "Sit quietly for 5 minutes prior to taking blood pressure." Question A 66-year-old client presents to the emergency department reporting severe headache and mild nausea for the past 6 hours. Upon assessment, the client’s BP is 210/120 mm Hg. The client has a history of hypertension and takes 1.0 mg clonidine twice daily. Which question is most important for the nurse to ask the client next? • “Have you taken your prescribed clonidine today?” uestion When measuring blood pressure in each arm of a healthy adult, the nurse recognizes that the pressures • differ no more than 5 mm Hg between arms. Question According to the DASH diet, how many servings of vegetables should a person consume each day? • 4 or 5 Question A nurse is providing education about lifestyle modifications to a group of clients who have been newly diagnosed with hypertension. The nurse would include all the following statesments except: • Limit alcohol consumption to no more that 3 drinks per day for men and 2 drinks per day for women. Question When administering an angiotensin-converting enzyme (ACE) inhibitor with spironolactone, the nurse should be aware that which electrolyte imbalance may occur? • Hyperkalemia Question Which statements are true when the nurse is measuring blood pressure (BP)? Select all that apply. • Using a BP cuff that is too small will give a higher BP measurement. • The client’s arm should be positioned at the level of the heart. • The client should sit quietly while BP is being measured.