Medical-Surgical Nursing Chapter 32
TEST BANK (HYPERTENSTION) 2023
The nurse teaches a 28-yr-old man newly diagnosed with hypertension about lifestyle
modifications to reduce his blood pressure. Which patient statement requires
reinforcement of teaching?
A. "I will avoid adding salt to my food during or after cooking."
B."If I lose weight, I might not need to continue taking medications."
C. "I can lower my blood pressure by switching to smokeless tobacco."
D. "Diet changes can be as effective as taking blood pressure medications. -
CORRECT ANSWERS C
Nicotine contained in tobacco products (smoking and chew) cause vasoconstriction and
increase blood pressure. Persons with hypertension should restrict sodium to 1500
mg/day by avoiding foods high in sodium and not adding salt in preparation of food or at
meals. Weight loss can decrease blood pressure between 5 to 20 mm Hg. Following
dietary recommendations (e.g., the DASH diet) lowers blood pressure, and these
decreases compare with those achieved with blood pressure-lowering medication.
The nurse supervises an unlicensed assistant personnel (UAP) who is taking the blood
pressure of 58-yr-old obese female patient admitted with heart failure. Which action by
the UAP will require the nurse to intervene?
A. Waiting 2 minutes after position changes to take orthostatic pressures
B. Deflating the blood pressure cuff at a rate of 8 to 10 mm Hg per second
C. Taking the blood pressure with the patient's arm at the level of the heart
D. Taking a forearm blood pressure because the largest cuff will not fit the patient's
upper arm - CORRECT ANSWERS B.
The cuff should be deflated at a rate of 2 to 3 mm Hg per second. The arm should be
supported at the level of the heart for accurate blood pressure measurements. Using a
cuff that is too small causes a falsely high reading and too large causes a falsely low
reading. If the maximum size blood pressure cuff does not fit the upper arm, the forearm
may be used. Orthostatic blood pressures should be taken within 1 to 2 minutes of
repositioning the patient.
A 44-yr-old man is diagnosed with hypertension and receives a prescription for
benazepril (Lotensin). After providing instruction, which statement by the patient
indicates correct understanding?
A. "If I take this medication, I will not need to follow a special diet."
B. "It is normal to have some swelling in my face while taking this medication."
C. "I will need to eat foods such as bananas and potatoes that are high in potassium."
, D. "If I develop a dry cough while taking this medication, I should notify my doctor." -
CORRECT ANSWERS D.
Benazepril is an angiotensin-converting enzyme inhibitor. The medication inhibits
breakdown of bradykinin, which may cause a dry, hacking cough. Other adverse effects
include hyperkalemia. Swelling in the face could indicate angioedema and should be
reported immediately to the prescriber. Patients taking drug therapy for hypertension
should also attempt lifestyle modifications to lower blood pressure such as a reduced-
sodium diet.
A 67-yr-old woman with hypertension is admitted to the emergency department with a
blood pressure of 234/148 mm Hg and was started on nitroprusside (Nitropress). After
one hour of treatment, the mean arterial blood pressure (MAP) is 55 mm Hg. Which
nursing action is a priority?
A. Start an infusion of 0.9% normal saline at 100 mL/hr.
B. Maintain the current administration rate of the nitroprusside.
C. Request insertion of an arterial line for accurate blood pressure monitoring.
D. Stop the nitroprusside infusion and assess the patient for potential complications. -
CORRECT ANSWERS D.
Nitroprusside is a potent vasodilator medication. A blood pressure of 234/118 mm Hg
would have a calculated MAP of 177 mm Hg. Subtracting 25% (or 44 mm Hg) = 133
mm Hg. The initial treatment goal is to decrease MAP by no more than 25% within
minutes to 1 hour. For this patient, the goal MAP would be approximately 133 mm Hg.
Minimal MAP required to perfuse organs is around 60 to 65 mm Hg. Lowering the blood
pressure too rapidly may decrease cerebral, coronary, or renal perfusion and could
precipitate a stroke, myocardial infarction, or renal failure. The priority is to stop the
nitroprusside infusion and then use fluids only if necessary to support restoration of
MAP.
The nurse admits a 73-yr-old male patient with dementia for treatment of uncontrolled
hypertension. The nurse will closely monitor for hypokalemia if the patient receives
which medication?
A. Clonidine (Catapres)
B. Bumetanide (Bumex)
C.Amiloride (Midamor)
D. Spironolactone (Aldactone) - CORRECT ANSWERS B.
Bumetanide is a loop diuretic. Hypokalemia is a common adverse effect of this
medication. Amiloride is a potassium-sparing diuretic. Spironolactone is an aldosterone-
TEST BANK (HYPERTENSTION) 2023
The nurse teaches a 28-yr-old man newly diagnosed with hypertension about lifestyle
modifications to reduce his blood pressure. Which patient statement requires
reinforcement of teaching?
A. "I will avoid adding salt to my food during or after cooking."
B."If I lose weight, I might not need to continue taking medications."
C. "I can lower my blood pressure by switching to smokeless tobacco."
D. "Diet changes can be as effective as taking blood pressure medications. -
CORRECT ANSWERS C
Nicotine contained in tobacco products (smoking and chew) cause vasoconstriction and
increase blood pressure. Persons with hypertension should restrict sodium to 1500
mg/day by avoiding foods high in sodium and not adding salt in preparation of food or at
meals. Weight loss can decrease blood pressure between 5 to 20 mm Hg. Following
dietary recommendations (e.g., the DASH diet) lowers blood pressure, and these
decreases compare with those achieved with blood pressure-lowering medication.
The nurse supervises an unlicensed assistant personnel (UAP) who is taking the blood
pressure of 58-yr-old obese female patient admitted with heart failure. Which action by
the UAP will require the nurse to intervene?
A. Waiting 2 minutes after position changes to take orthostatic pressures
B. Deflating the blood pressure cuff at a rate of 8 to 10 mm Hg per second
C. Taking the blood pressure with the patient's arm at the level of the heart
D. Taking a forearm blood pressure because the largest cuff will not fit the patient's
upper arm - CORRECT ANSWERS B.
The cuff should be deflated at a rate of 2 to 3 mm Hg per second. The arm should be
supported at the level of the heart for accurate blood pressure measurements. Using a
cuff that is too small causes a falsely high reading and too large causes a falsely low
reading. If the maximum size blood pressure cuff does not fit the upper arm, the forearm
may be used. Orthostatic blood pressures should be taken within 1 to 2 minutes of
repositioning the patient.
A 44-yr-old man is diagnosed with hypertension and receives a prescription for
benazepril (Lotensin). After providing instruction, which statement by the patient
indicates correct understanding?
A. "If I take this medication, I will not need to follow a special diet."
B. "It is normal to have some swelling in my face while taking this medication."
C. "I will need to eat foods such as bananas and potatoes that are high in potassium."
, D. "If I develop a dry cough while taking this medication, I should notify my doctor." -
CORRECT ANSWERS D.
Benazepril is an angiotensin-converting enzyme inhibitor. The medication inhibits
breakdown of bradykinin, which may cause a dry, hacking cough. Other adverse effects
include hyperkalemia. Swelling in the face could indicate angioedema and should be
reported immediately to the prescriber. Patients taking drug therapy for hypertension
should also attempt lifestyle modifications to lower blood pressure such as a reduced-
sodium diet.
A 67-yr-old woman with hypertension is admitted to the emergency department with a
blood pressure of 234/148 mm Hg and was started on nitroprusside (Nitropress). After
one hour of treatment, the mean arterial blood pressure (MAP) is 55 mm Hg. Which
nursing action is a priority?
A. Start an infusion of 0.9% normal saline at 100 mL/hr.
B. Maintain the current administration rate of the nitroprusside.
C. Request insertion of an arterial line for accurate blood pressure monitoring.
D. Stop the nitroprusside infusion and assess the patient for potential complications. -
CORRECT ANSWERS D.
Nitroprusside is a potent vasodilator medication. A blood pressure of 234/118 mm Hg
would have a calculated MAP of 177 mm Hg. Subtracting 25% (or 44 mm Hg) = 133
mm Hg. The initial treatment goal is to decrease MAP by no more than 25% within
minutes to 1 hour. For this patient, the goal MAP would be approximately 133 mm Hg.
Minimal MAP required to perfuse organs is around 60 to 65 mm Hg. Lowering the blood
pressure too rapidly may decrease cerebral, coronary, or renal perfusion and could
precipitate a stroke, myocardial infarction, or renal failure. The priority is to stop the
nitroprusside infusion and then use fluids only if necessary to support restoration of
MAP.
The nurse admits a 73-yr-old male patient with dementia for treatment of uncontrolled
hypertension. The nurse will closely monitor for hypokalemia if the patient receives
which medication?
A. Clonidine (Catapres)
B. Bumetanide (Bumex)
C.Amiloride (Midamor)
D. Spironolactone (Aldactone) - CORRECT ANSWERS B.
Bumetanide is a loop diuretic. Hypokalemia is a common adverse effect of this
medication. Amiloride is a potassium-sparing diuretic. Spironolactone is an aldosterone-
