Deck 52: Management of Clients with Hypertensive Disorders

Question 1

To reduce the risk of orthostatic hypotension in a client prescribed a diuretic antihypertensive medication, the nurse would teach the client to

A) increase fluid intake.
B) increase intake of potassium.
C) sit up before standing, and stand before walking.
D) stand up quickly using sturdy support.

Answer 1

increase fluid intake.

Question 2

The nurse would consider referring a hypertensive client for step-down therapy when the blood pressure has been effectively controlled for at least

A) 3 months.
B) 6 months.
C) 1 year.
D) 2 years.

Answer 2

1 year.

Question 3

An African-American male is being started on medication for hypertension, and the physician has prescribed a beta blocker as first-line therapy. The most appropriate action by the nurse is to

A) consult with the physician about the choice of drug.
B) have the pharmacist review the client's other meds for interactions.
C) help the client plan ways to remain compliant with therapy.
D) provide appropriate education on the medication and its side effects.

Answer 3

consult with the physician about the choice of drug.

Question 4

The nurse would realize that outcomes for the diagnosis Ineffective Health Maintenance have been partly met when the client (Select all that apply)

A) begins and maintains an exercise program.
B) has ideas for incorporating medications into lifestyle.
C) helps design a diet modification.
D) says he/she will comply with whatever plan the nurse makes.
E) shows the nurse the correct way to take the pulse.

Question 5

In an exercise program for weight reduction in a hypertensive client, the nurse would discourage the use of heavy weights because this may cause

A) lactic acid buildup.
B) muscle strain.
C) rapid vasodilation.
D) vasovagal response.

Question 6

The nurse providing care to a client being treated for a hypertensive emergency would monitor the blood pressure to ensure that it is slowly reduced during the therapy to prevent

A) myocardial infarction.
B) pulmonary embolism.
C) renal ischemia.
D) vascular collapse.

Question 7

A client has two BP readings of (134/84) and 9138/86) at a community screening event. The client smokes and has "some sort of eye disease like my grandma had" plus the client states, "I might have high sugar." The most appropriate action by the nurse would be to (Select all that apply)

A) advise the client to return tomorrow for repeat blood pressure readings.
B) arrange for the client to be seen at a local urgent care center today.
C) inform the client about the high risk of developing hypertension.
D) tell the client that the blood pressure readings are not considered high.
E) work with the client to identify risk factors and create a plan to address them.

Question 8

In advising a hypertensive client who is reluctant to give up smoking, the nurse would state that nicotine from smoking

A) causes significant, irreversible changes in blood vessels.
B) does not affect blood pressure but increases risk of cardiovascular disease.
C) increases blood pressure immediately for a short time.
D) is statistically linked to the development of hypertension.

Question 9

The nurse would explain to a client that the most common cause of secondary hypertension is

A) chronic renal disease.
B) oral contraceptive use.
C) pregnancy.
D) primary hyperaldosteronism.

Question 10

When a client diagnosed with primary hypertension asks the nurse what causes this disease, the nurse's best response would be "High blood pressure is caused by

A) a decrease in plasma renin levels."
B) a number of factors, not just one cause."
C) arteriosclerotic vessel disease."
D) a kidney problem."

Question 11

When a client tells the nurse, "I heard that potassium supplements are effective in treating hypertension," the nurse's most appropriate reply would be as follows:

A) "Increased levels of potassium do not significantly affect blood pressure."
B) "Too much potassium can result in a dangerous rise in blood pressure."
C) "You can achieve the same benefits from low-sodium, high-potassium foods."
D) "You can try them for a while to see if you feel they are effective."

Question 12

The nurse working with hypertensive clients knows that what factor is most important in order for the client's treatment plan to be successful?

A) A sound treatment plan created by the health care team
B) Consultation with specialists like physical therapy and a dietitian
C) Long-term compliance and adherence to therapy
D) Provider willingness to try different medications

Question 13

An important action the nurse can take that will most likely increase client compliance with a sodium- and fat-restricted diet is to

A) offer to find the client a class on heart-healthy cooking.
B) provide verbal education on ways to modify the client's current diet.
C) refer the client for a consultation with a registered dietitian.
D) tell the client about complications that may occur from not being compliant.

Question 14

A hypertensive client, age 55, is slightly obese, has a sedentary lifestyle, and smokes half a pack of cigarettes daily. For the behavioral change with the most immediate and positive impact on his blood pressure, the nurse would focus on

A) caffeine restriction.
B) regular exercise.
C) smoking cessation.
D) weight reduction measures.

Question 15

In conducting a health interview with a hypertensive client, the nurse would ask the client about the presence of the typical manifestations of the disorder, which are

A) increasing muscle weakness.
B) nausea, vomiting, and abdominal pain.
C) none unless the hypertension is sustained.
D) peripheral edema and abdominal bloating.

Question 16

For a hypertensive client who reports being "really fired up" about losing weight, the nurse would recognize the need for more education on hearing the client's plan to

A) abruptly eliminate sugar from the diet.
B) lose 1 pound a week.
C) use over-the-counter appetite suppressants.
D) walk and climb stairs.

Question 17

For a client who wants to walk for exercise to reduce hypertension, the nurse would offer the guideline to walk

A) at the highest possible speed for 20 minutes, two or three times a week.
B) briskly for 30 to 45 minutes most days of the week.
C) slowly for 1 to 2 hours most days of the week.
D) with variable speeds and on hills at least twice a week.