Deck 22: Nursing Care of Patients With Hypertension

Question 1

The nurse is reinforcing teaching for a patient with hypertension.Which activity should the nurse include to help control hypertension?

A) Walk regularly.
B) Begin yoga weekly.
C) Begin a weight-lifting program.
D) Perform stretching exercises daily.

Answer 1

Walk regularly.

Question 2

The nurse is caring for a patient who is receiving furosemide (Lasix)for treatment of hypertension.Which laboratory test should the nurse carefully monitor?

A) Glucose
B) Potassium
C) Cholesterol
D) Hemoglobin

Answer 2

Potassium

Question 3

The nurse is measuring blood pressures during a screening clinic.For which blood pressure reading should the nurse instruct a patient to have follow-up in one year?

A) 108/80 mm Hg
B) 132/88 mm Hg
C) 148/94 mm Hg
D) 159/88 mm Hg

Answer 3

132/88 mm Hg

Question 4

A patient's current blood pressure reading is 144/94 mm Hg.A reading of 150/96 mm Hg was obtained on a prior occasion.Which type of hypertension should the nurse recognize that this patient is experiencing?

A) Prehypertension
B) Stage 1
C) Stage 2
D) Hypertensive emergency

Question 5

The nurse provides dietary teaching to a patient who is prescribed bumetanide (Bumex).Which food should the patient name as important to ingest while taking this medication?

A) Radish
B) Lettuce
C) Broccoli
D) Cucumber

Question 6

The nurse is planning care for patients with hypertension.Which ethnic group should the nurse understand is most sensitive to the effects of the beta blocker propranolol (Inderal)?

A) Chinese
B) Koreans
C) African Americans
D) Japanese Americans

Question 7

A patient is prescribed furosemide (Lasix)for hypertension and heart failure.Which statement should the nurse use to explain the purpose of this medication to the patient?

A) "The medication vasodilates the arterioles so the heart doesn't have to pump as often."
B) "Furosemide increases cardiac output so workload is decreased and the heart pumps more effectively."
C) "By removing excess water, blood pressure and then cardiac workload are lowered so the heart doesn't work so hard."
D) "Furosemide increases the blood flow to the kidneys so the normal renin-angiotensin cycle is optimized and blood pressure is lowered."

Question 8

A patient on antihypertensive medication has no insurance,three children,and reports feeling great and exercising daily.What should the nurse include in this patient's teaching plan to promote compliance?

A) Encourage increased rest periods.
B) Provide names of support groups.
C) Refer the patient for financial assistance.
D) Schedule an annual physical examination.

Question 9

The nurse is monitoring a patient with a hypertensive urgency.Which manifestation should the nurse expect to find?

A) Muscle weakness
B) Urinary retention
C) Severe headaches
D) Irregular heartbeats

Question 10

The nurse measures a blood pressure of 166/100 mm Hg on a participant of a screening clinic.Which follow-up should the nurse recommend to this participant?

A) 1 month
B) 2 months
C) 12 months
D) 24 months

Question 11

The nurse is measuring blood pressures during a screening clinic.Which recommended follow-up time frame should the nurse suggest to a patient for a blood pressure reading of 118/72 mm Hg?

A) 1 month
B) 2 months
C) l year
D) 2 years

Question 12

The nurse is planning care for a group of patients.Which individual should the nurse identify as being at the highest risk for developing hypertension?

A) A 60-year-old Japanese American man
B) A 56-year-old African American woman
C) A 45-year-old female tourist from China
D) A 51-year-old man who recently emigrated from Korea

Question 13

A patient asks the nurse what the doctor meant by the phrase,"hypertensive emergency." Which explanation should the nurse provide?

A) "It means that you've had a small stroke."
B) "It refers to an episode of very high blood pressure."
C) "It's when the heart is failing to pump blood effectively."
D) "It means the heart has become hyperactive and is beating too fast."

Question 14

The nurse is caring for a patient who is prescribed a thiazide diuretic.What instructions should the nurse provide this patient who reports fatigue due to sleep deprivation?

A) "Make position changes quickly."
B) "Take your medication early in the day."
C) "Take your medication before bedtime."
D) "Empty your bladder after the first dose."

Question 15

The nurse is reinforcing teaching provided to a patient who has been taught ways to decrease blood pressure.Which patient statement indicates a need for further teaching?

A) "I eat fried foods three times a week."
B) "I don't add salt to my food anymore."
C) "I walk my dog for 30 minutes every day."
D) "I take high blood pressure medication daily."

Question 16

The nurse is reinforcing teaching for a patient with hypertension.If a patient states,"I understand that if I do not eat or cook with salt,my hypertension will go away." What is the nurse's best response?

A) "Reducing salt in the diet increases blood pressure."
B) "Patients who take diuretics do not need to reduce their salt intake."
C) "Excessive salt intake is responsible for most types of hypertension."
D) "Some patients' blood pressure may not respond to salt restriction alone."

Question 17

The nurse is reinforcing teaching provided to a patient on the pathophysiology of hypertension.Which patient statement indicates understanding of this teaching?

A) "High blood pressure can cause serious problems."
B) "Hypertension is diagnosed with one high reading."
C) "High blood pressure has specific detectable symptoms."
D) "Most people have high blood pressure for brief periods."

Question 18

The nurse is obtaining a health history from an individual at a blood pressure screening clinic.Which information in the patient's history should the nurse identify as a modifiable risk factor for hypertension?

A) Age 57
B) Male gender
C) Cigarette smoking
D) Family history of hypertension

Question 19

The nurse is measuring blood pressures at a screening clinic.For which blood pressure reading should the nurse provide the patient with instructions for follow-up in 2 months?

A) 130/72 mm Hg
B) 148/96 mm Hg
C) 164/100 mm Hg
D) 184/110 mm Hg

Question 20

The nurse is measuring blood pressures during a screening clinic.Which participant statement indicates that teaching about blood pressure has been effective?

A) "My blood pressure is 118/68, which is normal."
B) "I need to keep my blood pressure around 130/90."
C) "Since my blood pressure is 148/94, I'm considered to have prehypertension."
D) "My blood pressure is 158/88, so I should have it checked at least twice a year."

Question 21

The nurse is caring for a patient in hypertensive emergency.What should the nurse expect to be the goal when treatment is provided for this patient?

A) Increase urine output
B) Negate the impact of sodium in the body
C) Ensure an adequate potassium blood level
D) Reduce blood pressure by 25% in one hour

Question 22

The nurse is contributing to the teaching plan for a patient taking antihypertensives to control blood pressure who is on a 2000-calorie DASH diet.What should be included in the teaching about this diet? (Select all that apply.)

A) Eat four or five servings of vegetables a day.
B) Include four to five servings of grains each day.
C) Consume four or five servings of fruit each day.
D) Eat four or five servings of nuts, seeds, and legumes each day.
E) Eat two or fewer servings of lean meat, poultry, or fish each day.
F) Consume two to three servings of low-fat or nonfat dairy products.

Question 23

The nurse is caring for a patient with stage 1 hypertension.Which medication should the nurse expect to be prescribed for this patient?

A) Verapamil (Calan)
B) Minoxidil (Loniten)
C) Diltiazem (Cardizem)
D) Hydrochlorothiazide (HydroDIURIL)

Question 24

The nurse is contributing to a staff education program about hypertension.Which factors should be included as possibly playing a role in the development of hypertension? (Select all that apply.)

A) Changes in kidney function
B) Increases in aldosterone levels
C) Increased baroreceptor sensitivity
D) Sympathetic nervous system overstimulation
E) Increased stretching ability of the blood vessels
F) Increased arteriolar premature ventricular contraction

Question 25

The nurse caring for a patient with newly diagnosed mild hypertension.Which medications should the nurse expect to be ordered for this patient?

A) Prazosin (Minipress)
B) Clonidine (Catapres)
C) Reserpine (Serpalan)
D) Hydrochlorothiazide (HydroDIURIL)

Question 26

A patient with hypertension has been following the Mediterranean diet however blood pressure has not been any lower.What additional information should the nurse obtain from the patient?

A) Amount of exercise each day
B) Ounces of water ingested each day
C) Total hours of sleep obtaining each night
D) Intake of recommended servings of red meat

Question 27

The infection control nurse observes a nurse on a cardiac unit.Which actions by the nurse would require intervention by the infection control nurse? (Select all that apply.)

A) Wipes stethoscope with a soft cloth before each patient use
B) Carries stethoscope in a laboratory coat pocket when not in use
C) Performs hand hygiene before and after contact with each patient
D) Leaves a thermometer in the room of a patient on contact precautions
E) Takes own stethoscope into the room of a patient on contact precautions
F) Uses a stethoscope and blood pressure cuff supplied in the patient's room

Question 28

The nurse reinforced teaching provided to a patient about complications of hypertension.Which organs if identified by a patient indicate correct understanding of the organs most likely to be damaged from uncontrolled hypertension? (Select all that apply.)

A) Eyes
B) Brain
C) Heart
D) Liver
E) Lungs
F) Kidneys

Question 29

The nurse is contributing to a teaching session about hypertension.Which patient should the nurse identify as having the greatest risk for hypertension?

A) A 43-year-old married mother of three teenagers
B) A 40-year-old man whose brother has hypertension
C) A 35-year-old male construction worker who smokes
D) A 34-year-old single female who is an administrative assistant

Question 30

A patient who has unsuccessfully implemented lifestyle modifications for high blood pressure asks what else can be done.What should the nurse respond to this patient?

A) "You should get more rest."
B) "You should decrease your exercise plan."
C) "You should consider more strenuous exercise."
D) "Your doctor may discuss medication with you."

Question 31

A patient with a history of hypertension used to take prescribed antihypertensive medication for headaches however stopped when the headaches disappeared.Now the patient's blood pressure is 198/110 mm Hg.What should the nurse emphasize when teaching this patient?

A) Symptoms are always present.
B) Symptoms may not always be present.
C) Symptoms occur only with malignant hypertension.
D) Symptoms occur only when there is an impending stroke.

Question 32

The nurse is reinforcing teaching provided to a patient about the complications of hypertension.Which organ should the patient state is at risk of damage from hypertension?

A) Eyes
B) Liver
C) Lungs
D) Stomach

Question 33

The nurse obtains a blood pressure reading from a patient who is being treated with lifestyle modifications and drug therapy for stage 1 hypertension.Which reading indicates that the treatment is having the desired effect?

A) 88/42 mm Hg
B) 126/70 mm Hg
C) 138/94 mm Hg
D) 144/86 mm Hg

Question 34

The nurse is caring for a patient who has possible kidney damage from high blood pressure.Which action should the nurse take?

A) Monitor glucose.
B) Encourage fluids.
C) Monitor urine color.
D) Review creatinine level.

Question 35

The nurse is reinforcing teaching provided to a patient with hypertension.Which food should the nurse include if the patient is prescribed a diet low in cholesterol and saturated fat?

A) Fried fish
B) Hamburger
C) Chopped steak
D) Grilled chicken

Question 36

A patient with essential hypertension asks the nurse to explain the cause for the disorder.What should the nurse respond to the patient?

A) "The cause is unknown."
B) "A pheochromocytoma causes it."
C) "Each person has a different cause."
D) "A coarctation of the aorta causes it."

Question 37

The nurse is contributing to the plan of care for a 76-year-old patient with hypertension.Which guideline should be used when following physician orders to treat elevated blood pressure?

A) Increase heart rate slowly.
B) Increase heart rate rapidly.
C) Reduce blood pressure slowly.
D) Reduce blood pressure quickly.

Question 38

A patient with mild hypertension is prescribed spironolactone (Aldactone).Which patient statement indicates that teaching about this medication was effective?

A) "I will use gum or hard candy to help dry my mouth."
B) "I will change from a supine to sitting or standing position quickly."
C) "I will use sunscreen and protective clothing to avoid photosensitivity."
D) "I will avoid potassium-rich foods such as bananas and take medication after meals."

Question 39

The nurse determines that teaching provided to a patient about the medication bumetanide (Bumex)was not effective.What did the patient say that caused the nurse to come to this conclusion?

A) "I will rise slowly."
B) "I should limit my potassium intake."
C) "The medication will make me urinate."
D) "I will take the medication when I am awake."

Question 40

The nurse becomes concerned that a male patient's blood pressure is 168/98 mm Hg after 6 months on antihypertensive medication.What question should the nurse ask after measuring this blood pressure?

A) Is the patient taking the medication?
B) What is the volume of alcohol ingested each day?
C) Which pharmacy is filling the prescribed medications?
D) How many hours of sleep does the patient receive each night?

Question 41

The nurse is preparing to measure a patient's blood pressure.What should the nurse do to ensure that the reading obtained is accurate? (Select all that apply.)

A) The patient is seated.
B) The patient's arm is at the level of the heart.
C) The patient's arm is lowered towards the floor.
D) The patient's arm is elevated towards the head.
E) The patient is standing against the examination table.

Question 42

A patient is being considered for medication therapy to treat high blood pressure.Prior to beginning medication,the nurse should prepare to schedule the patient for which diagnostic tests? (Select all that apply.)

A) Hematocrit
B) Electrocardiogram
C) Liver function tests
D) Blood glucose level
E) Cholesterol and triglycerides

Question 43

After completing a family history,the nurse is concerned that a patient is at risk for developing high blood pressure.What information did the nurse obtain to come to this conclusion? (Select all that apply.)

A) Brother has renal calculi.
B) Mother had type 2 diabetes mellitus.
C) Sister diagnosed with multiple sclerosis.
D) Father died with morbid obesity at age 55.
E) First cousin experienced retinal detachment.