Deck 22: Nursing Care of Patients With Hypertension

Question 1

The nurse is caring for a patient who is taking bumetanide (Bumex). The nurse recognizes that the patient understands important dietary interventions if the patient reported eating which of the following vegetables?

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

Answer 1

Broccoli

Question 2

The nurse is obtaining a health history for 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)Family history of hypertension
C)Cigarette smoking
D)Male gender

Answer 2

Cigarette smoking

Question 3

The nurse is reinforcing teaching on the pathophysiology of hypertension. Which of these statements by the patient would indicate understanding?

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

Answer 3

"High blood pressure can cause serious problems."

Question 4

The nurse is working at a blood pressure screening clinic. Which of these recommended follow-ups should the nurse suggest to a patient for a blood pressure reading of 166/100 mm Hg?

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

Question 5

The nurse is working at a blood pressure screening clinic. For which of these blood pressure readings should the nurse provide a 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 6

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

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

Question 7

When the nurse is monitoring a patient with a hypertensive urgency, which of these manifestations would the nurse expect to find?

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

Question 8

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)Potassium
B)Hemoglobin
C)Glucose
D)Cholesterol

Question 9

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

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

Question 10

A patient asks the nurse what the doctor meant by the phrase, "hypertensive emergency." Which of the following explanations would the nurse provide?

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

Question 11

The nurse is reinforcing teaching for a patient who has been taught ways to decrease blood pressure. Which of these patient statements would indicate a need for further teaching?

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

Question 12

When planning care, the nurse identifies that which of the following individuals is at highest risk for developing hypertension?

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

Question 13

In planning care for patients, which of these ethnic groups should the nurse understand is most sensitive to the effects of the beta blocker propranolol (Inderal)?

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

Question 14

The nurse is working at a blood pressure screening clinic. Which of these recommended follow-up time frames 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 15

The nurse is working in a clinic and obtains a blood pressure reading on a patient. The patient's blood pressure reading is 144/94 mm Hg. 150/96 mm Hg was obtained on a prior occasion. The nurse would recognize the patient would be classified as having which of these types of hypertension?

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

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 caring for a patient who is on antihypertensive medication and has no insurance, three children, and reports feeling great and exercising daily. The teaching plan for this patient should include which of these measures to promote compliance?

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

Question 18

The nurse is working at a blood pressure screening clinic. The nurse would recognize that patient teaching was effective by which of the following patient statements?

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 19

The nurse is working at a blood pressure screening clinic. Which of these blood pressure readings would the nurse tell a patient requires a follow-up visit in 1 year?

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

Question 20

A nurse is caring for a patient who has hypertension and heart failure. The nurse reviews the patient's medications and asks the student why the patient is receiving Furosemide (Lasix). Which of the following statements, if made by the student, would be best?

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

Question 21

The nurse is providing care for a patient with newly diagnosed mild hypertension. Which of the following medications would the nurse expect to be ordered for this patient?

A)Prazosin (Minipress)
B)Clonidine (Catapres)
C)Reserpine (Serpalan)
D)Hydrochlorothiazide (HydroDIURIL)
Multiple Response
Identify one or more choices that best complete the statement or answer the question.

Question 22

The nurse is reinforcing teaching about the symptoms of hypertension for a patient who has a blood pressure of 198/110 mm Hg. The patient had headaches 2 years ago from high blood pressure. After taking antihypertensive medication, the headaches stopped, so the patient stopped the medication. What should the teaching include?

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

Question 23

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

Question 24

The nurse obtains a blood pressure reading for a patient who is being treated with lifestyle modifications and drug therapy for stage 1 hypertension. Which of these readings would indicate 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 25

Which of these, if stated by a patient prescribed triamterene (Dyrenium) for mild hypertension, indicates to the nurse correct understanding of teaching?

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

Question 26

The nurse reinforced teaching on complications of hypertension. Which of these organs if identified by a patient indicates correct understanding of the organs at risk of damage from hypertension?

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

Question 27

For a patient with stage 1 hypertension, initial drug therapy would include which of these medications?

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

Question 28

The nurse would evaluate a patient as requiring more teaching for the medication bumetanide (Bumex) if the patient stated which of the following?

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

Question 29

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

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

Question 30

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

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

Question 31

The nurse is contributing to the teaching plan for a patient taking antihypertensives to control blood pressure who is on a 2,000-calorie DASH diet. What should be included in the teaching about this diet? (Select all that apply.?

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

Question 32

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

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

Question 33

The nurse is contributing to a teaching session on hypertension. Which of these patients does the nurse understand is at greatest risk for hypertension?

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

Question 34

The nurse is contributing to the plan of care for a 76-year-old patient who is hypertensive. When following physician orders to treat elevated blood pressure, which of these guidelines should be used?

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

Question 35

The nurse is caring for a patient who after 2 months of lifestyle modifications that have been unsuccessful, asks, "What else can be done to lower my blood pressure?" Which of these responses would be appropriate?

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

Question 36

The nurse is reinforcing teaching for a patient who has hypertension. Which of these foods should the nurse include for a diet low in cholesterol and saturated fat?

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

Question 37

The nurse is caring for a patient who has been diagnosed with essential hypertension. The patient asks, "What causes essential hypertension?" Which response is appropriate?

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

Question 38

In some cases of hypertensive emergency, blood pressure may need to be reduced by ____________________% within 1 hour.