Deck 35: Nursing Management Hypertension

Question 1

Which of the following actions should the nurse in the hypertension clinic take in order to obtain an accurate baseline blood pressure (BP) for a new client?

A)Obtain a BP reading in each arm and average the results.
B)Deflate the BP cuff at a rate of 5-10 mm Hg/second.
C)Have the client sit in a chair.
D)Assist the client to the supine position for BP measurements.

Answer 1

Have the client sit in a chair.

Question 2

The nurse is caring for a 52-year-old client who has no previous history of hypertension or other health problems and has suddenly developed a BP of 188/106 mm Hg. After reconfirming the BP, which of the following information is best for the nurse to tell theclient?

A)A BP recheck should be scheduled in a few weeks.
B)The dietary sodium and fat content should be decreased.
C)There is an immediate danger of a stroke and hospitalization will be required.
D)More diagnostic testing may be needed to determine the cause of the hypertension.

Answer 2

More diagnostic testing may be needed to determine the cause of the hypertension.

Question 3

The nurse obtains this information from a client with prehypertension. Which of the following findings is most important to address with the client?

A)Low dietary fibre intake
B)No regular aerobic exercise
C)BMI of 23 kg/m²
D)Drinks wine with dinner once a week

Answer 3

No regular aerobic exercise

Question 4

The nurse has just finished teaching a client who is hypertensive about the newly prescribed quinapril. Which of the following client statements indicates that more teaching is needed?

A)"The medication may not work as well if I take any Aspirin."
B)"My health care provider may order a blood potassium level occasionally."
C)"I will call my health care provider if I notice that I have a frequent cough."
D)"I won't worry if I have a little swelling around my lips and face."

Question 5

Which of the following actions should the nurse include in the plan of care for a client who is receiving sodium nitroprusside to treat a hypertensive emergency?

A)Organize nursing activities so that the client has undisturbed sleep for 6 to 8 hours at night.
B)Assist the client up in the chair for meals to avoid complications associated with immobility.
C)Use an automated noninvasive blood pressure machine to obtain frequent BP measurements.
D)Place the client on NPO status to prevent aspiration caused by nausea and the associated vomiting.

Question 6

The nurse is admitting a client with a history of hypertension and is being treated with a diuretic and an angiotensin-converting enzyme (ACE) inhibitor to the emergency department. The client has symptoms of a severe headache and has a BP of 240/118 mmHg. Which of the following questions should the nurse ask first?

A)Did you take any acetaminophen today?
B)Do you have any recent stressful events in your life?
C)Have you been consistently taking your medications?
D)Have you recently taken any antihistamine medications?

Question 7

Which of the following BP findings by the nurse indicate that no changes in therapy are needed for a client with stage 1 hypertension who has a history of heart failure?

A)108/64 mm Hg
B)128/76 mm Hg
C)140/90 mm Hg
D)136/82 mm Hg

Question 8

The nurse is assessing a client who is being investigated for possible white coat hypertension. Which of the following actions should the nurse implement first?

A)Schedule the client for frequent BP checks in the clinic.
B)Instruct the client about the need to decrease stress levels.
C)Tell the client how to self-monitor and record BPs at home.
D)Teach the client about ambulatory blood pressure monitoring.

Question 9

Which of the following nursing actions should the nurse take first in order to assist a client with newly diagnosed stage 1 hypertension in making needed dietary changes?

A)Have the client record dietary intake for 3 days.
B)Give the client a detailed list of low-sodium foods.
C)Teach the client about foods that are high in sodium.
D)Help the client make an appointment with a dietitian.

Question 10

During change-of-shift report, the nurse obtains this information about a client who is hypertensive and received the first dose of propranolol during the previous shift. Which of the following information indicates that the client needs immediate intervention?

A)The client's most recent BP reading is 156/94 mm Hg.
B)The client's pulse has dropped from 64 to 58 beats/minute.
C)The client has developed wheezes throughout the lung fields.
D)The client complains that the fingers and toes feel quite cold.

Question 11

The nurse is reviewing the laboratory test results for a client who has recently been diagnosed with hypertension. Which result is most important to communicate to the health care provider?

A)Serum creatinine of 230 mcmol/L
B)Serum potassium of 3.8 mmol/L
C)Serum hemoglobin of 147 g/L
D)Blood glucose level of 5.3 mmol/L

Question 12

The nurse is caring for a client who is experiencing a hypertensive crisis and is receiving sodium nitroprusside. Which of the following time frequencies should the nurse assess the clients' blood pressure and pulse during the initial administration ofthis medication?

A)2-3 minutes
B)5-10 minutes
C)15-30 minutes
D)Hourly

Question 13

When a client with hypertension who has a new prescription for atenolol returns to the health clinic after 2 weeks for a follow-up visit, the BP is unchanged from the previous visit. Which of the following actions should the nurse take first?

A)Provide information about the use of multiple drugs to treat hypertension.
B)Teach the client about the reasons for a possible change in drug therapy.
C)Remind the client that lifestyle changes also are important in BP control.
D)Ask the client about whether the medication is actually being taken.

Question 14

The nurse is teaching a client with stage 1 hypertension about diet modifications that should be implemented. Which of the following diet choices indicates that the teaching has been effective?

A)The client avoids eating nuts or nut butters.
B)The client restricts intake of dietary protein.
C)The client has only one cup of coffee in the morning.
D)The client has a glass of low-fat milk with each meal.

Question 15

Which of the following information should the nurse include when teaching a client with newly diagnosed hypertension?

A)Dietary sodium restriction will control BP for most clients.
B)Most clients are able to control BP through lifestyle changes.
C)Hypertension is usually asymptomatic until significant organ damage occurs.
D)Annual BP checks are needed to monitor treatment effectiveness.

Question 16

The nurse in the emergency department received change-of-shift report on these four clients with hypertension. Which of the following clients should the nurse assess first?

A)52-year-old with a BP of 212/90 who has intermittent claudication
B)43-year-old with a BP of 190/102 who is complaining of chest pain
C)50-year-old with a BP of 210/110 who has a creatinine of 133 mcmol/L
D)48-year-old with a BP of 200/98 whose urine shows microalbuminuria

Question 17

The nurse is caring for a client with hypertension and has just administered the initial dose of labetalol. Which of the following actions should the nurse take?

A)Encourage oral fluids to prevent dry mouth or dehydration.
B)Instruct the client to ask for help if heart palpitations occur.
C)Ask the client to request assistance when getting out of bed.
D)Teach the client that headaches may occur with this medication.

Question 18

The nurse is caring for a client who has just diagnosed with hypertension and has a new prescription for captopril. Which of the following information is important to include when teaching the client?

A)Check BP daily before taking the medication.
B)Increase fluid intake if dryness of the mouth is a problem.
C)Include high-potassium foods such as bananas in the diet.
D)Change position slowly to help prevent dizziness and falls.

Question 19

The charge nurse observes a new RN doing discharge teaching for a client who is hypertensive and has a new prescription for enalapril. Which of the following actions by the new RN should cause the charge nurse to intervene in the client's care?

A)Check the BP with a home BP monitor every day.
B)Move slowly when moving from lying to standing.
C)Increase the dietary intake of high-potassium foods.
D)Make an appointment with the dietitian for teaching.

Question 20

The nurse is caring for a client with hypertension and has a prescription for nadolol. Which of the following assessment findings should the nurse report to the health care provider before administering this medication?

A)Asthma
B)Peptic ulcer disease
C)Alcohol dependency
D)Myocardial infarction

Question 21

The nurse is providing nutritional teaching to a client with hypertension. Which of the following food groups should the nurse tell the client that they should have four to five daily servings of? (Select all that apply.)

A)Whole grains
B)Vegetables
C)Meat, fish, and poultry
D)Fat-free dairy food
E)Fruit

Question 22

The nurse obtains a blood pressure of 180/75 mm Hg for a client. What is the client's mean arterial pressure (MAP)?

Question 23

Which of the following assessment findings for a client who is receiving furosemide to treat stage 2 hypertension is most important to report to the health care provider?

A)Blood glucose level of 10 mmol/L
B)Blood potassium level of 3.0 mmol/L
C)Early morning BP reading of 164/96 mm Hg
D)Orthostatic systolic BP decrease of 12 mm Hg