Question 1

A student nurse is caring for a client who is hypertensive. What nursing intervention should the student nurse perform to ensure that the client does not suffer any injury due to significant regulation in blood pressure (BP)?

Accepted Answer

Monitoring postural changes in BP is important to ensure the client does not suffer from any injury due to significant regulation in blood pressure. Postural changes refer to changes in BP when the client moves from sitting or lying down to standing up. It is essential to measure and monitor this change in BP as it can be a potential indicator of high BP. This will help the nurse to take appropriate measures to prevent injuries or falls due to dizziness or lightheadedness that can result from postural hypotension. Monitoring the client's position when sleeping and assessing the surroundings are also important, but monitoring postural changes in BP is the most appropriate nursing intervention in this scenario.

Question 2

During the physical assessment of a client with hypertension, what would you expect to be the most obvious finding?

Accepted Answer

Hypertension is defined as sustained increase in either one or both systolic or diastolic blood pressure measurements.

Question 3

You are teaching a health class at the local YMCA. What body system would you explain regulates arterial blood pressure?

Accepted Answer

The autonomic nervous system, specifically the sympathetic and parasympathetic branches, regulates arterial blood pressure by controlling the constriction and relaxation of blood vessels.

Question 4

You are the triage nurse in a walk-in clinic when a diabetic client visits the clinic and asks you to take their blood pressure (BP). The measurements are 150/90 mm Hg. Which of the following should you recommend to normalize the client's BP?

Accepted Answer

The client has hypertension with a systolic blood pressure of ≥140 mm Hg and a diastolic blood pressure of ≥90 mm Hg. For diabetics, the target blood pressure is <130/80 mm Hg. Lifestyle modifications including smoking cessation, low-fat diet, and daily exercise may ultimately help the client, but drug therapy is the most effective and immediate way to normalize their blood pressure.

Question 5

A client, newly admitted to the nursing unit, has a primary diagnosis of renal failure. When assessing the client, the nurse notes a blood pressure (BP) of 180/100. The nurse knows that this is what kind of hypertension?

Accepted Answer

A BP of 180/100 is considered severely elevated and may indicate secondary hypertension, which is caused by an underlying condition such as renal failure. Primary or essential hypertension refers to sustained high BP without an identifiable cause, while malignant hypertension is a severe and rapidly progressive form of hypertension that can cause organ damage.

Question 6

A client has just been diagnosed with prehypertension. What would the nurse instruct this client to do to restore his blood pressure below hypertensive levels?

Accepted Answer

Decreasing sodium intake is a recommended lifestyle change to help lower blood pressure and manage prehypertension.

Question 7

A client comes to the walk-in clinic complaining of "just not feeling well" and "having a discharge from my eyes". While assessing this client, the nurse notes a blood pressure of 205/102. The nurse knows that these findings indicate what?

Accepted Answer

The answer of A client comes to the walk-in clinic...

Question 8

An African American client at the clinic has just been diagnosed with essential hypertension. The client tells the nurse that they do not take medicine. What would the nurse tell the client is the most serious consequence of chronic hypertension?

Accepted Answer

The answer of An African American client at the clinic...

Question 9

A client is being seen at the clinic for a routine physical when the nurse notes the client's blood pressure is 150/97. The client is considered to be a healthy, well-nourished young adult. What type of hypertension does this client have?

Accepted Answer

The elevated blood pressure reading in a healthy, well-nourished young adult with no underlying medical condition suggests the presence of essential hypertension. Essential hypertension is the most common type and is often referred to as primary or idiopathic hypertension, meaning its cause is unknown. Secondary hypertension would be caused by an underlying medical condition, pathologic hypertension would be a severe and rapidly progressive form of hypertension, and malignant hypertension would be a medical emergency characterized by extremely high blood pressure readings and evidence of organ damage. None of these conditions are suggested by the scenario presented.

Question 10

You are caring for a client with hypertension who is experiencing complications. What diagnostic test evaluates the efficiency or inefficiency of the heart to pump blood?

Accepted Answer

A Multiple Gated Acquisition (MUGA) scan evaluates the efficiency of the heart to pump blood by measuring the ejection fraction and assessing the function of the ventricles.

Question 11

A female client, aged 82, visits the clinic for a blood pressure (BP) check. Her hypertension is not well controlled, and a new blood pressure medicine is prescribed. What is important for the nurse to teach this client about her blood pressure medicine?

Accepted Answer

Orthostatic hypotension, or dizziness upon standing, is a common adverse effect of many blood pressure medications, especially in older adults. It's important for patients to be aware of this so they can take precautions to prevent falls or injuries.

Question 12

What is blood pressure?

Accepted Answer

Blood pressure refers to the force created by the volume of blood present in the arterial walls. It is usually measured in millimeters of mercury (mmHg) and is a crucial indicator of overall cardiovascular health.

Question 13

The public health nurse is presenting a workshop on hypertension for the Parent Teacher Organization of the local elementary school. Aparent asks the nurse who is at risk for hypertension. What would be the nurse's best answer?

Accepted Answer

People with diabetes are at a higher risk for hypertension. This is because high blood sugar levels can damage the lining of blood vessels, leading to narrowing and increased blood pressure.

Question 14

When caring for a client with essential hypertension what instruction should the nurse provide to the client to normalize blood pressure?

Accepted Answer

One of the major factors contributing to essential hypertension is high salt intake. Therefore, reducing sodium intake can help normalize blood pressure.

Question 15

The nursing instructor is teaching a class on how to assess blood pressure. What would the instructor teach as an appropriate nursing action when assessing a client with hypertension?

Accepted Answer

The answer of The nursing instructor is teaching a class...

Question 16

You are precepting a new graduate nurse on your unit. The two of you are caring for a client with malignant hypertension. The new nurse asks what malignant hypertension can cause. What would be your best answer?

Accepted Answer

Malignant hypertension, also known as hypertensive emergency, can cause left ventricular failure due to the high blood pressure causing damage to the heart muscles and potentially leading to cardiogenic shock. It can also cause damage to other organs such as the brain, kidneys, and eyes. While peripheral edema and pulmonary hypertension can occur in hypertension, they are not specific to malignant hypertension. Right ventricular failure is generally associated with pulmonary hypertension or chronic obstructive pulmonary disease (COPD).

Question 17

Which of the following diagnostic tests may reveal an enlarged left ventricle?

Accepted Answer

Echocardiography is a diagnostic test that utilizes ultrasound to create images of the heart. It is often used to evaluate the size and function of the heart, and can reveal an enlarged left ventricle. Computed tomographic and positron emission tomography scans are imaging tests that can also provide information about the heart, but are not typically used to specifically evaluate for left ventricular enlargement. Fluorescein angiography is a test used to visualize blood vessels in the eye and is not used to evaluate the heart.

Question 18

The nurse in an oncology clinic notes that the client being treated has hypertension. What tumor is a predisposing condition for secondary hypertension?

Accepted Answer

Pheochromocytoma is a tumor of the adrenal gland that can produce excess amounts of catecholamines, leading to secondary hypertension. Wilm's tumor is a pediatric kidney tumor, astrocytoma is a tumor of the brain, and lymphoma is a cancer of the lymphatic system, none of which are commonly associated with secondary hypertension.

Question 19

The nurse is caring for an 82-year-old male client who has come to the clinic for a yearly physical. When assessing the client, the nurse notes the blood pressure (BP) is 140/93. The nurse knows that in older clients what happens that may elevate the systolic BP?

Accepted Answer

As individuals age, their arteries lose elasticity and become stiffer. This can cause an increase in systolic blood pressure, with little effect on diastolic blood pressure.

Question 20

The nurse is caring for a client with malignant hypertension. What would be an appropriate nursing intervention for this client?

Accepted Answer

The appropriate nursing intervention for a client with malignant hypertension is to monitor their blood pressure every few minutes by applying an automatic BP recording machine. This is important to detect any sudden increase in blood pressure that could cause an adverse event such as a stroke. Monitoring mental and emotional status, blood sugar, and temperature are also important, but not as crucial as monitoring blood pressure in this specific client population.

Quiz 27: Caring for Clients With Hypertension

A student nurse is caring for a client who is hypertensive. What nursing intervention should the student nurse perform to ensure that the client does not suffer any injury due to significant regulation in blood pressure (BP) ?