Nokea
A client, newly prescribed a low-sodium diet due to hypertension, is asking for help with meal choices. The client names four favorite meal choices. Which selection would be best?
- A. Toasted cheese sandwich on whole wheat toast with tomato soup
- B. Creamed chipped beef over toast with mashed potatoes
- C. Hot dog with ketchup and relish on whole wheat bun
- D. Green pepper stuffed with diced tomatoes and chicken
Correct Answer: D
Rationale: Fresh vegetables are low in sodium. A green pepper with (fresh) diced tomatoes and chicken is a good low-sodium, high vegetable and protein selection. Cheese and soup (tomato and creamed) are high in sodium. Processed meats such as a hot dogs and condiments such as ketchup are high in sodium.
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An older adult client visits the clinic for a blood pressure (BP) check. The client's hypertension is not well controlled, and a new blood pressure medicine is prescribed. What is important for the nurse to teach this client about the blood pressure medicine?
- A. Take the medicine on an empty stomach.
- B. A possible adverse effect of blood pressure medicine is dizziness when you stand.
- C. There are no adverse effects from blood pressure medicine.
- D. A severe drop in blood pressure is possible.
Correct Answer: B
Rationale: A possible adverse effect of all antihypertensive drugs is postural hypotension, which can lead to falls. Teaching should include tips for managing syncope and dizziness. The nurse would not teach the client to take the medicine on an empty stomach.
The nurse is obtaining a health history from a client with a blood pressure of $146 / 88 \mathrm{~mm} \mathrm{Hg}$. The client states that lifestyle changes have not been effective in lowering blood pressure. Which medication classification does the nurse anticipate first?
- A. ACE inhibitors
- B. Beta-blocker
- C. Thiazide diuretic
- D. Calcium channel blocker
Correct Answer: C
Rationale: Clients with hypertension, unable to be lowered by lifestyle changes, usually are placed on a thiazide diuretic initially. However, most people with hypertension will need two or more antihypertensive medications to reduce their blood pressure.
What is blood pressure?
- A. The force produced by the volume of blood in arterial walls
- B. The force produced by the volume of blood in the venous system
- C. The measurement of cardiac output
- D. The peripheral resistance of the cardiac output
Correct Answer: A
Rationale: Blood pressure (BP) is the force produced by the volume of blood in arterial walls. It is represented by the formula: $\mathrm{BP}=\mathrm{CO}$ (cardiac output) PR (peripheral resistance). This makes the other options incorrect.
The nurse would screen a client from which ethnic background for hypertension at an early age?
- A. Asian population
- B. Japanese population
- C. Mexican population
- D. Population of African descent
Correct Answer: D
Rationale: The population of African descent is at the highest risk for development of hypertension. The other ethnic backgrounds have a lower risk.
The nurse is volunteering at a community blood pressure screening. A client, never diagnosed with hypertension, presents with a blood pressure of $158 / 90 \mathrm{~mm} \mathrm{Hg}$. Which assessment question(s) is appropriate for the nurse to ask? Select all that apply.
- A. Have you recently drunk a caffeinated beverage?
- B. Did you have a beer after work?
- C. Do you smoke?
- D. Do you have a friend accompanying you?
- E. Are you married and with children?
Correct Answer: A,C
Rationale: At a community blood pressure clinic, the nurse would assess for common factors for a blood pressure to be elevated. Factors that can affect blood pressures readings include smoking or drinking coffee within 30 minutes of the reading. One beer after work should not affect the blood pressure reading, and some individuals may find it relaxing. Social situations are difficult to assess in a community blood pressure clinic.