Nokea
A group of student nurses are practicing taking blood pressure. A 56-year-old male student has a blood pressure reading of 146/96 mm Hg. Upon hearing the reading, he exclaims, My pressure has never been this high. Do you think my doctor will prescribe medication to reduce it? Which of the following responses by the nursing instructor would be best?
- A. Yes. Hypertension is prevalent among men; it is fortunate we caught this during your routine examination
- B. We will need to reevaluate your blood pressure because your age places you at high risk for hypertension
- C. A single elevated blood pressure does not confirm hypertension. You will need to have your blood pressure reassessed several times before a diagnosis can be made
- D. You have no need to worry. Your pressure is probably elevated because you are being tested
Correct Answer: C
Rationale: Hypertension is confirmed by two or more readings with systolic pressure of at least 140 mm Hg and diastolic pressure of at least 90 mm Hg. An age of 56 does not constitute a risk factor in and of itself. The nurse should not tell the student that there is no need to worry.
You may also like to solve these questions
A patient with secondary hypertension has come into the clinic for a routine check-up. The nurse is aware that the difference between primary hypertension and secondary hypertension is which of the following?
- A. Secondary hypertension has a specific cause
- B. Secondary hypertension has a more gradual onset than primary hypertension
- C. Secondary hypertension does not cause target organ damage
- D. Secondary hypertension does not normally respond to antihypertensive drug therapy
Correct Answer: A
Rationale: Secondary hypertension has a specific identified cause. A cause could include narrowing of the renal arteries, renal parenchymal disease, hyperaldosteronism, certain medications, pregnancy, and coarctation of the aorta. Secondary hypertension does respond to antihypertensive drug therapy and can cause target organ damage if left untreated.
An older adult is newly diagnosed with primary hypertension and has just been started on a beta-blocker. The nurses health education should include which of the following?
- A. Increasing fluids to avoid extracellular volume depletion from the diuretic effect of the beta-blocker
- B. Maintaining a diet high in dairy to increase protein necessary to prevent organ damage
- C. Use of strategies to prevent falls stemming from postural hypotension
- D. Limiting exercise to avoid injury that can be caused by increased intracranial pressure
Correct Answer: C
Rationale: Elderly people have impaired cardiovascular reflexes and are more sensitive to postural hypotension. The nurse teaches patients to change positions slowly when moving from lying or sitting positions to a standing position, and counsels elderly patients to use supportive devices as necessary to prevent falls that could result from dizziness. Lifestyle changes, such as regular physical activity/exercise, and a diet rich in fruits, vegetables, and low-fat dairy products, is strongly recommended. Increasing fluids in elderly patients may be contraindicated due to cardiovascular disease. Increased intracranial pressure is not a risk and activity should not normally be limited.
The nurse is providing care for a patient with a diagnosis of hypertension. The nurse should consequently assess the patient for signs and symptoms of which other health problem?
- A. Migraines
- B. Atrial-septal defect
- C. Atherosclerosis
- D. Thrombocytopenia
Correct Answer: C
Rationale: Hypertension is both a sign and a risk factor for atherosclerotic heart disease. It is not associated with structural cardiac defects, low platelet levels, or migraines.
The nurse is assessing a patient new to the clinic. Records brought to the clinic with the patient show the patient has hypertension and that her current BP readings approximate the readings from when she was first diagnosed. What contributing factor should the nurse first explore in an effort to identify the cause of the clients inadequate BP control?
- A. Progressive target organ damage
- B. Possibility of medication interactions
- C. Lack of adherence to prescribed drug therapy
- D. Possible heavy alcohol use or use of recreational drugs
Correct Answer: C
Rationale: Deviation from the therapeutic program is a significant problem for people with hypertension and other chronic conditions requiring lifetime management. An estimated 50% of patients discontinue their medications within 1 year of beginning to take them. Consequently, this is a more likely problem than substance use, organ damage, or adverse drug interactions.
The nurse is developing a nursing care plan for a patient who is being treated for hypertension. What is a measurable patient outcome that the nurse should include?
- A. Patient will reduce Na+ intake to no more than 2.4 g daily
- B. Patient will have a stable BUN and serum creatinine levels
- C. Patient will abstain from fat intake and reduce calorie intake
- D. Patient will maintain a normal body weight
Correct Answer: A
Rationale: Dietary sodium intake of no more than 2.4 g sodium is recommended as a dietary lifestyle modification to prevent and manage hypertension. Giving a specific amount of allowable sodium intake makes this a measurable goal. None of the other listed goals is quantifiable and measurable.