Nokea
A patient comes to the walk-in clinic complaining of frequent headaches. While assessing the patients vital signs, the nurse notes the BP is 161/101 mm Hg. According to JNC 7, how would this patients BP be defined if a similar reading were obtained at a subsequent office visit?
- A. High normal
- B. Normal
- C. Stage 1 hypertensive
- D. Stage 2 hypertensive
Correct Answer: D
Rationale: JNC 7 defines stage 2 hypertension as a reading 160/100 mm Hg.
You may also like to solve these questions
A student nurse is taking care of an elderly patient with hypertension during a clinical experience. The instructor asks the student about the relationships between BP and age. What would be the best answer by the student?
- A. Because of reduced smooth muscle tone in blood vessels, blood pressure tends to go down with age, not up
- B. Decreases in the strength of arteries and the presence of venous insufficiency cause hypertension in the elderly
- C. Structural and functional changes in the cardiovascular system that occur with age contribute to increases in blood pressure
- D. The neurologic system of older adults is less efficient at monitoring and regulating blood pressure
Correct Answer: C
Rationale: Structural and functional changes in the heart and blood vessels contribute to increases in BP that occur with aging. Venous insufficiency does not cause hypertension, however. Increased BP is not primarily a result of neurologic changes.
The nurse is planning the care of a patient who has been diagnosed with hypertension, but who otherwise enjoys good health. When assessing the response to an antihypertensive drug regimen, what blood pressure would be the goal of treatment?
- A. 156/96 mm Hg or lower
- B. 140/90 mm Hg or lower
- C. Average of 2 BP readings of 150/80 mm Hg
- D. 120/80 mm Hg or lower
Correct Answer: B
Rationale: The goal of antihypertensive drug therapy is a BP of 140/90 mm Hg or lower. A pressure of 130/80 mm Hg is the goal for patients with diabetes or chronic kidney disease.
A patient in hypertensive urgency is admitted to the hospital. The nurse should be aware of what goal of treatment for a patient in hypertensive urgency?
- A. Normalizing BP within 2 hours
- B. Obtaining a BP of less than 110/70 mm Hg within 36 hours
- C. Obtaining a BP of less than 120/80 mm Hg within 36 hours
- D. Normalizing BP within 24 to 48 hours
Correct Answer: D
Rationale: In cases of hypertensive urgency, oral agents can be administered with the goal of normalizing BP within 24 to 48 hours. For patients with this health problem, a BP of 120/80 mm Hg may be unrealistic.
A patient newly diagnosed with hypertension asks the nurse what happens when uncontrolled hypertension is prolonged. The nurse explains that a patient with prolonged, uncontrolled hypertension is at risk for developing what health problem?
- A. Renal failure
- B. Right ventricular hypertrophy
- C. Glaucoma
- D. Anemia
Correct Answer: A
Rationale: When uncontrolled hypertension is prolonged, it can result in renal failure, myocardial infarction, stroke, impaired vision, left ventricular hypertrophy, and cardiac failure. Glaucoma and anemia are not directly associated with hypertension.
The critical care nurse is caring for a patient just admitted in a hypertensive emergency. The nurse should anticipate the administration of what medication?
- A. Warfarin (Coumadin)
- B. Furosemide (Lasix)
- C. Sodium nitroprusside (Nitropress)
- D. Ramipril (Altace)
Correct Answer: C
Rationale: The medications of choice in hypertensive emergencies are those that have an immediate effect. IV vasodilators, including sodium nitroprusside (Nitropress), nicardipine hydrochloride (Cardene), clevidipine (Cleviprex), fenoldopam mesylate (Corlopam), enalaprilat, and nitroglycerin, have immediate actions that are short lived (minutes to 4 hours), and they are therefore used for initial treatment. Ramipril is administered orally and would not meet the patients immediate need for BP management. Diuretics, such as Lasix, are not used as initial treatments and there is no indication for anticoagulants such as Coumadin.