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During an adult patients last two office visits, the nurse obtained BP readings of 122/84 mm Hg and 130/88 mm Hg, respectively. How would this patients BP be categorized?
- A. Normal
- B. Prehypertensive
- C. Stage 1 hypertensive
- D. Stage 2 hypertensive
Correct Answer: B
Rationale: Prehypertension is defined systolic BP of 120 to 139 mm Hg or diastolic BP of 80 to 89 mm Hg.
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The hospital nurse cares for many patients who have hypertension. What nursing diagnosis is most common among patients who are being treated for this health problem?
- A. Deficient knowledge regarding the lifestyle modifications for management of hypertension
- B. Noncompliance with therapeutic regimen related to adverse effects of prescribed therapy
- C. Deficient knowledge regarding BP monitoring
- D. Noncompliance with treatment regimen related to medication costs
Correct Answer: B
Rationale: Deviation from the therapeutic program is a significant problem for people with hypertension and other chronic conditions requiring lifetime management. For many patients, this is related to adverse effects of medications. Medication cost is relevant for many patients, but adverse effects are thought to be a more significant barrier. Many patients are aware of necessary lifestyle modification, but do not adhere to them. Most patients are aware of the need to monitor their BP.
The nurse is screening a number of adults for hypertension. What range of blood pressure is considered normal?
- A. Less than 140/90 mm Hg
- B. Less than 130/90 mm Hg
- C. Less than 129/89 mm Hg
- D. Less than 120/80 mm Hg
Correct Answer: D
Rationale: JNC 7 defines a blood pressure of less than 120/80 mm Hg as normal, 120 to 129/80 to 89 mm Hg as prehypertension, and 140/90 mm Hg or higher as hypertension.
A patients recently elevated BP has prompted the primary care provider to prescribe furosemide (Lasix). The nurse should closely monitor which of the following?
- A. The clients oxygen saturation level
- B. The patients red blood cells, hematocrit, and hemoglobin
- C. The patients level of consciousness
- D. The patients potassium level
Correct Answer: D
Rationale: Loop diuretics can cause potassium depletion. They do not normally affect level of consciousness, erythrocytes, or oxygen saturation.
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.
A nurse is performing blood pressure screenings at a local health fair. While obtaining subjective assessment data from a patient with hypertension, the nurse learns that the patient has a family history of hypertension and she herself has high cholesterol and lipid levels. The patient says she smokes one pack of cigarettes daily and drinks about a pack of beer every day. The nurse notes what nonmodifiable risk factor for hypertension?
- A. Hyperlipidemia
- B. Excessive alcohol intake
- C. A family history of hypertension
- D. Closer adherence to medical regimen
Correct Answer: C
Rationale: Unlike cholesterol levels, alcohol intake, and adherence to treatment, family history is not modifiable.