Nokea
The nurse is caring for a client with hypertension. The nurse is correct to realize that a 24-hour urine is ordered to determine if the cause of hypertension is related to the dysfunction of what?
- A. Thyroid gland
- B. Adrenal gland
- C. Pituitary gland
- D. Thymus
Correct Answer: B
Rationale: The 24-hour urine collection specimen is ordered to determine dysfunction of the adrenal gland. The 24-hour urine detects elevated catecholamines. The other options are not evaluated by a 24-hour urine.
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The nurse and a dietitian are instructing the client on a low-sodium diet needed to lower the blood pressure. Which question is most important for the nurse to ask?
- A. Who eats meals with you?
- B. How do you prepare your food?
- C. Do you eat three meals per day?
- D. Do you snack in the evening?
Correct Answer: B
Rationale: Asking the client how food is prepared gives the nurse and dietitian the ability to judge the sodium content. Typically, canned or prepared food and food from a restaurant will have elevated sodium levels. Sodium content in food prepared from fresh ingredients is usually minimal. Asking about whom the client eats with or the client's eating patterns are not as helpful in determining sodium content.
The nurse is working on a clinical research study, obtaining data evaluating central aortic systolic pressure and brachial arm systolic pressure. The client notes a difference in the readings. Which response by the nurse is most accurate?
- A. The difference is due to machine calibration.
- B. The difference is due to the location of pressure measurement.
- C. The difference is due to the discomfort caused by the measurement procedure.
- D. The difference is due to the constrictive force on the arteries when the measurement is taken.
Correct Answer: B
Rationale: Central aortic systolic pressure results, reflecting pressure at the root of the aorta, can be documented as $30 \mathrm{~mm} \mathrm{Hg}$ lower than when corresponding results obtained at the brachial arm. The differences are not due to machine calibration, discomfort, or constriction of the arteries.
The nurse is instructing a client who is newly prescribed an antihypertensive medication. Which nursing instruction is emphasized to maintain client safety?
- A. Use a pillbox to store daily medication.
- B. Sit on the edge of the chair and rise slowly.
- C. Do not operate a motor vehicle.
- D. Take the medication at the same time daily.
Correct Answer: B
Rationale: The nursing instruction emphasized to maintain client safety is to sit on the edge of the chair before rising slowly. By doing so, the client reduces the possibility of falls related to postural hypotension. Using a pillbox to store medications and taking the medication at the same time daily is good medication management instruction, but not necessarily related to safety. There is no reason when taking antihypertensive medications to restrict driving.
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.
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.