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The nurse is creating a community teaching demonstration focusing on the cause of blood pressure. When completing the visual aid, which body structures represent the mechanism of blood pressure?
- A. Lung and arteries
- B. Heart and blood vessels
- C. Brain and sympathetic nervous system
- D. Kidneys and autonomic nervous system
Correct Answer: B
Rationale: Blood pressure is the force produced by the volume of the blood in arterial walls. It is represented by the formula: BP- CO (cardiac output) PR (peripheral resistance). To highlight the mechanism of cardiac output, a heart would be on the visual aid and blood vessels.
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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.
The physician is ordering a test for the hypertensive client that will be able to evaluate whether the client has experienced heart damage. Which diagnostic test would the nurse anticipate to determine heart damage?
- A. Blood chemistry
- B. Multiple gated acquisition scan (MUGA)
- C. Chest radiograph
- D. Fluorescein angiography
Correct Answer: B
Rationale: The nurse realizes that undiagnosed (untreated), long-standing hypertension can cause heart damage. The diagnostic test that best determines heart damage is the multiple gate acquisition scan (MUGA). This test is used to detect how efficiently the heart pumps. A blood chemistry determines electrolyte balance. A chest radiograph (chest $x$-ray) can provide details of the heart size through shading on the scan. Fluorescein angiography is an ophthalmologic test revealing leaking retinal blood vessels.
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 evaluating the types of medications prescribed for a client's hypertension. Which of the following medication classifications establishes an action on vasoconstrictive hormones in the blood stream?
- A. Beta-blocker
- B. ACE inhibitor
- C. Loop diuretic
- D. Calcium channel blocker
Correct Answer: B
Rationale: The angiotensin-converting enzyme (ACE) inhibitor's primary action is to prevent the conversion of angiotensin I to angiotensin II, a potent vasoconstricting hormone in the blood. A beta-blocker blocks the beta-adrenergic receptors decreasing sympathetic nervous system stimulation. Loop diuretics excrete water from the loop of Henle, reducing circulating blood volume. Calcium channel blockers dilate coronary and peripheral arteries.
The nurse is caring for a client who is newly diagnosed with hypertension. The client states, 'I do not understand what is causing my blood pressure to continue to rise.' Which information does the nurse recognize as the key structure in regulating arterial blood pressure?
- A. Heart
- B. Lung
- C. Brain
- D. Kidney
Correct Answer: D
Rationale: The body regulates blood pressure throughout the day. The components of the autonomic nervous system, the kidneys, and endocrine glands regulate arterial pressure. The heart is the pump sending blood throughout the system. The lungs exchange oxygen but do not affect blood pressure. The brain recognizes and processes sympathetic nervous system activity to raise blood pressure.