Nokea
The nurse is employed in a physician's office and is caring for a client present for an annual exam. A blood pressure of $124 / 84 \mathrm{~mm} \mathrm{Hg}$ is documented. Following revised guidelines for identifying hypertension, which educational pamphlet is helpful?
- A. Increasing fluids for low blood pressure
- B. Stress reduction to lower prehypertensive state
- C. Use of beta-blockers for treatment of hypertension
- D. Diagnostic testing for determining cardiac functioning
Correct Answer: B
Rationale: A blood pressure of $124 / 84 \mathrm{~mm} \mathrm{Hg}$ is now considered to be in the lower range of prehypertension. Knowledge of stress reduction may be helpful in lowering the blood pressure without medication therapy. A blood pressure of $124 / 84 \mathrm{~mm} \mathrm{Hg}$ is not considered a low blood pressure or in need of medication therapy due to hypertension. Diagnostic testing for cardiac functioning is not typical for a client with prehypertension.
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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.
The nurse is teaching a health class at the local community center. What body system would the nurse explain regulates arterial blood pressure?
- A. Cardiovascular system
- B. Immune system
- C. Lymphatic system
- D. Autonomic nervous system
Correct Answer: D
Rationale: The autonomic nervous system, the kidneys, and various endocrine glands regulate arterial pressure. The cardiovascular system, immune system, and lymphatic systems do not regulate arterial blood pressure.
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 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.
The nurse is caring for a client with essential hypertension. The nurse reviews lab work and assesses kidney function. Which action of the kidney would the nurse evaluate as the body's attempt to regulate high blood pressure?
- A. The kidney retains sodium and water.
- B. The kidney excretes sodium and water.
- C. The kidney retains sodium and excretes water.
- D. The kidney retains water and excretes sodium.
Correct Answer: B
Rationale: Hypernatremia (elevated serum sodium level) increases blood volume, which raises blood pressure. The kidney's response to the elevation in blood pressure is to excrete sodium and excess water. Any retention of sodium and water would increase blood volume and, thus, blood pressure. Sodium and water move together.