Nokea
The nurse is providing care for a patient with a diagnosis of hypertension. The nurse should consequently assess the patient for signs and symptoms of which other health problem?
- A. Migraines
- B. Atrial-septal defect
- C. Atherosclerosis
- D. Thrombocytopenia
Correct Answer: C
Rationale: Hypertension is both a sign and a risk factor for atherosclerotic heart disease. It is not associated with structural cardiac defects, low platelet levels, or migraines.
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A 40-year-old male newly diagnosed with hypertension is discussing risk factors with the nurse. The nurse talks about lifestyle changes with the patient and advises that the patient should avoid tobacco use. What is the primary rationale behind that advice to the patient?
- A. Quitting smoking will cause the patients hypertension to resolve
- B. Tobacco use increases the patients concurrent risk of heart disease
- C. Tobacco use is associated with a sedentary lifestyle
- D. Tobacco use causes ventricular hypertrophy
Correct Answer: B
Rationale: Smoking increases the risk for heart disease, for which a patient with hypertension is already at an increased risk. Quitting will not necessarily cause hypertension to resolve and smoking does not directly cause ventricular hypertrophy. The association with a sedentary lifestyle is true, but this is not the main rationale for the nurses advice; the association with heart disease is more salient.
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.
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 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 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.