Nokea
The nurse is teaching a client about chronic untreated hypertension. What complication will the nurse explain to the client?
- A. peripheral edema
- B. right-sided heart failure
- C. stroke
- D. pulmonary insufficiency
Correct Answer: C
Rationale: A stroke occurs if vessels in the brain rupture and bleed. If an aneurysm has developed in the aorta from chronic hypertension, it may burst and cause hemorrhage and shock. Peripheral edema, right-sided heart failure, and pulmonary insufficiency are not usually consequences of untreated chronic hypertension.
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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.
A client, newly prescribed a low-sodium diet due to hypertension, is asking for help with meal choices. The client names four favorite meal choices. Which selection would be best?
- A. Toasted cheese sandwich on whole wheat toast with tomato soup
- B. Creamed chipped beef over toast with mashed potatoes
- C. Hot dog with ketchup and relish on whole wheat bun
- D. Green pepper stuffed with diced tomatoes and chicken
Correct Answer: D
Rationale: Fresh vegetables are low in sodium. A green pepper with (fresh) diced tomatoes and chicken is a good low-sodium, high vegetable and protein selection. Cheese and soup (tomato and creamed) are high in sodium. Processed meats such as a hot dogs and condiments such as ketchup are high in sodium.
What is blood pressure?
- A. The force produced by the volume of blood in arterial walls
- B. The force produced by the volume of blood in the venous system
- C. The measurement of cardiac output
- D. The peripheral resistance of the cardiac output
Correct Answer: A
Rationale: Blood pressure (BP) is the force produced by the volume of blood in arterial walls. It is represented by the formula: $\mathrm{BP}=\mathrm{CO}$ (cardiac output) PR (peripheral resistance). This makes the other options incorrect.
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 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.