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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.
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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.
Which of the following nursing diagnoses is the nurse most correct to choose when caring for a client with long-standing hypertension?
- A. Impaired Gas Exchange
- B. Activity Intolerance
- C. Altered Tissue Perfusion
- D. Risk for Decreased Cardiac Output
Correct Answer: C
Rationale: The nurse is most correct in choosing Altered Tissue Perfusion for the client with long-standing hypertension. In hypertension, the extra work increases the size of the heart muscle. Eventually, the heart cannot meet the body's metabolic needs limiting the perfusion to the tissues. Impaired Gas Exchange, Activity Intolerance, and a Risk for Decreased Cardiac Output may occur due to the ineffective perfusion.
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.
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.
Which of the following client scenarios would be correct for the nurse to identify as a client with secondary hypertension?
- A. A client experiencing depression
- B. A client diagnosed with kidney disease
- C. A client of advanced age
- D. A client with excessive alcohol intake
Correct Answer: B
Rationale: Secondary hypertension is an elevated blood pressure that results from or is secondary to some other disorder such as kidney disease, a tumor of the adrenal medulla, or atherosclerosis. Depression alone is typically not associated with hypertension. Advanced age and alcohol intake are considered factors for essential hypertension.