Nokea
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.
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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.
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.
The nurse is caring for a client with malignant hypertension. What would be an appropriate nursing intervention for this client?
- A. Monitor the client's mental and emotional status every hour.
- B. Monitor the blood pressure (BP) every few minutes by applying an automatic BP recording machine.
- C. Monitor the client's blood sugar every hour.
- D. Monitor the client's temperature every few minutes.
Correct Answer: B
Rationale: The nurse applies an automatic BP recording machine to the arm to measure the BP every few minutes. The nurse also keeps emergency equipment and drugs ready in case complications develop. Monitoring the client's mental and emotional status, blood sugar, or temperature every few minutes will not reflect the sudden rise in BP of a client with malignant hypertension.
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 screening a client at a health fair for hypertension. Which assessment data, provided by the client, would prompt the nurse to stress physician involvement? Select all that apply.
- A. Fatigue
- B. Constipation
- C. Headache
- D. Insomnia
- E. Dysuria
- F. Blurred vision
Correct Answer: A,C,D,F
Rationale: When assessing the client for symptoms of hypertension, the nurse should recognize that the client may note fatigue, headache, insomnia, and blurred vision. Other symptoms include dizziness, nervousness, nosebleeds, angina, and dyspnea. Constipation and dysuria are not signs of hypertension.