Nokea
When teaching a client newly diagnosed with hypertension, which instructions would the nurse incorporate into the teaching plan? Select all that apply.
- A. Lose weight.
- B. Stop smoking.
- C. Reduce stress.
- D. Decrease exercise.
- E. Increase sodium intake.
Correct Answer: A,B,C
Rationale: Nonpharmacologic management of hypertension should include weight loss, stress reduction, regular aerobic exercise, smoking cessation, moderation of alcohol, and decreased sodium intake.
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A client with hypertension has a fungal infection and has been prescribed fluconazole for the fungal infection and losartan for hypertension. The nurse would be alert for which of the following?
- A. Increased risk of adverse effects of losartan
- B. Increased risk of hypersensitivity reaction
- C. Decreased hypotensive effect of losartan
- D. Increased risk of hypoglycemia
Correct Answer: A
Rationale: Increased risk of antihypertensive effects and adverse reactions are associated with the concomitant use of fluconazole and losartan. Decreased hypotensive effect of losartan is seen with use of indomethacin and does not occur with the concomitant use of these drugs. Increased risk of hypoglycemia and increased risk of hypersensitivity do not occur with the concomitant use of these drugs.
A client, aged 60 years, is receiving nitroprusside for hypertensive emergency. The nurse would be alert for the development of which of the following?
- A. Significant hypotension
- B. Rebound hypertension
- C. Blindness
- D. Stroke
Correct Answer: A
Rationale: An older adult client is at risk for significant hypotension when receiving nitroprusside. To prevent this, the dosage should be reduced during the initial period of therapy. Rebound hypertension, stroke, and blindness will not occur during nitroprusside therapy.
The use of angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin II receptor blockers (ARBs) are contraindicated in clients with which of the following medical conditions? Select all that apply.
- A. Bilateral stenosis
- B. Angioedema
- C. Pregnancy
- D. Diabetes
- E. Hyperlipidemia
Correct Answer: A,B,C
Rationale: The use of ACEIs and ARBs is contraindicated if the client has impaired renal function, heart failure, salt or volume depletion, bilateral stenosis, angioedema, or as pregnant.
The nurse should notify the primary health care provider when which of the following occur while a client is receiving an antihypertensive? Select all that apply.
- A. Weight gain of 2 lb or more per day
- B. Headache
- C. Edema
- D. Insomnia
- E. Sedation
Correct Answer: A,C
Rationale: The nurse should notify the primary health care provider if a client has a weight gain of 2 lb or more per day or edema of the hands, fingers, feet, legs, or sacral area.
During a routine check-up of a 45 -year-old client with renal disease, the nurse observes an increase in the client's blood pressure. The nurse identifies this as most likely which of the following?
- A. Essential hypertension
- B. Secondary hypertension
- C. Rebound hypertension
- D. Hypertensive emergency
Correct Answer: B
Rationale: Secondary hypertension results as a consequence of renal impairment. In secondary hypertension there is usually a known cause for the development of hypertension. Renal disease is one of the causes of secondary hypertension. When there is no known cause of hypertension, it is called essential hypertension. Rebound hypertension occurs when a client abruptly stops taking antihypertensive medication. Hypertensive emergency is a high blood pressure state, which has to be lowered immediately.