Nokea
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.
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The nurse is caring for a client with hypertension. The nurse is correct to realize that a 24-hour urine is ordered to determine if the cause of hypertension is related to the dysfunction of what?
- A. Thyroid gland
- B. Adrenal gland
- C. Pituitary gland
- D. Thymus
Correct Answer: B
Rationale: The 24-hour urine collection specimen is ordered to determine dysfunction of the adrenal gland. The 24-hour urine detects elevated catecholamines. The other options are not evaluated by a 24-hour urine.
The nurse is evaluating the types of medications prescribed for a client's hypertension. Which of the following medication classifications establishes an action on vasoconstrictive hormones in the blood stream?
- A. Beta-blocker
- B. ACE inhibitor
- C. Loop diuretic
- D. Calcium channel blocker
Correct Answer: B
Rationale: The angiotensin-converting enzyme (ACE) inhibitor's primary action is to prevent the conversion of angiotensin I to angiotensin II, a potent vasoconstricting hormone in the blood. A beta-blocker blocks the beta-adrenergic receptors decreasing sympathetic nervous system stimulation. Loop diuretics excrete water from the loop of Henle, reducing circulating blood volume. Calcium channel blockers dilate coronary and peripheral arteries.
The nurse is caring for a client with accelerated hypertension. Which body system would the nurse assess to identify early signs of blood pressure progression?
- A. Eyes
- B. Kidney
- C. Heart
- D. Musculoskeletal system
Correct Answer: A
Rationale: Accelerated hypertension is defined as a markedly elevated blood pressure with symptoms of hemorrhages and exudates in the eyes. If the hypertension is untreated, accelerated hypertension progresses to malignant hypertension with symptoms of papilledema. Long-standing hypertension can produce changes in the kidney, heart, and musculoskeletal system.
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.
The nurse in an oncology clinic notes that the client being treated has hypertension. What tumor is a predisposing condition for secondary hypertension?
- A. Pheochromocytoma
- B. Wilms' tumor
- C. Astrocytoma
- D. Lymphoma
Correct Answer: A
Rationale: Predisposing conditions include kidney disease, pheochromocytoma (a tumor of the adrenal medulla), hyperaldosteronism (increased secretion of mineralocorticoid by the adrenal cortex), atherosclerosis, use of cocaine or other cardiac stimulants (e.g., weight-control drugs, caffeine), and use of oral contraceptives. Wilms' tumors, astrocytomas, and lymphomas are not predisposing conditions for secondary hypertension.