Nokea
Which of the following information should the nurse include when teaching a patient with newly diagnosed hypertension?
- A. Dietary sodium restriction will control BP for most patients.
- B. Most patients are able to control BP through lifestyle changes.
- C. Hypertension is usually asymptomatic until significant organ damage occurs.
- D. Annual BP checks are needed to monitor treatment effectiveness.
Correct Answer: C
Rationale: Hypertension is usually asymptomatic until target organ damage has occurred. Lifestyle changes and sodium restriction are used to help manage blood pressure, but drugs are needed for most patients. BP should be checked by the health care provider every 3-6 months.
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The nurse obtains a blood pressure of 180/75 mm Hg for a patient. What is the patient's mean arterial pressure (MAP)?
- A. 110
- B. 120
- C. 130
- D. 140
Correct Answer: A
Rationale: MAP = (DBP + 1/3 Pulse pressure). For a BP of 180/75 mm Hg, pulse pressure = 180 - 75 = 105 mm Hg. MAP = 75 + (1/3 * 105) = 75 + 35 = 110 mm Hg.
The charge nurse observes a new RN doing discharge teaching for a patient who is hypertensive and has a new prescription for enalapril. Which of the following actions by the new RN should cause the charge nurse to intervene in the patient's care?
- A. Check the BP with a home BP monitor every day.
- B. Move slowly when moving from lying to standing.
- C. Increase the dietary intake of high-potassium foods.
- D. Make an appointment with the dietitian for teaching.
Correct Answer: C
Rationale: The ACE inhibitors cause retention of potassium by the kidney, so hyperkalemia is a possible adverse effect. The other teaching by the new RN is appropriate for a patient with newly diagnosed hypertension who has just started therapy with enalapril.
The nurse obtains this information from a patient with pre-hypertension. Which of the following findings is most important to address with the patient?
- A. Low dietary fibre intake
- B. No regular aerobic exercise
- C. BMI of 23 kg/m^2
- D. Drinks wine with dinner once a week
Correct Answer: B
Rationale: The recommendations for preventing hypertension include exercising aerobically for 30-60 minutes four to seven days a week. A BMI of 23 kg/m^2 is within the normal BMI range. The Dietary Approaches to Stop Hypertension (DASH) diet is high in fibre, but increasing fibre alone will not prevent hypertension from developing. The patient's alcohol intake will not increase the hypertension risk.
Which of the following BP findings by the nurse indicate that no changes in therapy are needed for a patient with stage 1 hypertension who has a history of heart failure?
- A. 108/64 mm Hg
- B. 128/76 mm Hg
- C. 140/90 mm Hg
- D. 136/82 mm Hg
Correct Answer: B
Rationale: The goal for antihypertensive therapy for a patient with hypertension and heart failure is a BP of <130/80 mm Hg. The BP of 108/64 may indicate overtreatment of the hypertension and an increased risk for adverse effects of drugs. The other two blood pressures indicate a need for modifications in the patient's treatment.
The nurse is caring for a patient with hypertension and has a prescription for propranolol. Which of the following assessment findings should the nurse report to the health care provider before administering this medication?
- A. Asthma
- B. Peptic ulcer disease
- C. Alcohol dependency
- D. Myocardial infarction
Correct Answer: A
Rationale: Nonselective β-adrenergic blockers can cause bronchospasm, putting the patient with a history of asthma at high risk. β-adrenergic blockers will have no effect on the patient's peptic ulcer disease or alcohol dependency. β-adrenergic blocker therapy is recommended after MI.