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While reviewing a client's lab work, the nurse notices the client's potassium is elevated. The nurse checks the client's medication record. Which of the following, if found, would the nurse identify as contributing to the client's elevated potassium level? Select all that apply.
- A. Atenolol
- B. Aliskiren
- C. Clonidine
- D. Metoprolol
- E. Eplerenone
Correct Answer: B,E
Rationale: Direct renin inhibitors such as aliskiren and the drug eplerenone can cause hyperkalemia. Atenolol and metoprolol are beta blockers. Clonidine is a centrally acting adrenergic drug.
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A nurse is reviewing the medical records of several clients who have come to the clinic for a visit. The nurse determines that a client with which blood pressure readings would be identified as prehypertensive?
- A. 112 / 72 mm Hg
- B. 128 / 86 mm Hg
- C. 144 / 92 mm Hg
- D. 164 / 102 mm Hg
Correct Answer: B
Rationale: Prehypertension is classified as a systolic blood pressure ranging between 120 and 139 mm Hg or a diastolic pressure ranging between 80 and 89 mm Hg. A systolic pressure below 120 mm Hg and a diastolic pressure below 80 mm Hg is considered normal. Stage 1 hypertension would be characterized by a systolic pressure between 140 and 159 mm Hg or a diastolic pressure between 90 and 99 mm Hg. Stage 2 hypertension would be characterized by a systolic pressure of 160 mm Hg or greater or a diastolic pressure of 100 mm Hg or greater.
When providing care to a client with hypertension who is receiving antihypertensive therapy, which assessment would be the highest priority?
- A. Pain rating
- B. Blood pressure monitoring
- C. Weight measurement
- D. Complaints of adverse reactions
Correct Answer: B
Rationale: Although assessing for pain, measuring weight, and assessing for complaints of adverse reactions are important, monitoring the client's blood pressure would have the highest priority because the drug therapy regimen may need to be adjusted or changed if the client's response is inadequate.
A client with hypertension comes to the clinic for a follow-up visit. Which of the following would be appropriate for the nurse to do when assisting the client in managing his hypertension? Select all that apply.
- A. Find local resources in the community for taking blood pressure.
- B. Teach client how to properly record weight and blood pressure.
- C. Schedule regular monitoring of weight and blood pressure.
- D. Schedule an appointment to see a cardiologist.
- E. Schedule an appointment to see a nephrologist.
Correct Answer: A,B,C
Rationale: In the ambulatory care setting, the nurse helps plan a schedule of regular monitoring of weight and blood pressure, finds local resources for taking blood pressure in the community, and teaches the client how to record weight and blood pressure readings.
After teaching a group of nursing students about hypertension, the instructor determines that the teaching was successful when the students identify which of the following as a risk factor for development of hypertension? Select all that apply.
- A. Advancing age
- B. Family history
- C. Caucasian race
- D. Cigarette smoking
- E. Chronic alcohol consumption
Correct Answer: A,B,D,E
Rationale: Risk factors for hypertension include advancing age, family history, cigarette smoking, and chronic alcohol consumption. African American race is also a risk factor.
A client has a nursing diagnosis of Activity Intolerance related to fatigue and weakness. Which of the following would be appropriate for the nurse to include in the client's plan of care?
- A. Encouraging ambulation as tolerated
- B. Maintaining bed rest as much as possible
- C. Mandating the use of assistive devices
- D. Encouraging activities early in the morning when fatigue is less
- E. Promoting rest periods throughout the day as necessary
Correct Answer: A,E
Rationale: The client is encouraged to walk and ambulate as he or she can tolerate. Assistive devices may be used if needed, but these should not be mandated for use. The client can gradually increase tolerance by increasing the daily amount of activity. Planning rest periods according to the individual's tolerance is appropriate. Rest can take many forms, such as sitting in a chair, napping, watching television, or sitting with legs elevated.