Chapter 31 Quiz

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Question #1

The nurse is planning the care of a patient admitted to the hospital with hypertension. What objective will help to meet the needs of this patient?

A Lowering and controlling the blood pressure without adverse effects and without undue cost

B Making sure that the patient adheres to the therapeutic medication regimen

C Instructing the patient to enter a weight loss program and begin an exercise regimen

D Scheduling the patient for all follow-up visits and making phone calls to the home to ensure adherence

Question #2

The nurse is conducting a service project for a local elderly community group on the topic of hypertension. The nurse will relay that which risk factors and cardiovascular problems are related to hypertension? Select all that apply.,,

A Elevated high-density lipoprotein (HDL) cholesterol

B Smoking

C Overweight/obesity

D Decreased low-density lipoprotein (LDL) levels

E Age ≥65 in women

Question #3

The nurse teaches the client which guidelines regarding lifestyle modifications for hypertension?

A Reduce smoking to no more than four cigarettes per day

B Limit aerobic physical activity to 15 minutes, three times per week

C Maintain adequate dietary intake of fruits and vegetables

D Stop alcohol intake

Question #4

An older adult client visits the clinic for a blood pressure check. The client’s hypertension is not well controlled, and a new blood pressure medicine is prescribed. What is important for the nurse to teach this client about blood pressure medicine?

A A severe drop in blood pressure is possible.

B There are no adverse effects from blood pressure medicine.

C Take the medicine on an empty stomach.

D A possible adverse effect of blood pressure medicine is dizziness when you stand.

Question #5

A nurse educator is providing information to a small group of clients about hypertension without comorbities. What does the nurse explain about the target goals of the Eighth Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC8)?

A 135/80 or lower

B 140/90 or lower

C 135/85 or lower

D 150/90 or lower

Question #6

A client is being seen at the clinic on a monthly basis for assessment of blood pressure. The client has been checking blood pressure at home as well and has reported a systolic pressure of 158 and a diastolic pressure of 64. What does the nurse suspect this client is experiencing?

A Hypertensive urgency

B Secondary hypertension

C Primary hypertension

D Isolated systolic hypertension

Question #7

A client with a history of hypertension is receiving client education about structures that regulate arterial pressure. Which structure is a component of that process?

A parasympathetic nervous system

B lungs

C kidneys

D limbic system

Question #8

The nurse is instructing a student on the proper technique for measuring blood pressure (BP). Which student action indicates a need for further teaching?

A Wraps the blood pressure cuff firmly around the arm

B Palpates the systolic pressure before auscultating blood pressure

C Centers the blood pressure cuff bladder directly over the brachial artery

D Positions the arm at waist level

Question #9

A client is taking 50 mg of oral spironolactone twice a day to assist with blood pressure control. While the nurse is performing the morning assessment, the client reports nausea, general muscle cramps, and weakness. The ECG strip shows a peaked, narrow T-wave, which is a change. What electrolyte imbalance does the nurse suspect?

A Hyponatremia

B Hyperkalemia

C Hypokalemia

D Hypernatremia

Question #10

A nurse is caring for a client who has hypertension and diabetes mellitus. The client’s blood pressure this morning was 150/92 mm Hg. When the client asks the nurse what his or her blood pressure should be, what is the nurse’s most appropriate response?

A “The lower the better. Blood pressure of 120/80 mm Hg is best for everyone.”

B “The current recommendation is for everyone to have blood pressure of 140/90 mm Hg or lower.”

C “Your blood pressure is fine. Just keep doing what you’re doing.”

D “Clients with diabetes should have a lower blood pressure goal. You should strive for 130/80 mm Hg.”

Question #11

Which statements are true when the nurse is measuring blood pressure (BP)? Select all that apply.,,

A Using a BP cuff that is too small will give a higher BP measurement.

B The client’s BP should be measured 1 hour before consuming alcohol.

C Using a BP cuff that is too large will give a higher BP measurement.

D The client should sit quietly while BP is being measured.

E The client’s arm should be positioned at the level of the heart.

Question #12

A 66-year-old client presents to the emergency department reporting severe headache and mild nausea for the past 6 hours. Upon assessment, the client’s BP is 210/120 mm Hg. The client has a history of hypertension and takes 1.0 mg clonidine twice daily. Which question is mostimportant for the nurse to ask the client next?

A “Are you having chest pain or shortness of breath?”

B “Do you have a dry mouth or nasal congestion?”

C “Did you take any medication for your headache?”

D “Have you taken your prescribed clonidine today?”

Question #13

Papilledema is a fairly common symptom of elevated blood pressure. The best way to detect this condition is through:

A ophthalmic examination.

B an MRI.

C laboratory tests

D using a sphygmomanometer.

Question #14

When administering benazepril with spironolactone, the nurse should be aware that which electrolyte imbalance may occur?

A Hypercalcemia

B Hyperkalemia

C Hypokalemia

D Hypocalcemia

Question #15

An older adult client has newly diagnosed stage 2 hypertension. The health care provider has prescribed Chlorothiazide and Benazepril. What will the nurse monitor this client for?

A Postural hypertension and resulting injury

B Postural hypotension and resulting injury

C Sexual dysfunction

D Rebound hypertension

Question #16

Which describes a situation in which blood pressure is severely elevated and there is evidence of actual or probable target organ damage?

A Primary hypertension

B Hypertensive urgency

C Secondary hypertension

D Hypertensive emergency

Question #17

It is important for the nurse to encourage the client to rise slowly from a sitting or lying position because gradual changes in position

A help reduce the work required by the heart to resupply oxygen to the brain.

B provide time for the heart to reduce the rate of contraction to resupply oxygen to the brain.

C provide time for the heart to increase the rate of contraction to resupply oxygen to the brain.

D help reduce the blood pressure to resupply oxygen to the brain.

Question #18

The nurse is teaching a client about chronic untreated hypertension. What complication will the nurse explain to the client?

A stroke

B peripheral edema

C pulmonary insufficiency

D right-sided heart failure

Question #19

An older adult client has newly diagnosed stage 2 hypertension. The health care provider has prescribed the client hydrochlorothiazide and enalapril. What will the nurse be sure to include in educating this client?

A Do not become dependent on canes, walkers, or handrails.

B Eat plenty of salty food to prevent hypotension.

C Change positions (lying or sitting to standing) slowly.

D Check blood pressure every day for signs of rebound hypertension.

Question #20

The nurse is performing an assessment on a patient to determine the effects of hypertension on the heart and blood vessels. What specific assessment data will assist in determining this complication? (Select all that apply.),,

A Character of apical and peripheral pulses

B Heart rhythm

C Lung sounds

D Respiratory rate

E Heart rate

Question #21

When measuring the blood pressure in each arm of a healthy adult client, the nurse recognizes that which statement is true?

A Pressures must be equal in both arms.

B Pressures should not differ more than 5 mm Hg between arms.

C Pressures may vary, with the higher pressure found in the left arm.

D Pressures may vary 10 mm Hg or more between arms.

Question #22

A client is being seen at the clinic for a routine physical when the nurse notes the client’s blood pressure is 150/97. The client is considered to be a healthy, well-nourished young adult. What type of hypertension does this client have?

A Pathologic

B Essential (primary)

C Secondary

D Malignant

Question #23

The nurse is caring for an older adult client who has come to the clinic for a yearly physical. When assessing the client, the nurse notes the blood pressure (BP) is 140/93. The nurse knows that in older clients what happens that may elevate the systolic BP?

A Loss of arterial elasticity

B Decrease in cardiac output

C Decrease in blood volume

D Increase in calcium intake

Question #24

A nurse is teaching a client who is newly diagnosed with hypertension and diabetes mellitus. What will the nurse specify about this client’s target blood pressure?

A 150/95 or lower

B 125/85 or lower

C 130/80 or lower

D 145/95 or lower

Question #25

A nurse is teaching a client with severe hypertension about the damage this condition can cause to the body. What system/organs will the nurse note are particularly targeted for damage due to severe hypertension?

A Gastrointestinal

B Musculoskeletal

C Integumentary

D Sensory

Question #26

According to the DASH diet, how many servings of vegetables should a person consume each day?

A 4 or 5

B 2 or fewer

C 7 or 8

D 2 or 3

Question #27

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 which of the following?

A The thymus

B The adrenal gland

C The thyroid gland

D The pituitary gland

Question #28

The nurse is volunteering at a community blood pressure screening. A client, never diagnosed with hypertension, presents with a blood pressure of 158/90 mm Hg. Which assessment questions, asked by the nurse, are appropriate? Select all that apply.,,

A “Do you have a friend accompanying you?”

B “Are you married and with children?”

C “Did you have a beer after work?”

D “Do you smoke?”

E “Have you recently drunk a caffeinated beverage?”

Question #29

The physician is ordering a test for the hypertensive client that will be able to evaluate whether the client has experienced heart damage. Which diagnostic test would the nurse anticipate to determine heart damage?

A Blood chemistry

B Fluorescein angiography

C Multiple gated acquisition scan (MUGA)

D Chest radiograph

Question #30

The nurse is instructing a client who is newly prescribed an antihypertensive medication. Which nursing instruction is emphasized to maintain client safety?

A Do not operate a motor vehicle.

B Sit on the edge of the chair and rise slowly.

C Take the medication at the same time daily.

D Use a pillbox to store daily medication.

Question #31

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 Brain and sympathetic nervous system

B Kidneys and autonomic nervous system

C Lung and arteries

D Heart and blood vessels

Question #32

A nurse is educating a client about monitoring blood pressure readings at home. What will the nurse be sure to emphasize?

A “Sit with legs crossed when taking your blood pressure.”

B “Sit quietly for 5 minutes prior to taking blood pressure.”

C “Avoid smoking cigarettes for 8 hours prior to taking blood pressure.”

D “Be sure the forearm is well supported above heart level while taking blood pressure.”

Question #33

It is appropriate for the nurse to recommend smoking cessation for clients with hypertension because nicotine

A increases the heart rate, constricts arterioles, and reduces the heart’s ability to eject blood

B increases the heart rate, constricts arterioles, and increases the heart’s ability to eject blood.

C decreases circulating blood volume.

D decreases the heart rate, constricts arterioles, and reduces the heart’s ability to eject blood.

Question #34

Nurses should implement measures to relieve emotional stress for clients with hypertension because the reduction of stress

A decreases the production of neurotransmitters that constrict peripheral arterioles.

B increases blood volume and improves the potential for greater cardiac output.

C increases the production of neurotransmitters that constrict peripheral arterioles.

D increases the resistance that the heart must overcome to eject blood.

Question #35

A 35-year-old client has been diagnosed with hypertension. The client is a stock broker, smokes daily, and has diabetes. During a follow-up appointment, the client states that regular visits to the doctor just to check blood pressure (BP) are cumbersome and time consuming. As the nurse, which aspect of client teaching would you recommend?

A Discussing methods for stress reduction

B Purchasing a self-monitoring BP cuff

C Administering glycemic control

D Advising smoking cessation

Question #36

The nurse and a dietitian are instructing the client on a low-sodium diet needed to lower the blood pressure. Which question, asked by the nurse, is most important?

A “Who eats meals with you?”

B “How do you prepare your food?”

C “Do you snack in the evening?”

D “Do you eat three meals per day?”

Question #37

Which of the following is the nurse most correct to recognize as a direct effect of client hypertension?

A Hyperglycemia resulting from insulin receptor resistance

B Anemia resulting from bone marrow suppression

C Emphysema related to poor gas exchange

D Renal dysfunction resulting from atherosclerosis

Question #38

A client who is newly diagnosed with hypertension is going to be starting antihypertensive medicine. What is one of the main things the client and the client’s spouse should watch for?

A blurred vision

B persistent cough

C dizziness

D tremor

Question #39

A client, newly admitted to the nursing unit, has a primary diagnosis of renal failure. When assessing the client, the nurse notes a blood pressure (BP) of 180/100. The nurse knows that this is what kind of hypertension?

A Secondary

B Primary

C Essential

D Malignant

Question #40

A nurse is providing education about hypertension to a community group. What are possible consequences of untreated hypertension? Select all that apply.,,

A Tension pneumothorax

B Myocardial infarction

C Stroke

D Pancreatitis

E Coronary artery disease

Question #41

A nurse providing education about hypertension to a community group is discussing the high risk for cardiovascular complications. What are risk factors for cardiovascular problems in clients with hypertension? Select all that apply.,,

A Diabetes mellitus

B Smoking

C Physical inactivity

D Gallbladder disease

E Gallbladder disease

Question #42

A nurse is teaching about lifestyle modifications to a group of clients with known hypertension. Which statement would the nurse include in the education session?

A Engage in aerobic activity at least 30 minutes/day most days of the week.

B Limit alcohol consumption to no more that 3 drinks per day.

C Maintain a body mass index between 30 and 35.

D Maintain a waist circumference of 45 inches (114 cm) (men) and 40 inches (102 cm) (women) or less.

Question #43

Which diuretic medication conserves potassium?

A Furosemide

B Chlorthalidone

C Chlorothiazide

D Spironolactone

Question #44

A client is placed on a low-sodium (500 mg/day) diet. Which client statement indicates that the nurse’s nutrition teaching plan has been effective?

A “I chose a tossed salad with sardines and oil and vinegar dressing for lunch.”

B “I’m glad I can still have chicken bouillon.”

C “I chose broiled chicken with a baked potato for dinner.”

D “I can still eat a ham-and-cheese sandwich with potato chips for lunch.”

Question #45

The nurse is caring for a client with a blood pressure of 210/100 mm Hg in the emergency room. What is the most appropriate route of administration for antihypertensive agents?

A sublingual

B oral

C intramuscular

D continuous IV infusion

Question #46

A client is brought to the emergency department with reports of a bad headache and an increase in blood pressure. The blood pressure reading obtained by the nurse is 260/180 mm Hg. What is the therapeutic goal for reduction of the mean blood pressure?

A Rapidly reduce the blood pressure so the client will not suffer a stroke.

B Reduce the blood pressure to about 140/80 mm Hg.

C Reduce the blood pressure by 20% to 25% within the first hour of treatment.

D Reduce the blood pressure by 50% within the first hour of treatment.

Question #47

A patient is flying overseas for 1 week for business and packed antihypertensive medications in a suitcase. After arriving at the intended destination, the patient found that the luggage had been stolen. If the patient cannot take the medication, what condition becomes a concern?

A Left ventricular hypertrophy

B Isolated systolic hypertension

C Angina

D Rebound hypertension

Question #48

A client is admitted to the intensive care unit (ICU) with a diagnosis of hypertension emergency/crisis. The client’s blood pressure (BP) is 200/130 mm Hg. The nurse is preparing to administer IV nitroprusside. Upon assessment, which finding requires immediate intervention by the nurse?

A Numbness and weakness in the left arm

B Chest pain score of 3 (on a scale of 1 to 10)

C Urine output of 40 mL over the past hour

D Nausea and severe headache

Question #49

The nurse is employed in a physician’s office and is caring for a client present for an annual exam. A blood pressure of 124/84 mm Hg is documented. Following revised guidelines for identifying hypertension, which educational pamphlet is help?

A Diagnostic testing for determining cardiac functioning

B Use of beta-blockers for treatment of hypertension

C Stress reduction to lower prehypertensive state

D Increasing fluids for low blood pressure

Question #50

Which describes a situation in which blood pressure is severely elevated and there is evidence of actual or probable target organ damage?

A Secondary hypertension

B Hypertensive emergency

C Hypertensive urgency

D Primary hypertension

Question #51

Approximately what percentage of adults in the United States have hypertension?

A 20

B 25

C 10

D 30

Question #52

Which diagnostic method is recommended to determine whether left ventricular hypertrophy has occurred?

A Blood urea nitrogen

B Blood chemistry

C Electrocardiography

D Echocardiography

Question #53

A systolic blood pressure of 135 mm Hg would be classified as

A stage 2 hypertension.

B normal.

C prehypertension.

D stage 1 hypertension.

Question #54

Which client statement indicates a good understanding of the nutritional modifications needed to manage hypertension?

A “A glass of red wine each day will lower my blood pressure.”

B “I should eliminate caffeine from my diet to lower my blood pressure.”

C “If I include less fat in my diet, I’ll lower my blood pressure.”

D “Limiting my salt intake to 2 grams per day will improve my blood pressure.”

Question #55

A client is taking amiloride and lisinopril for the treatment of hypertension. What laboratory studies should the nurse monitor while the client is taking these two medications together?

A Magnesium level

B Calcium level

C Sodium level

D Potassium level

Question #56

Which finding indicates that hypertension is progressing to target organ damage?

A Urine output of 60 mL over 2 hours

B Retinal blood vessel damage

C Chest x-ray showing pneumonia

D Blood urea nitrogen concentration of 12 mg/dL

Question #57

Hypertension that can be attributed to an underlying cause is termed

A isolated systolic hypertension.

B essential hypertension.

C secondary hypertension.

D primary hypertension.

Question #58

The nurse is administering metoprolol to a client. What type of medication should the nurse educate the client about?

A Beta blocker

B Angiotensin-converting enzyme (ACE) inhibitor

C Vasodilator

D Diuretic

Question #59

Officially, hypertension is diagnosed when the client demonstrates a systolic blood pressure greater than ______ mm Hg and a diastolic blood pressure greater than _____ mm Hg over a sustained period.

A 110, 60

B 130, 80

C 140, 90

D 120, 70

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