Test
Chapter 31
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Preguntas del test (40)
1An older adult is newly diagnosed with primary hypertension and has just been started on a beta-blocker. The nurse’s health education should include which of the following?
- AIncreasing fluids to avoid extracellular volume depletion from the diuretic effect of the beta-blocker
- BMaintaining a diet high in dairy to increase protein necessary to prevent organ damage
- CUse of strategies to prevent falls stemming from postural hypotension
- DLimiting exercise to avoid injury that can be caused by increased intracranial pressure
2A patient with primary hypertension comes to the clinic complaining of a gradual onset of blurry vision and decreased visual acuity over the past several weeks. The nurse is aware that these symptoms could be indicative of what?
- ARetinal blood vessel damage
- BGlaucoma
- CCranial nerve damage
- DHypertensive emergency
3A nurse is performing blood pressure screenings at a local health fair. While obtaining subjective assessment data from a patient with hypertension, the nurse learns that the patient has a family history of hypertension and she herself has high cholesterol and lipid levels. The patient says she smokes one pack of cigarettes daily and drinks about a pack of beer every day. The nurse notes what nonmodifiable risk factor for hypertension?
- AHyperlipidemia
- BExcessive alcohol intake
- CA family history of hypertension
- DCloser adherence to medical regimen
4The staff educator is teaching ED nurses about hypertensive crisis. The nurse educator should explain that hypertensive urgency differs from hypertensive emergency in what way?
- AThe BP is always higher in a hypertensive emergency.
- BVigilant hemodynamic monitoring is required during treatment of hypertensive emergencies.
- CHypertensive urgency is treated with rest and benzodiazepines to lower BP.
- DHypertensive emergencies are associated with evidence of target organ damage.
5A group of student nurses are practicing taking blood pressure. A 56-year-old male student has a blood pressure reading of 146/96 mm Hg. Upon hearing the reading, he exclaims, “My pressure has never been this high. Do you think my doctor will prescribe medication to reduce it?” Which of the following responses by the nursing instructor would be best?
- A“Yes. Hypertension is prevalent among men; it is fortunate we caught this during your routine examination.”
- B“We will need to reevaluate your blood pressure because your age places you at high risk for hypertension.”
- C“A single elevated blood pressure does not confirm hypertension. You will need to have your blood pressure reassessed several times before a diagnosis can be made.”
- D“You have no need to worry. Your pressure is probably elevated because you are being tested.”
6A 40-year-old male newly diagnosed with hypertension is discussing risk factors with the nurse. The nurse talks about lifestyle changes with the patient and advises that the patient should avoid tobacco use. What is the primary rationale behind that advice to the patient?
- AQuitting smoking will cause the patient’s hypertension to resolve.
- BTobacco use increases the patient’s concurrent risk of heart disease.
- CTobacco use is associated with a sedentary lifestyle.
- DTobacco use causes ventricular hypertrophy.
7A patient has been prescribed antihypertensives. After assessment and analysis, the nurse has identified a nursing diagnosis of risk for ineffective health maintenance related to nonadherence to therapeutic regimen. When planning this patient’s care, what desired outcome should the nurse identify?
- APatient takes medication as prescribed and reports any adverse effects.
- BPatient’s BP remains consistently below 140/90 mm Hg.
- CPatient denies signs and symptoms of hypertensive urgency.
- DPatient is able to describe modifiable risk factors for hypertension.
8The nurse is providing care for a patient with a new diagnosis of hypertension. How can the nurse best promote the patient’s adherence to the prescribed therapeutic regimen?
- AScreen the patient for visual disturbances regularly.
- BHave the patient participate in monitoring his or her own BP.
- CEmphasize the dire health outcomes associated with inadequate BP control.
- DEncourage the patient to lose weight and exercise regularly.
9A patient newly diagnosed with hypertension asks the nurse what happens when uncontrolled hypertension is prolonged. The nurse explains that a patient with prolonged, uncontrolled hypertension is at risk for developing what health problem?
- ARenal failure
- BRight ventricular hypertrophy
- CGlaucoma
- DAnemia
10A patient with primary hypertension complains of dizziness with ambulation. The patient is currently on an alpha-adrenergic blocker and the nurse assesses characteristic signs and symptoms of postural hypotension. When teaching this patient about risks associated with postural hypotension, what should the nurse emphasize?
- ARising slowly from a lying or sitting position
- BIncreasing fluids to maintain BP
- CStopping medication if dizziness persists
- DTaking medication first thing in the morning
11The nurse is planning the care of a patient who has been diagnosed with hypertension, but who otherwise enjoys good health. When assessing the response to an antihypertensive drug regimen, what blood pressure would be the goal of treatment?
- A156/96 mm Hg or lower
- B140/90 mm Hg or lower
- CAverage of 2 BP readings of 150/80 mm Hg
- D120/80 mm Hg or lower
12A patient in a hypertensive emergency is admitted to the ICU. The nurse anticipates that the patient will be treated with IV vasodilators, and that the primary goal of treatment is what?
- ALower the BP to reduce onset of neurologic symptoms, such as headache and vision changes.
- BDecrease the BP to a normal level based on the patient’s age.
- CDecrease the mean arterial pressure between 20% and 25% in the first hour of treatment.
- DReduce the BP to £ 120/75 mm Hg as quickly as possible.
13The nursing lab instructor is teaching student nurses how to take blood pressure. To ensure accurate measurement, the lab instructor would teach the students to avoid which of the following actions?
- AMeasuring the BP after the patient has been seated quietly for more than 5 minutes
- BTaking the BP at least 10 minutes after nicotine or coffee ingestion
- CUsing a cuff with a bladder that encircles at least 80% of the limb
- DUsing a bare forearm supported at heart level on a firm surface
14A nurse is teaching an adult female patient about the risk factors for hypertension. What should the nurse explain as risk factors for primary hypertension?
- AObesity and high intake of sodium and saturated fat
- BDiabetes and use of oral contraceptives
- CMetabolic syndrome and smoking
- DRenal disease and coarctation of the aorta
15The nurse is caring for an older adult with a diagnosis of hypertension who is being treated with a diuretic and beta-blocker. Which of the following should the nurse integrate into the management of this client’s hypertension?
- AEnsure that the patient receives a larger initial dose of antihypertensive medication due to impaired absorption.
- BPay close attention to hydration status because of increased sensitivity to extracellular volume depletion.
- CRecognize that an older adult is less likely to adhere to his or her medication regimen than a younger patient.
- DCarefully assess for weight loss because of impaired kidney function resulting from normal aging.
16A patient with secondary hypertension has come into the clinic for a routine check-up. The nurse is aware that the difference between primary hypertension and secondary hypertension is which of the following?
- ASecondary hypertension has a specific cause.
- BSecondary hypertension has a more gradual onset than primary hypertension.
- CSecondary hypertension does not cause target organ damage.
- DSecondary hypertension does not normally respond to antihypertensive drug therapy.
17The nurse is assessing a patient new to the clinic. Records brought to the clinic with the patient show the patient has hypertension and that her current BP readings approximate the readings from when she was first diagnosed. What contributing factor should the nurse first explore in an effort to identify the cause of the client’s inadequate BP control?
- AProgressive target organ damage
- BPossibility of medication interactions
- CLack of adherence to prescribed drug therapy
- DPossible heavy alcohol use or use of recreational drugs
18A patient has come to the clinic for a follow-up assessment that will include a BP reading. To ensure an accurate reading, the nurse should confirm that the patient has done which of the following?
- ATried to rest quietly for 5 minutes before the reading is taken
- BRefrained from smoking for at least 8 hours
- CDrunk adequate fluids during the day prior
- DAvoided drinking coffee for 12 hours before the visit
19The nurse is providing care for a patient with a diagnosis of hypertension. The nurse should consequently assess the patient for signs and symptoms of which other health problem?
- AMigraines
- BAtrial-septal defect
- CAtherosclerosis
- DThrombocytopenia
20The nurse is developing a nursing care plan for a patient who is being treated for hypertension. What is a measurable patient outcome that the nurse should include?
- APatient will reduce Na+ intake to no more than 2.4 g daily.
- BPatient will have a stable BUN and serum creatinine levels.
- CPatient will abstain from fat intake and reduce calorie intake.
- DPatient will maintain a normal body weight.
21A patient with newly diagnosed hypertension has come to the clinic for a follow-up visit. The patient asks the nurse why she has to come in so often. What would be the nurse’s best response?
- AWe do this so you don’t suffer a stroke.
- BWe do this to determine how your blood pressure changes throughout the day.
- CWe do this to see how often you should change your medication dose.
- DWe do this to make sure your health is stable. We’ll then monitor it at routinely scheduled intervals.
22The hospital nurse cares for many patients who have hypertension. What nursing diagnosis is most common among patients who are being treated for this health problem?
- ADeficient knowledge regarding the lifestyle modifications for management of hypertension
- BNoncompliance with therapeutic regimen related to adverse effects of prescribed therapy
- CDeficient knowledge regarding BP monitoring
- DNoncompliance with treatment regimen related to medication costs
23The nurse is teaching a patient about some of the health consequences of uncontrolled hypertension. What health problems should the nurse describe?
SELECT ALL THAT APPLY- ATransient ischemic attacks
- BCerebrovascular accident
- CRetinal hemorrhage
- DVenous insufficiency
- ERight ventricular hypertrophy
24The nurse is collaborating with the dietitian and a patient with hypertension to plan dietary modifications. These modifications should include which of the following?
- AReduced intake of protein and carbohydrates
- BIncreased intake of calcium and vitamin D
- CReduced intake of fat and sodium
- DIncreased intake of potassium, vitamin B12 and vitamin D
25The critical care nurse is caring for a patient just admitted in a hypertensive emergency. The nurse should anticipate the administration of what medication?
- AWarfarin (Coumadin)
- BFurosemide (Lasix)
- CSodium nitroprusside (Nitropress)
- DRamipril (Altace)
26A patient in hypertensive emergency is being cared for in the ICU. The patient has become hypovolemic secondary to natriuresis. What is the nurse’s most appropriate action?
- AAdd sodium to the patient’s IV fluid, as ordered.
- BAdminister a vasoconstrictor, as ordered.
- CPromptly cease antihypertensive therapy.
- DAdminister normal saline IV, as ordered.
27During an adult patient’s last two office visits, the nurse obtained BP readings of 122/84 mm Hg and 130/88 mm Hg, respectively. How would this patient’s BP be categorized?
- ANormal
- BPrehypertensive
- CStage 1 hypertensive
- DStage 2 hypertensive
28A patient comes to the walk-in clinic complaining of frequent headaches. While assessing the patient’s vital signs, the nurse notes the BP is 161/101 mm Hg. According to JNC 7, how would this patient’s BP be defined if a similar reading were obtained at a subsequent office visit?
- AHigh normal
- BNormal
- CStage 1 hypertensive
- DStage 2 hypertensive
29A patient has been diagnosed as being prehypertensive. What should the nurse encourage this patient to do to aid in preventing a progression to a hypertensive state?
- AAvoid excessive potassium intake.
- BExercise on a regular basis.
- CEat less protein and more vegetables.
- DLimit morning activity.
30The nurse is screening a number of adults for hypertension. What range of blood pressure is considered normal?
- ALess than 140/90 mm Hg
- BLess than 130/90 mm Hg
- CLess than 129/89 mm Hg
- DLess than 120/80 mm Hg
31A community health nurse teaching a group of adults about preventing and treating hypertension. The nurse should encourage these participants to collaborate with their primary care providers and regularly monitor which of the following?
- AHeart rate
- BSodium levels
- CPotassium levels
- DBlood lipid levels
32A community health nurse is planning an educational campaign addressing hypertension. The nurse should anticipate that the incidence and prevalence of hypertension are likely to be highest among members of what ethnic group?
- APacific Islanders
- BAfrican Americans
- CAsian-Americans
- DHispanics
33The home health nurse is caring for a patient who has a comorbidity of hypertension. What assessment question most directly addresses the possibility of worsening hypertension?
- AAre you eating less salt in your diet?
- BHow is your energy level these days?
- CDo you ever get chest pain when you exercise?
- DDo you ever see spots in front of your eyes?
34A student nurse is taking care of an elderly patient with hypertension during a clinical experience. The instructor asks the student about the relationships between BP and age. What would be the best answer by the student?
- ABecause of reduced smooth muscle tone in blood vessels, blood pressure tends to go down with age, not up.
- BDecreases in the strength of arteries and the presence of venous insufficiency cause hypertension in the elderly.
- CStructural and functional changes in the cardiovascular system that occur with age contribute to increases in blood pressure.
- DThe neurologic system of older adults is less efficient at monitoring and regulating blood pressure.
35A 55-year-old patient comes to the clinic for a routine check-up. The patient’s BP is 159/100 mm Hg and the physician diagnoses hypertension after referring to previous readings. The patient asks why it is important to treat hypertension. What would be the nurse’s best response?
- AHypertension can cause you to develop dangerous blood clots in your legs that can migrate to your lungs.
- BHypertension puts you at increased risk of type 1 diabetes and cancer in your age group.
- CHypertension is the leading cause of death in people your age.
- DHypertension greatly increases your risk of stroke and heart disease.
36The nurse is reviewing the medication administration record of a patient who takes a variety of medications for the treatment of hypertension. What potential therapeutic benefits of antihypertensives should the nurse identify?
SELECT ALL THAT APPLY- AIncreased venous return
- BDecreased peripheral resistance
- CDecreased blood volume
- DDecreased strength and rate of myocardial contractions
- EDecreased blood viscosity
37A newly diagnosed patient with hypertension is prescribed Diuril, a thiazide diuretic. What patient education should the nurse provide to this patient?
- AEat a banana every day because Diuril causes moderate hyperkalemia.
- BTake over-the-counter potassium pills because Diuril causes your kidneys to lose potassium.
- CDiuril can cause low blood pressure and dizziness, especially when you get up suddenly.
- DDiuril increases sodium levels in your blood, so cut down on your salt.
38A patient in hypertensive urgency is admitted to the hospital. The nurse should be aware of what goal of treatment for a patient in hypertensive urgency?
- ANormalizing BP within 2 hours
- BObtaining a BP of less than 110/70 mm Hg within 36 hours
- CObtaining a BP of less than 120/80 mm Hg within 36 hours
- DNormalizing BP within 24 to 48 hours
39A patient’s medication regimen for the treatment of hypertension includes hydrochlorothiazide. Following administration of this medication, the nurse should anticipate what effect?
- ADrowsiness or lethargy
- BIncreased urine output
- CDecreased heart rate
- DMild agitation
40A patient’s recently elevated BP has prompted the primary care provider to prescribe furosemide (Lasix). The nurse should closely monitor which of the following?
- AThe client’s oxygen saturation level
- BThe patient’s red blood cells, hematocrit, and hemoglobin
- CThe patient’s level of consciousness
- DThe patient’s potassium level
Información
- Descripción
- (Cardiac) Nursing Test sobre Chapter 31, creado por Jessica Levine el 06/10/2016.
- Autor
- Jessica Levine
- Idioma
- English
- Visitas
- 512
- Etiquetas
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