Hypertension NCLEX

Hypertension NCLEX ScienceMedicineNursing cdcaspers Save NCLEX Hypertension 136 terms roberto_castrellon Preview Antihypertensive NCLEX questions 13 terms catherine_northey Preview

NCLEX style questions: Hypertensio...

20 terms hannahk0729Preview Hypert

• terms

s64 A nurse is educating a group of older adults on the impact of lifestyle changes on hypertension. The nurse includes which of the following in the education? (SATA)

• learn how to read and interpret food labels
• the sodium content of commonly consumed foods
• techniques to incorporate more physical activity into the daily routine
• the actions of calcium channel blocker medications on hypertension
• the importance of adhering to pharmacological regimens for treatment of hypertension

A B C Options A and B address dietary interventions to control hypertension. Option C addresses physical activity. These all involve lifestyle changes to control hypertension. Options D and E are related to pharmacological treatment of hypertension.The nurse teaches a client about lifestyle modifications to help manage hypertension. Which client statement indicates teaching has been effective?

a) I won't be able to run in marathons anymore

b) I know i need to give up my cigarettes and alcohol

• i need to get started on my medications right away
• my father had hypertension, did nothing, and lived to be 90 years old

B Limiting intake of alcohol and discontinuing tobacco products are important nonpharmacological methods for controlling hypertension.Implementing lifestyle modifications may eliminate the need for pharmacotherapy, so the client may not have to take medication right away.Increasing physical activity is an important lifestyle modification for controlling hypertension. The fact that the client's father had hypertension and lived to be 90 years old does not mean that the client will have the same experience; the client is in denial.

Which precaution is most important for you to teach a patient who has been prescribed a beta blocker drug for hypertension?

• avoid alcoholic beverage while taking this drug
• weigh yourself daily at the same time every morning
• wear gloves and other warm clothing during col weather
• do not suddenly stop taking this drug without notifying your prescriber

D A nurse is teaching a larger female client about alcohol intake and how it affects hypertension. The client asks if drinking two beers at night is an acceptable intake. What answer by the nurse is best?

• no, women should only have one beer a day as a general rule
• no, you should not drink any alcohol with hypertension
• yes, since you are larger, you can have more alcohol
• yes, two beers per day is acceptable amount of alcohol

A Alcohol intake should be limited to 2 drink per day for men and 1 drink per day for women. A "drink" is classified as one beer, 1.5 ox of har liquor, or 5 ounces of wine. Limited alcohol intake is acceptable with hypertension. The women's size does not matter.When developing a presentation for a local community group on hypertension, the nurse integrates information about the importance of blood pressure control. Which of the following would the nurse include? SATA

a) HTN increases the buildup of atherosclerotic plaque

b) HTN increases risk of stroke

c) HTN increases risk fo colorectal carcinoma

d) HTN increases risk fo liver disease

e) HTN increases the workload of the heart

A B E Hypertension is serious, because is causes the heart to work too hard and contributes to atherosclerosis. HTN also increases the risk of heart disease, heart failure (HF), kidney disease, blindness, and stroke.The community health nurse is preparing a program geared toward primary prevention of hypertension. When preparing the program, what activities will aid the nurse in meeting the goals of primary prevention?

• providing dietary counseling for clients with hypertension
• offering free blood pressure screenings to participants
• having a contest for participants to win an automatic blood pressure cuff for home use
• providing literature to discuss modifiable risk factors

D Primary prevention activities seek to reduce the incidence of disease. These are risk factors associated with hypertension. Change in modifiable risk factors may result in the reduction of disease incidence.Secondary prevention is the reducing of risks and complications to the client who already has a disorder. Ex- providing dietary counseling, free blood pressure screenings, and a contest for a free BP cuff

A patient taking metoprolol (Lopressor) for hypertension reports all of the following side effects. Fo which side effect will you notify the prescriber?

• increased urination during the daytime

b) Heart rate of 68/min

• chest pain during exercise
• decreased sexual ability

C A client has had hypertension for 20 years. The nurse should asses the client for?

• renal insufficiency and failure
• valvular heart disease

c) Endocarditis

• peptic ulcer disease

A Renal disease, including renal insufficiency and failure, is a complication of hypertension. Effective treatment of hypertension assists in preventing this complication.An industrial health nurse at a larger printing plant finds a male employee's BP to be elevated on two occasions 1 month apart and refers him to his private physician. The employee is about 25 lbs overweight and has smoked a pack of cigarettes daily for more than 20 years. The client was prescribed Atenolol (Tenormin) for the hypertension. The nurse should instruct the client to:

• avoid sudden discontinuation of the drug
• monitor the blood pressure annually
• follow a 2 g sodium diet
• discontinue the medication if severe headaches develop

A Sudden discontinuation of this drug is dangerous because it may exacerbate symptoms. This medication should not be discontinued without a physicians order.Metoprolol (Toprol XL) is added to the pharmacologic therapy of a diabetic female diagnosed with stage 2 hypertension initially treated with

Furosemide (Lasix) and Ramipril (Altace). An expected therapeutic effect is:

• decrease in heart rate
• lessening of fatigue
• improvement in blood sugar levels
• increase in urine output

A The effect of a beta blocker is a decrease in heart rate, contractility, and afterload, which leads to a decrease in blood pressure. The client at first may have an increase in fatigue when starting the beta blocker. The mechanism of action does not improve blood sugar or urine output.

A client is taking clonidine (Catapres) for treatment of hypertension. The nurse should teach the client about which of the following common adverse effects of this drug? SATA

a) Dry Mouth

b) Hyperkalemia

c) Impotence

d) Pancreatitis

e) Sleep disturbance

A C E Clonidine (Catapres) is a central-acting adrenergic antagonist. It reduces sympathetic outflow from the central nervous system. Dry mouth, impotence, and sleep disturbances are possible adverse effects.In teaching the hypertensive client to avoid orthostatic hypotension, the nurse should emphasize which of the following instructions? SATA

• plan regular times for taking medications
• rise slowly form bed
• avoid standing still for long periods
• avoid excessive alcohol intake
• avoid hot baths

B C Changing positions slowly and avoiding long periods of standing may limit the occurrence of orthostatic hypotension. Scheduling regular medication times is important for blood pressure management but this aspect is not related to the development of orthostatic hypotension.The nurse teaches a client, who has recently been diagnosed with hypertension, about dietary restrictions: a low-calorie, low-fat, low-sodium diet. Which of the following menu selections would best meet the client's needs?

• mixed green salad with blue cheese dressing, crackers, and cold cuts
• ham sandwich on rye bread and an orange
• baked chicken, an apple, and slice of white bread
• hot dogs, baked beans, and celery and carrot sticks

C Processed and cured meat products, such as cold cuts, ham, and hot dogs, are all high in both fat and sodium and should be avoided on a low- calorie, low-fat, low-salt diet. Dietary restrictions of all types are complex and difficult to implement with clients who are basically asymptomatic.A client's job involves working in a warm, dry room, frequently bending and crouching to check the underside of a high-speed press, and wearing eye guards. Given this information, the nurse should assess the client for which of the following?

• muscle aches
• thirst
• lethargy
• orthostatic hypotension

D Possible dizziness from orthostatic hypotension when rising from a crouched or bent position increases the client's risk of being injured by the equipment. The nurse should assess the client's blood pressure in all three positions (lying, sitting, and standing) at all routine visits. The client may experience muscle aches, or thirst from working in a warm, dry room, but these are not as potentially dangerous as orthostatic hypotension. The client should not be experiencing lethargy.