Chapter 33 Nursing Management Hypertension

Topics: Hypertension, Blood pressure, Myocardial infarction Pages: 9 (3529 words) Published: February 23, 2015
Chapter 33: Nursing Management: Hypertension
Test Bank
1. Which action will the nurse in the hypertension clinic take in order to obtain an accurate

baseline blood pressure (BP) for a new patient?
a. Deflate the BP cuff at a rate of 5 to 10 mm Hg per second. b. Have the patient sit in a chair with the feet flat on the floor. c. Assist the patient to the supine position for BP measurements. d. Obtain two BP readings in the dominant arm and average the results. ANS: B

The patient should be seated with the feet flat on the floor. The BP is obtained in both arms, and the results of the two arms are not averaged. The patient does not need to be in the supine position. The cuff should be deflated at 2 to 3 mm Hg per second. DIF: Cognitive Level: Understand (comprehension)

REF: 723
TOP: Nursing Process: Assessment
MSC: NCLEX: Health Promotion and Maintenance
2. The nurse obtains the following information from a patient newly diagnosed with

prehypertension. Which finding is most important to address with the patient? a. Low dietary fiber intake
b. No regular aerobic exercise
c. Weight 5 pounds above ideal weight
d. Drinks a beer with dinner on most nights

The recommendations for preventing hypertension include exercising aerobically for 30 minutes most days of the week. A weight that is 5 pounds over the ideal body weight is not a risk factor for hypertension. The Dietary Approaches to Stop Hypertension (DASH) diet is high in fiber, but increasing fiber alone will not prevent hypertension from developing. The patient’s alcohol intake is within guidelines and will not increase the hypertension risk. DIF: Cognitive Level: Apply (application)

TOP: Nursing Process: Planning
MSC: NCLEX: Health Promotion and Maintenance
3. Which action should the nurse take when administering the initial dose of oral labetalol

(Normodyne) to a patient with hypertension?
a. Encourage the use of hard candy to prevent dry mouth.
b. Instruct the patient to ask for help if heart palpitations occur. c. Ask the patient to request assistance when getting out of bed. d. Teach the patient that headaches may occur with this medication. ANS: C

Labetalol decreases sympathetic nervous system activity by blocking both á- and β-adrenergic receptors, leading to vasodilation and a decrease in heart rate, which can cause severe orthostatic hypotension. Heart palpitations, dry mouth, dehydration, and headaches are possible side effects of other antihypertensives.


DIF: Cognitive Level: Apply (application)
TOP: Nursing Process: Implementation
MSC: NCLEX: Physiological Integrity
4. After the nurse teaches the patient with stage 1 hypertension about diet modifications that

should be implemented, which diet choice indicates that the teaching has been effective? a. The patient avoids eating nuts or nut butters.
b. The patient restricts intake of chicken and fish.
c. The patient has two cups of coffee in the morning.
d. The patient has a glass of low-fat milk with each meal.

For the prevention of hypertension, the Dietary Approaches to Stop Hypertension (DASH) recommendations include increasing the intake of calcium-rich foods. Caffeine restriction and decreased protein intake are not included in the recommendations. Nuts are high in beneficial nutrients and 4 to 5 servings weekly are recommended in the DASH diet. DIF: Cognitive Level: Apply (application)

TOP: Nursing Process: Evaluation
MSC: NCLEX: Physiological Integrity
5. A patient has just been diagnosed with hypertension and has been started on captopril

(Capoten). Which information is important to include when teaching the patient about this medication?
a. Check blood pressure (BP) in both arms before taking the medication. b. Increase fluid intake if dryness of the mouth is a problem. c. Include high-potassium foods such as bananas in the diet. d. Change position slowly to help prevent...
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