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Chap. 27 Assessment & mngmnt of pt. w_ hypertension Exam 2
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Chap. 27 Assessment & mngmnt of pt. w_ hypertension Exam 2
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Chap. 27 Assessment & mngmnt of pt. w/hypertension Exam 2
Ans : A
Feedback : Blurred vision , spots in front of the eyes , and diminished visual acuity can
mean retinal blood vessel damage indicative of damage elsewhere in the vascular
system as a result of hypertension . Glaucoma and cranial nerve damage do not
normally cause these symptoms . A hypertensive emergency would have a more rapid
onset . - ANS-A 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 ?
A ) Retinal blood vessel damage
B ) Glaucoma
C ) Cranial nerve damage
D ) Hypertensive emergency
Ans : A
Feedback : diagnosis of risk for ineffective health The most appropriate expected
outcome for a patient who is given the nursing maintenance is that he or she takes the
are valid aspects of care , but none directly relates to the patients role in his medication
as prescribed . The other listed goals or her treatment regimen . - ANS-A 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 patients care , what desired
outcome should the nurse identify ?
A ) Patient takes medication as prescribed and reports any adverse effects .
B ) Patients BP remains consistently below 140/90 mm Hg .
C ) Patient denies signs and symptoms of hypertensive urgency .
D ) Patient is able to describe modifiable risk factors for hypertension .
Ans : A
Feedback : Obesity , stress , high intake of sodium or saturated fat , and family history
are all risk factors for primary hypertension . Diabetes and oral contraceptives are risk
,factors for secondary hypertension . Metabolic syndrome , renal disease , and
coarctation of the aorta are causes of secondary hypertension . - ANS-A nurse is
teaching an adult female patient about the risk factors for hypertension . What should
the nurse explain as risk factors for primary hypertension ?
A ) Obesity and high intake of sodium and saturated fat
B ) Diabetes and use of oral contraceptives
C ) Metabolic syndrome and smoking
D ) Renal disease and coarctation of the aorta
Ans : A
Feedback : Patients who experience postural hypotension should be taught to rise
slowly from a lying or sitting position and use a cane or walker if necessary for safety . It
is not necessary to teach these patients about increasing fluids or taking medication in
the morning ( this would increase the effects of dizziness ) . Patient should not be taught
to stop the medication if dizziness persists because this is unsafe and beyond the
nurses scope of practice . - ANS-10. A 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 ?
A) Rising slowly from a lying or sitting position
B) Increasing fluids to maintain BP
C) Stopping medication if dizziness persists
D) Taking medication first thing in the morning w
Ans : A
Feedback : Prior to the nurse assessing the patients BP , the patient should try to rest
quietly for 5 minutes . The forearm should be positioned at heart level . Caffeine
products and cigarette smoking should be avoided for at least 30 minutes prior to the
visit . Recent fluid intake is not normally relevant . - ANS-A 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 ?
A ) Tried to rest quietly for 5 minutes before the reading is taken
B ) Refrained from smoking for at least 8 hours
C ) Drunk adequate fluids during the day prior
D ) Avoided drinking coffee for 12 hours before the visit
, Ans : A
Feedback : Pubill Dietary sodium intake of no more than 2.4 g sodium is recommended
as a dietary lifestyle modification to prevent and manage hypertension . Giving a
specific amount of allowable sodium intake makes this a measurable goal . None of the
other listed goals is quantifiable and measurable . - ANS-The 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 ?
A ) Patient will reduce Nat intake to no more than 2.4 g daily .
B ) Patient will have a stable BUN and serum creatinine levels .
C ) Patient will abstain from fat intake and reduce calorie intake .
D ) Patient will maintain a normal body weight .
Ans : A
Feedback : Secondary hypertension has a specific identified cause . A cause could
include narrowing of the renal arteries , renal parenchymal disease ,
hyperaldosteronism , certain medications , pregnancy , and coarctation of the aorta .
Secondary hypertension does respond to antihypertensive drug therapy and can cause
target organ damage if left untreated . - ANS-A patient with secondary hypertension has
come into the clinic for a routine check up . The nurse is aware that the difference
secondary hypertension is which of the following ? between primary hypertension and
A ) Secondary hypertension has a specific cause .
B ) Secondary hypertension has a more gradual onset than primary hypertension .
C ) Secondary hypertension does not cause target organ damage .
D ) Secondary hypertension does not normally respond to antihypertensive drug
therapy .
Ans : A
Feedback : When uncontrolled hypertension is prolonged , it can result in renal failure ,
myocardial infarction , stroke , impaired vision , left ventricular hypertrophy , and cardiac
failure . Glaucoma and anemia are not directly associated with hypertension . - ANS-A
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 ?
A ) Renal failure
B ) Right ventricular hypertrophy
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