MULTIPLE CHOICE
1. Which action would the nurse in the hypertension clinic take 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...
Harding: Lewis’s Medical -Surgical Nursing, 12th Edition MULTIPLE CHOICE 1. Which action would the nurse in the hypertension clinic take 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 measurement. 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) TOP: Nursing Process : Assessment MSC: NCLEX: Health Promotion and Maintenance 2. Which information about a patient newly diagnosed with elevated blood pressure is most important for the nurse to address with the patient? a. Low dietary fiber intake b. No regular physical exercise c. Drinks a beer with dinner every night d. Weight is 5 pounds above ideal weight ANS: B 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 does not increase the hypertension risk. DIF: Cognitive Level : Analyze (Analysis) TOP: Nursing Process : Planning MSC: NCLEX: Health Promotion and Maintenance 3. Which action would the nurse take when giving the first dose of oral labetalol to a patient hospitalized with hypertension? a. Encourage the use of hard candy to prevent dry mouth. b. Teach the patient that headaches often occur with this drug. c. Instruct the patient to call for help if heart palpitations occur. d. Ask the patient to request assistance before getting out of bed. ANS: D Labetalol decreases sympathetic nervous system activity by blocking both - and -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, 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 drinks low-fat milk with each meal. d. The patient has two cups of coffee in the morning. ANS: C Increased levels of dietary potassium and calcium are associated with lower BP. People with hypertension should receive adequate intake of these from food sources such as low-fat milk. Plant based and Mediterranean diets with increased fruit, nut, vegetable, legumes, and lean proteins from fish and vegetables decreases BP and mortality rates from cardiovascular disease. Caffeine intake or restriction and
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