KSA Hypertension Exam 2024 Expected Questions and Answers (Verified by Expert)

KSA Hypertension Exam 2024 Expected Questions and Answers (Verified by Expert) KSA Hypertension Exam 2024 Expected Questions and Answers (Verified by Expert) KSA Hypertension Exam 2024 Expected Questions and Answers (Verified by Expert) KSA Hypertension2024 Expected Questions and Answers (Verified by Expert) 1. The nurse teaches a 28-yr-old man newly diagnosed with hypertension about lifestyle modifications to reduce his blood pressure. Which patient statement requires reinforcement of teaching? - "I will avoid adding salt to my food during or after cooking." - "If I lose weight, I might not need to continue taking medications." - "I can lower my blood pressure by switching to smokeless tobacco." - "Diet changes can be as effective as taking blood pressure medications." ANS - "I can lower my blood pressure by switching to smokeless tobacco." Nicotine contained in tobacco products (smoking and chew) cause vasoconstriction and increase blood pressure. Persons with hypertension should restrict sodium to 1500 mg/day by avoiding foods high in sodium and not adding salt in preparation of food or at meals. Weight loss can decrease blood pressure between 5 to 20 mm Hg. Following dietary recommendations (e.g., the DASH diet) lowers blood pressure, and these decreases compare with those achieved with blood pressure-lowering medication. 2. The nurse supervises an unlicensed assistant personnel (UAP) who is taking the blood pressure of 58-yr-old obese female patient admitted with heart failure. Which action by the UAP will require the nurse to intervene? - Waiting 2 minutes after position changes to take orthostatic pressures - Deflating the blood pressure cuff at a rate of 8 to 10 mm Hg per second - Taking the blood pressure with the patient's arm at the level of the heart - Taking a forearm blood pressure because the largest cuff will not fit the patient's upper arm ANS - Deflating the blood pressure cuff at a rate of 8 to 10 mm Hg per second The cuff should be deflated at a rate of 2 to 3 mm Hg per second. The arm should be supported at the level of the heart for accurate blood pressure measurements. Using a cuff that is too small causes a falsely high reading and too large causes a falsely low reading. If the maximum size blood pressure cuff does not fit the upper arm, the forearm may be used. Orthostatic blood pressures should be taken within 1 to 2 minutes of repositioning the patient. 3. A 44-yr-old man is diagnosed with hypertension and receives a prescription for benazepril (Lotensin). After providing instruction, which statement by the patient indicates correct understanding? - "If I take this medication, I will not need to follow a special diet." - "It is normal to have some swelling in my face while taking this medication." - "I will need to eat foods such as bananas and potatoes that are high in potassium." - "If I develop a dry cough while taking this medication, I should notify my doctor." ANS - "If I develop a dry cough while taking this medication, I should notify my doctor." Benazepril is an angiotensin-converting enzyme inhibitor. The medication inhibits breakdown of bradykinin, which may cause a dry, hacking cough. Other adverse effects include hyperkalemia. Swelling in the face could indicate angioedema and should be reported immediately to the prescriber. Patients taking drug therapy for hypertension should also attempt lifestyle modifications to lower blood pressure such as a reduced-sodium diet. 4. A 67-yr-old woman with hypertension is admitted to the emergency depart- ment with a blood pressure of 234/148 mm Hg and was started on nitroprus- side (Nitropress). After one hour of treatment, the mean arterial blood pressure (MAP) is 55 mm Hg. Which nursing action is a priority? - Start an infusion of 0.9% normal saline at 100 mL/hr. - Maintain the current administration rate of the nitroprusside. - Request insertion of an arterial line for accurate blood pressure monitoring. - Stop the nitroprusside infusion and assess the patient for potential com- plications. ANS - Stop the nitroprusside infusion and assess the patient for potential complications. Nitroprusside is a potent vasodilator medication. A blood pressure of 234/118 mm Hg would have a calculated MAP of 177 mm Hg. Subtracting 25% (or 44 mm Hg) = 133 mm Hg. The initial treatment goal is to decrease MAP by no more than 25% within minutes to 1 hour. For this patient, the goal MAP would be approximately 133 mm Hg. Minimal MAP required to perfuse organs is around 60 to 65 mm Hg. Lowering the blood pressure too rapidly may decrease cerebral, coronary, or renal perfusion and could precipitate a stroke, myocardial infarction, or renal failure. The priority is to stop the nitroprusside infusion and then use fluids only if necessary to support restoration of MAP. 5. The nurse admits a 73-yr-old male patient with dementia for treatment of uncontrolled hypertension. The nurse will closely monitor for hypokalemia if the patient receives which medication? - Clonidine (Catapres) - Bumetanide (Bumex) - Amiloride (Midamor) - Spironolactone (Aldactone) ANS - Bumetanide (Bumex) Bumetanide is a loop diuretic. Hypokalemia is a common adverse effect of this medication. Amiloride is a potassium-sparing diuretic. Spironolactone is an aldos- terone-receptor blocker. Hyperkalemia is an adverse effect of both amiloride and spironolactone. Clonidine is a central-acting ±a-drenergic antagonist and does not cause electrolyte abnormalities. 6. The nurse teaches a patient with hypertension that uncontrolled hyperten- sion may damage organs in the body primarily by which mechanism? - Hypertension promotes atherosclerosis and damage to the walls of the arteries. - Hypertension causes direct pressure on organs, resulting in necrosis and replacement of cells with scar tissue. - Hypertension causes thickening of the capillary membranes, leading to hypoxia of organ systems. - Hypertension increases blood viscosity, which contributes to intravascular coagulation and tissue necrosis distal to occlusions. ANS - Hypertension promotes atherosclerosis and damage to the walls of the arteries. Hypertension is a major risk factor for the development of atherosclerosis by mech- anisms not yet fully known. However, when atherosclerosis develops, it damages the walls of arteries and reduces circulation to target organs and tissues. 7. When teaching a patient about dietary management of stage 1 hypertension, which instruction is most appropriate? - Increase water intake. - Restrict sodium intake. - Increase protein intake. - Use calcium supplements. ANS - Restrict sodium intake. The patient should decrease intake of sodium. This will help to control hypertension, which can be aggravated by excessive salt intake, which in turn leads to fluid retention. Protein intake does not affect hypertension. Calcium supplements are not recommended to lower blood pressure. 8. In caring for a patient admitted with poorly controlled hypertension, which laboratory test result should the nurse understand as indicating the presence of target organ damage? - Serum uric acid of 3.8 mg/dL - Serum creatinine of 2.6 mg/dL - Serum potassium of 3.5 mEq/L - Blood urea nitrogen of 15 mg/dL ANS - Serum creatinine of 2.6 mg/dL The normal serum creatinine level is 0.6 to 1.3 mg/dL. This elevated level indicates target organ damage to the kidneys. The other laboratory results are within normal limits. 9. When providing dietary instruction to a patient with hypertension, the nurse would advise the patient to restrict intake of which meat? - Broiled fish - Roasted duck - Roasted turkey - Baked chicken breast ANS - Roasted duck Roasted duck is high in fat, which should be avoided by the patient with hypertension. Weight loss may slow the progress of atherosclerosis and overall cardiovascular disease risk. The other meats are lower in fat and are therefore acceptable in the diet.