Medical-Surgical Nursing In Canada (3rd Edition) Chapter 35 exam 2023 with complete solution graded A+

A new patient is seen at an outpatient clinic for a routine health examination. During the patient's initial visit, which technique would the nurse use to assess the patient's blood pressure (BP)? a. Have the patient sit with the arm supported at heart level, and measure the BP in each arm first. b. Average all the BP readings obtained in both arms to establish a baseline BP for the patient. c. Measure the first BP with the patient lying supine, and repeat the measurement in 5 minutes in the opposite arm. d. Take additional measurements if there is a difference of more than 10 mm Hg between the first and second BP readings. - ANS: A To obtain the baseline BP, the patient's arm should be at the level of the heart. The BP is obtained in both arms; if there is a difference, the arm with the higher pressure should be used to monitor BP. REF: page 885, Table 35-13 The nurse assesses the risk factors for hypertension in a patient with high normal BP. Which risk factor would the nurse identify from the health history and advise the patient to change, in order to prevent hypertension? a. Little or no regular exercise b. No use of relaxation techniques c. High dietary intake of simple sugars d. Drinking wine with dinner once a week - ANS: A The recommendations for preventing hypertension include exercising aerobically for 30 minutes most days of the week. REF: page 873, Table 35-3 The nurse measures the BP of a 78-year-old patient and finds it to be 168/86 mm Hg in both arms. What will the nurse include in the teaching plan for this patient? a. Increased BP is a normal finding in older adults. b. Prehypertension indicates the need for lifestyle changes. c. It is important to address the increased BP.d. A high probability of kidney and heart disease exists. - ANS: C Although an increase in systolic BP (SBP) is a common finding in older adults, the recommendations for treating elevated BP are unchanged. An SBP of >140 mm Hg is a more important cardiovascular risk factor than diastolic BP (DBP) in individuals older than 50. The diagnosis of prehypertension indicates a systolic BP between 120 and 139 mm Hg and a DBP between 80 and 89 mm Hg. REF: page 884, Table 35-11 Why should the nurse teach a patient who is taking labetalol (Normodyne) for treatment of hypertension to change position slowly? a. The medication blocks the vasoconstrictive and sodium-retaining properties initiated by the presence of angiotensin. b. The medication paralyzes the smooth muscle of blood vessels, and they cannot constrict in response to sympathetic stimulation. c. The medication blocks the normal sympathetic nervous system response to position changes in vasoconstriction and increased heart rate. d. The medication blocks the movement of calcium into the cardiac cells, and cardiac output cannot increase in response to decreased BP. - ANS: C