Medical-Surgical Nursing Chapter 32 TEST
BANK (HYPERTENSTION)
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?
A. "I will avoid adding salt to my food during or after cooking."
B."If I lose weight, I might not need to continue taking medications."
C. "I can lower my blood pressure by switching to smokeless tobacco."
D. "Diet changes can be as effective as taking blood pressure medications. - ANSC
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.
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?
A. Waiting 2 minutes after position changes to take orthostatic pressures
B. Deflating the blood pressure cuff at a rate of 8 to 10 mm Hg per second
C. Taking the blood pressure with the patient's arm at the level of the heart
D. Taking a forearm blood pressure because the larg - ANSB.
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.
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?
A. "If I take this medication, I will not need to follow a special diet."
B. "It is normal to have some swelling in my face while taking this medication."
C. "I will need to eat foods such as bananas and potatoes that are high in potassium."
D. "If I develop a dry cough while taking this medication, I s - ANSD.
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.
A 67-yr-old woman with hypertension is admitted to the emergency department with a blood
pressure of 234/148 mm Hg and was started on nitroprusside (Nitropress). After one hour of
treatment, the mean arterial blood pressure (MAP) is 55 mm Hg. Which nursing action is a
priority?
A. Start an infusion of 0.9% normal saline at 100 mL/hr.
B. Maintain the current administration rate of the nitroprusside.
C. Request insertion of an arterial line for accurate blood pressure monitoring.
D. Stop the nit - ANSD.
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.
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?
A. Clonidine (Catapres)
B. Bumetanide (Bumex)
C.Amiloride (Midamor)
D. Spironolactone (Aldactone) - ANSB.
Bumetanide is a loop diuretic. Hypokalemia is a common adverse effect of this medication.
Amiloride is a potassium-sparing diuretic. Spironolactone is an aldosterone-receptor blocker.
Hyperkalemia is an adverse effect of both amiloride and spironolactone. Clonidine is a
central-acting α-adrenergic antagonist and does not cause electrolyte abnormalities.
The nurse teaches a patient with hypertension that uncontrolled hypertension may damage
organs in the body primarily by which mechanism?
BANK (HYPERTENSTION)
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?
A. "I will avoid adding salt to my food during or after cooking."
B."If I lose weight, I might not need to continue taking medications."
C. "I can lower my blood pressure by switching to smokeless tobacco."
D. "Diet changes can be as effective as taking blood pressure medications. - ANSC
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.
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?
A. Waiting 2 minutes after position changes to take orthostatic pressures
B. Deflating the blood pressure cuff at a rate of 8 to 10 mm Hg per second
C. Taking the blood pressure with the patient's arm at the level of the heart
D. Taking a forearm blood pressure because the larg - ANSB.
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.
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?
A. "If I take this medication, I will not need to follow a special diet."
B. "It is normal to have some swelling in my face while taking this medication."
C. "I will need to eat foods such as bananas and potatoes that are high in potassium."
D. "If I develop a dry cough while taking this medication, I s - ANSD.
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.
A 67-yr-old woman with hypertension is admitted to the emergency department with a blood
pressure of 234/148 mm Hg and was started on nitroprusside (Nitropress). After one hour of
treatment, the mean arterial blood pressure (MAP) is 55 mm Hg. Which nursing action is a
priority?
A. Start an infusion of 0.9% normal saline at 100 mL/hr.
B. Maintain the current administration rate of the nitroprusside.
C. Request insertion of an arterial line for accurate blood pressure monitoring.
D. Stop the nit - ANSD.
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.
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?
A. Clonidine (Catapres)
B. Bumetanide (Bumex)
C.Amiloride (Midamor)
D. Spironolactone (Aldactone) - ANSB.
Bumetanide is a loop diuretic. Hypokalemia is a common adverse effect of this medication.
Amiloride is a potassium-sparing diuretic. Spironolactone is an aldosterone-receptor blocker.
Hyperkalemia is an adverse effect of both amiloride and spironolactone. Clonidine is a
central-acting α-adrenergic antagonist and does not cause electrolyte abnormalities.
The nurse teaches a patient with hypertension that uncontrolled hypertension may damage
organs in the body primarily by which mechanism?
