Ch 32 - Hypertension - Med-Surg Nursing
st st st st st st
Whichstactionstwillstthestnursestinstthesthypertensionstclinicsttakesttostobtainstanst
accuratestbaseline
bloodstpressurest(BP)stforstastnewstpatient?
a.stDeflatestthestBPstcuffstatstastratestofst5sttost10stmmstHgstperstsecond.
b.stHavestthestpatientstsitstinstastchairstwithstthestfeetstflatstonstthestfloor.
c.stAssiststthestpatientsttostthestsupinestpositionstforstBPstmeasurements.
d.stObtainsttwostBPstreadingsstinstthestdominantstarmstandstaveragestthestresults.s
t-stcorrectstanswer✔ ✔ ANS:stB
Thestpatientstshouldstbestseatedstwithstthestfeetstflatstonstthestfloor.stThestBPstissto
btainedstinstbothstarms,
andstthestresultsstofstthesttwostarmsstarestnotstaveraged.stThestpatientstdoesstnotstn
eedsttostbestinstthestsupine
position.stThestcuffstshouldstbestdeflatedstatst2sttost3stmmstHgstperstsecond.
DIF:stCognitivestLevel:stUnderstandst(comprehension)stREF:st696
Thestnursestobtainsstthestfollowingstinformationstfromstastpatientstnewlystdiagn
osedstwith
prehypertension.stWhichstfindingstisstmoststimportantsttostaddressstwithstthestp
atient?
a.stLowstdietarystfiberstintake
,b.stNostregularstphysicalstexercise
c.stDrinksstastbeerstwithstdinnersteverystnight
d.stWeightstisst5stpoundsstabovestidealstweightst-stcorrectstanswer✔ ✔
ANS:stB
Thestrecommendationsstforstpreventingsthypertensionstincludestexercisingsta
erobicallystforst30
minutesstmoststdaysstofstthestweek.stAstweightstthatstisst5stpoundsstoverstthestidea
lstbodystweightstisstnotsta
riskstfactorstforsthypertension.stThestDietarystApproachessttostStopstHypertens
ionst(DASH)stdietstis
highstinstfiber,stbutstincreasingstfiberstalonestwillstnotstpreventsthypertensionstfr
omstdeveloping.stThe
patient'sstalcoholstintakestisstwithinstguidelinesstandstwillstnotstincreasestthesthy
pertensionstrisk.
DIF:stCognitivestLevel:stAnalyzest(analysis)stREF:st689
Whichstactionstshouldstthestnursesttakestwhenstgivingstthestinitialstdosestofstoralst
labetalolsttostastpatient
withsthypertension?
a.stEncouragestthestusestofsthardstcandysttostpreventstdrystmouth.
b.stTeachstthestpatientstthatstheadachesstoftenstoccurstwithstthisstdrug.
c.stInstructstthestpatientsttostcallstforsthelpstifstheartstpalpitationsstoccur.
, d.stAskstthestpatientsttostrequeststassistancestbeforestgettingstoutstofstbed.st-
stcorrectstanswer✔ ✔ ANS:stD
Labetalolstdecreasesstsympatheticstnervousstsystemstactivitystbystblockingstbo
thsta-standstb-
adrenergicstreceptors,stleadingsttostvasodilationstandstastdecreasestinstheartstrat
e,stwhichstcanstcause
severestorthostaticsthypotension.stHeartstpalpitations,stdrystmouth,stdehydrati
on,standstheadachesstare
possiblestsidesteffectsstofstotherstantihypertensives.
DIF:stCognitivestLevel:stApplyst(application)stREF:st692
Afterstthestnursestteachesstthestpatientstwithststagest1sthypertensionstaboutstdietst
modificationsstthat
shouldstbestimplemented,stwhichstdietstchoicestindicatesstthatstthestteachingstha
sstbeenstmoststeffective?
a.stThestpatientstavoidssteatingstnutsstorstnutstbutters.
b.stThestpatientstrestrictsstintakestofstchickenstandstfish.
c.stThestpatientstdrinksstlow-fatstmilkstwithsteachstmeal.
d.stThestpatientsthassttwostcupsstofstcoffeestinstthestmorning.st-stcorrectstanswer
✔ ✔ ANS:stC
Forstthestpreventionstofsthypertension,stthestDietarystApproachessttostStopstHy
pertensionst(DASH)
recommendationsstincludestincreasingstthestintakestofstcalcium-
richstfoods.stCaffeinestrestrictionstand
st st st st st st
Whichstactionstwillstthestnursestinstthesthypertensionstclinicsttakesttostobtainstanst
accuratestbaseline
bloodstpressurest(BP)stforstastnewstpatient?
a.stDeflatestthestBPstcuffstatstastratestofst5sttost10stmmstHgstperstsecond.
b.stHavestthestpatientstsitstinstastchairstwithstthestfeetstflatstonstthestfloor.
c.stAssiststthestpatientsttostthestsupinestpositionstforstBPstmeasurements.
d.stObtainsttwostBPstreadingsstinstthestdominantstarmstandstaveragestthestresults.s
t-stcorrectstanswer✔ ✔ ANS:stB
Thestpatientstshouldstbestseatedstwithstthestfeetstflatstonstthestfloor.stThestBPstissto
btainedstinstbothstarms,
andstthestresultsstofstthesttwostarmsstarestnotstaveraged.stThestpatientstdoesstnotstn
eedsttostbestinstthestsupine
position.stThestcuffstshouldstbestdeflatedstatst2sttost3stmmstHgstperstsecond.
DIF:stCognitivestLevel:stUnderstandst(comprehension)stREF:st696
Thestnursestobtainsstthestfollowingstinformationstfromstastpatientstnewlystdiagn
osedstwith
prehypertension.stWhichstfindingstisstmoststimportantsttostaddressstwithstthestp
atient?
a.stLowstdietarystfiberstintake
,b.stNostregularstphysicalstexercise
c.stDrinksstastbeerstwithstdinnersteverystnight
d.stWeightstisst5stpoundsstabovestidealstweightst-stcorrectstanswer✔ ✔
ANS:stB
Thestrecommendationsstforstpreventingsthypertensionstincludestexercisingsta
erobicallystforst30
minutesstmoststdaysstofstthestweek.stAstweightstthatstisst5stpoundsstoverstthestidea
lstbodystweightstisstnotsta
riskstfactorstforsthypertension.stThestDietarystApproachessttostStopstHypertens
ionst(DASH)stdietstis
highstinstfiber,stbutstincreasingstfiberstalonestwillstnotstpreventsthypertensionstfr
omstdeveloping.stThe
patient'sstalcoholstintakestisstwithinstguidelinesstandstwillstnotstincreasestthesthy
pertensionstrisk.
DIF:stCognitivestLevel:stAnalyzest(analysis)stREF:st689
Whichstactionstshouldstthestnursesttakestwhenstgivingstthestinitialstdosestofstoralst
labetalolsttostastpatient
withsthypertension?
a.stEncouragestthestusestofsthardstcandysttostpreventstdrystmouth.
b.stTeachstthestpatientstthatstheadachesstoftenstoccurstwithstthisstdrug.
c.stInstructstthestpatientsttostcallstforsthelpstifstheartstpalpitationsstoccur.
, d.stAskstthestpatientsttostrequeststassistancestbeforestgettingstoutstofstbed.st-
stcorrectstanswer✔ ✔ ANS:stD
Labetalolstdecreasesstsympatheticstnervousstsystemstactivitystbystblockingstbo
thsta-standstb-
adrenergicstreceptors,stleadingsttostvasodilationstandstastdecreasestinstheartstrat
e,stwhichstcanstcause
severestorthostaticsthypotension.stHeartstpalpitations,stdrystmouth,stdehydrati
on,standstheadachesstare
possiblestsidesteffectsstofstotherstantihypertensives.
DIF:stCognitivestLevel:stApplyst(application)stREF:st692
Afterstthestnursestteachesstthestpatientstwithststagest1sthypertensionstaboutstdietst
modificationsstthat
shouldstbestimplemented,stwhichstdietstchoicestindicatesstthatstthestteachingstha
sstbeenstmoststeffective?
a.stThestpatientstavoidssteatingstnutsstorstnutstbutters.
b.stThestpatientstrestrictsstintakestofstchickenstandstfish.
c.stThestpatientstdrinksstlow-fatstmilkstwithsteachstmeal.
d.stThestpatientsthassttwostcupsstofstcoffeestinstthestmorning.st-stcorrectstanswer
✔ ✔ ANS:stC
Forstthestpreventionstofsthypertension,stthestDietarystApproachessttostStopstHy
pertensionst(DASH)
recommendationsstincludestincreasingstthestintakestofstcalcium-
richstfoods.stCaffeinestrestrictionstand
