NUR 390 EXAM 2 BLUEPRINT FOR SUMMER | COMPREHENSIVE STUDY GUIDE, NCLEX-STYLE
PRACTICE QUESTIONS AND ANSWERS 2026/2027
Module 5: Hypertension (HTN)
Dietary Guidelines for Clients with Hypertension
Emphasizes a diet rich in fruits, vegetables, whole grains, legumes, seeds, nuts, fish, and
low-fat dairy.
Recommends reducing intake of meat, sweets, and alcohol to manage blood pressure
(BP).
Highlights the DASH diet (Dietary Approaches to Stop Hypertension) which promotes
high fiber, calcium, and potassium intake.
Advises limiting sodium intake to <2000 mg initially, transitioning to <1500 mg for
maximum benefit.
Research indicates that individuals on the DASH diet can lower their BP within 2 weeks.
Hypertension Classification and Risks
Blood Pressure Categories: Normal (<120/<80), Elevated (120-129/<80), Stage 1 (130-
139/80-89), Stage 2 (≥140/≥90).
Uncontrolled hypertension can lead to serious health risks including myocardial
infarction (MI), stroke, and heart failure.
Other complications include kidney damage, eye damage, and cognitive issues such as
vascular dementia.
Emphasizes the importance of regular monitoring and management of BP to prevent
organ damage.
Client Teaching and Management Strategies
Encourage maintaining a healthy body weight and engaging in 30 minutes of exercise
most days.
Recommend resistance training and cessation of tobacco and alcohol use.
Stress the importance of managing chronic conditions like diabetes and high cholesterol.
Suggest stress management techniques and adherence to prescribed drug therapy.
, Important Lab Findings for Hypertension
Monitor potassium levels (normal range: 3.5-5.0) and creatinine levels (>1.3 indicates
potential kidney issues).
Report abnormal protein levels in urine (>30 mg) as it may indicate muscle breakdown.
Ensure all lab results are within normal limits (WNL) to assess overall health status.
Hypertensive Crisis: Nursing Assessment and Findings
Recognize hypertensive crisis as systolic BP >180 and/or diastolic BP >120.
Assess for evidence of target organ disease, which may include symptoms like headache,
nausea, and confusion.
Identify potential causes such as non-adherence to medications, drug use, or acute
medical events (e.g., stroke, MI).
Prioritize assessment of symptoms like blurred vision, chest pain, and dyspnea.
Module 5: Arrhythmias
Management of Bradycardia and Tachycardia
Bradycardia: Defined as a heart rate <60 bpm with a normal QRS complex. Treatment
includes stopping or reducing medications and administering IV atropine.
Tachycardia: Sinus tachycardia is defined as a heart rate of 101-180 bpm. Management
may involve pain management and the use of beta blockers or calcium channel blockers
(CCBs).
AV Blocks and Atrial Fibrillation (AFIB)
1st Degree AV Block: Monitor as it is non-life-threatening; characterized by a prolonged
PR interval (>0.2 seconds).
2nd Degree AV Block: Asymptomatic cases require monitoring; symptomatic cases may
need atropine or temporary pacing.
AFIB: The goal is to decrease ventricular response to <100 bpm and reduce stroke risk.
Treatment options include calcium blockers, beta blockers, and anticoagulation therapy
if AFIB persists for >48 hours.
Premature Ventricular Contractions (PVC) and Atrial Flutter
PVC: Characterized by a premature QRS complex that is wide and distorted. Often
associated with stimulants and can be caused by exercise or emotional distress.
PRACTICE QUESTIONS AND ANSWERS 2026/2027
Module 5: Hypertension (HTN)
Dietary Guidelines for Clients with Hypertension
Emphasizes a diet rich in fruits, vegetables, whole grains, legumes, seeds, nuts, fish, and
low-fat dairy.
Recommends reducing intake of meat, sweets, and alcohol to manage blood pressure
(BP).
Highlights the DASH diet (Dietary Approaches to Stop Hypertension) which promotes
high fiber, calcium, and potassium intake.
Advises limiting sodium intake to <2000 mg initially, transitioning to <1500 mg for
maximum benefit.
Research indicates that individuals on the DASH diet can lower their BP within 2 weeks.
Hypertension Classification and Risks
Blood Pressure Categories: Normal (<120/<80), Elevated (120-129/<80), Stage 1 (130-
139/80-89), Stage 2 (≥140/≥90).
Uncontrolled hypertension can lead to serious health risks including myocardial
infarction (MI), stroke, and heart failure.
Other complications include kidney damage, eye damage, and cognitive issues such as
vascular dementia.
Emphasizes the importance of regular monitoring and management of BP to prevent
organ damage.
Client Teaching and Management Strategies
Encourage maintaining a healthy body weight and engaging in 30 minutes of exercise
most days.
Recommend resistance training and cessation of tobacco and alcohol use.
Stress the importance of managing chronic conditions like diabetes and high cholesterol.
Suggest stress management techniques and adherence to prescribed drug therapy.
, Important Lab Findings for Hypertension
Monitor potassium levels (normal range: 3.5-5.0) and creatinine levels (>1.3 indicates
potential kidney issues).
Report abnormal protein levels in urine (>30 mg) as it may indicate muscle breakdown.
Ensure all lab results are within normal limits (WNL) to assess overall health status.
Hypertensive Crisis: Nursing Assessment and Findings
Recognize hypertensive crisis as systolic BP >180 and/or diastolic BP >120.
Assess for evidence of target organ disease, which may include symptoms like headache,
nausea, and confusion.
Identify potential causes such as non-adherence to medications, drug use, or acute
medical events (e.g., stroke, MI).
Prioritize assessment of symptoms like blurred vision, chest pain, and dyspnea.
Module 5: Arrhythmias
Management of Bradycardia and Tachycardia
Bradycardia: Defined as a heart rate <60 bpm with a normal QRS complex. Treatment
includes stopping or reducing medications and administering IV atropine.
Tachycardia: Sinus tachycardia is defined as a heart rate of 101-180 bpm. Management
may involve pain management and the use of beta blockers or calcium channel blockers
(CCBs).
AV Blocks and Atrial Fibrillation (AFIB)
1st Degree AV Block: Monitor as it is non-life-threatening; characterized by a prolonged
PR interval (>0.2 seconds).
2nd Degree AV Block: Asymptomatic cases require monitoring; symptomatic cases may
need atropine or temporary pacing.
AFIB: The goal is to decrease ventricular response to <100 bpm and reduce stroke risk.
Treatment options include calcium blockers, beta blockers, and anticoagulation therapy
if AFIB persists for >48 hours.
Premature Ventricular Contractions (PVC) and Atrial Flutter
PVC: Characterized by a premature QRS complex that is wide and distorted. Often
associated with stimulants and can be caused by exercise or emotional distress.
