31 HYPERTENSION - BRUNNER EXAM QUESTIONS
AND ANSWERS 100% CORRECT!!
,1. An older adult is newly diagnosed with primary hypertension and has just been
started on a beta-blocker. The nurse's health education should include which of the
following?
A) Increasing fluids to avoid extracellular volume depletion from the diuretic effect of the
beta-blocker
B) Maintaining a diet high in dairy to increase protein necessary to prevent organ
damage
C) Use of strategies to prevent falls stemming from postural hypotension
D) Limiting exercise to avoid injury that can be caused by increased intracranial
pressure - ANSWER Ans: C
Feedback:
Elderly people have impaired cardiovascular reflexes and are more sensitive to
postural hypotension. The nurse teaches patients to change positions slowly when
moving from lying or sitting positions to a standing position, and counsels elderly
patients to use supportive devices as necessary to prevent falls that could result from
dizziness. Lifestyle changes, such as regular physical activity/exercise, and a diet rich in
fruits, vegetables, and low-fat dairy products, is strongly recommended. Increasing
fluids in elderly patients may be contraindicated due to cardiovascular disease.
Increased intracranial pressure is not a risk and activity should not normally be limited.
2. A patient with primary hypertension comes to the clinic complaining of a gradual
onset of blurry vision and decreased visual acuity over the past several weeks. The
nurse is aware that these symptoms could be indicative of what?
A) Retinal blood vessel damage
B) Glaucoma
C) Cranial nerve damage
D) Hypertensive emergency - ANSWER Ans: A
Feedback:
Blurred vision, spots in front of the eyes, and diminished visual acuity can mean retinal
blood vessel damage indicative of damage elsewhere in the vascular system as a result
of hypertension. Glaucoma and cranial nerve damage do not normally cause these
symptoms. A hypertensive emergency would have a more rapid onset.
3. A nurse is performing blood pressure screenings at a local health fair. While obtaining
subjective assessment data from a patient with hypertension, the nurse learns that the
patient has a family history of hypertension and she herself has high cholesterol and
lipid levels. The patient says she smokes one pack of cigarettes daily and drinks "about
a pack of beer" every day. The nurse notes what nonmodifiable risk factor for
hypertension?
A) Hyperlipidemia
, B) Excessive alcohol intake
C) A family history of hypertension
D) Closer adherence to medical regimen - ANSWER Ans: C
Feedback:
Unlike cholesterol levels, alcohol intake and adherence to treatment, family history is
not modifiable.
5. A group of student nurses are practicing taking blood pressure. A 56-year-old male
student has a blood pressure reading of 146/96 mm Hg. Upon hearing the reading, he
exclaims, "My pressure has never been this high. Do you think my doctor will prescribe
medication to reduce it?" Which of the following responses by the nursing instructor
would be best?
A) "Yes. Hypertension is prevalent among men; it is fortunate we caught this during your
routine examination."
B) "We will need to reevaluate your blood pressure because your age places you at
high risk for hypertension."
C) "A single elevated blood pressure does not confirm hypertension. You will need to
have your blood pressure reassessed several times before a diagnosis can be made."
D) "You have no need to worry. Your pressure is probably elevated because you are
being tested." - ANSWER Ans: C
Feedback:
Hypertension is confirmed by two or more readings with systolic pressure of at least
140 mm Hg and diastolic pressure of at least 90 mm Hg. An age of 56 does not
constitute a risk factor in and of itself. The nurse should not tell the student that there is
no need to worry.
6. A 40-year-old male newly diagnosed with hypertension is discussing risk factors with
the nurse. The nurse talks about lifestyle changes with the patient and advises that the
patient should avoid tobacco use. What is the primary rationale behind that advice to
the patient?
A) Quitting smoking will cause the patient's hypertension to resolve.
B) Tobacco use increases the patient's concurrent risk of heart disease.
C) Tobacco use is associated with a sedentary lifestyle.
D) Tobacco use causes ventricular hypertrophy. - ANSWER Ans: B
Feedback:
Smoking increases the risk for heart disease, for which a patient with hypertension is
already at an increased risk. Quitting will not necessarily cause hypertension to resolve
and smoking does not directly cause ventricular hypertrophy. The association with a
sedentary lifestyle is true, but this is not the main rationale for the nurse's advice; the
association with heart disease is more salient.
AND ANSWERS 100% CORRECT!!
,1. An older adult is newly diagnosed with primary hypertension and has just been
started on a beta-blocker. The nurse's health education should include which of the
following?
A) Increasing fluids to avoid extracellular volume depletion from the diuretic effect of the
beta-blocker
B) Maintaining a diet high in dairy to increase protein necessary to prevent organ
damage
C) Use of strategies to prevent falls stemming from postural hypotension
D) Limiting exercise to avoid injury that can be caused by increased intracranial
pressure - ANSWER Ans: C
Feedback:
Elderly people have impaired cardiovascular reflexes and are more sensitive to
postural hypotension. The nurse teaches patients to change positions slowly when
moving from lying or sitting positions to a standing position, and counsels elderly
patients to use supportive devices as necessary to prevent falls that could result from
dizziness. Lifestyle changes, such as regular physical activity/exercise, and a diet rich in
fruits, vegetables, and low-fat dairy products, is strongly recommended. Increasing
fluids in elderly patients may be contraindicated due to cardiovascular disease.
Increased intracranial pressure is not a risk and activity should not normally be limited.
2. A patient with primary hypertension comes to the clinic complaining of a gradual
onset of blurry vision and decreased visual acuity over the past several weeks. The
nurse is aware that these symptoms could be indicative of what?
A) Retinal blood vessel damage
B) Glaucoma
C) Cranial nerve damage
D) Hypertensive emergency - ANSWER Ans: A
Feedback:
Blurred vision, spots in front of the eyes, and diminished visual acuity can mean retinal
blood vessel damage indicative of damage elsewhere in the vascular system as a result
of hypertension. Glaucoma and cranial nerve damage do not normally cause these
symptoms. A hypertensive emergency would have a more rapid onset.
3. A nurse is performing blood pressure screenings at a local health fair. While obtaining
subjective assessment data from a patient with hypertension, the nurse learns that the
patient has a family history of hypertension and she herself has high cholesterol and
lipid levels. The patient says she smokes one pack of cigarettes daily and drinks "about
a pack of beer" every day. The nurse notes what nonmodifiable risk factor for
hypertension?
A) Hyperlipidemia
, B) Excessive alcohol intake
C) A family history of hypertension
D) Closer adherence to medical regimen - ANSWER Ans: C
Feedback:
Unlike cholesterol levels, alcohol intake and adherence to treatment, family history is
not modifiable.
5. A group of student nurses are practicing taking blood pressure. A 56-year-old male
student has a blood pressure reading of 146/96 mm Hg. Upon hearing the reading, he
exclaims, "My pressure has never been this high. Do you think my doctor will prescribe
medication to reduce it?" Which of the following responses by the nursing instructor
would be best?
A) "Yes. Hypertension is prevalent among men; it is fortunate we caught this during your
routine examination."
B) "We will need to reevaluate your blood pressure because your age places you at
high risk for hypertension."
C) "A single elevated blood pressure does not confirm hypertension. You will need to
have your blood pressure reassessed several times before a diagnosis can be made."
D) "You have no need to worry. Your pressure is probably elevated because you are
being tested." - ANSWER Ans: C
Feedback:
Hypertension is confirmed by two or more readings with systolic pressure of at least
140 mm Hg and diastolic pressure of at least 90 mm Hg. An age of 56 does not
constitute a risk factor in and of itself. The nurse should not tell the student that there is
no need to worry.
6. A 40-year-old male newly diagnosed with hypertension is discussing risk factors with
the nurse. The nurse talks about lifestyle changes with the patient and advises that the
patient should avoid tobacco use. What is the primary rationale behind that advice to
the patient?
A) Quitting smoking will cause the patient's hypertension to resolve.
B) Tobacco use increases the patient's concurrent risk of heart disease.
C) Tobacco use is associated with a sedentary lifestyle.
D) Tobacco use causes ventricular hypertrophy. - ANSWER Ans: B
Feedback:
Smoking increases the risk for heart disease, for which a patient with hypertension is
already at an increased risk. Quitting will not necessarily cause hypertension to resolve
and smoking does not directly cause ventricular hypertrophy. The association with a
sedentary lifestyle is true, but this is not the main rationale for the nurse's advice; the
association with heart disease is more salient.
