Hypertension: Chapter 18, Care of Patients with Hypertension and Peripheral Vascular Disease

Question 1 of 9

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Which diagnosis would the nurse expect for a patient who has had three occasions of systolic blood pressure of 130 to 139 mm Hg and diastolic blood pressure of 85 to 89 mm Hg?

• • Stage 2 hypertensionThese readings are too low to be considered stage 2 hypertension.
• • Primary hypertensionPrimary hypertension is the term that applies when no underlying cause for high blood pressure can be established.
• Correct
  • High-normal blood pressureHigh-normal blood pressure is diagnosed in adults when two or more readings on at least two subsequent visits are a systolic of 130 to 139 mm Hg and diastolic of 80 to 89 mm Hg.
• • Normal blood pressureNormal blood pressure is considered systolic <130 mm Hg and diastolic <85 mm Hg.

Question 2 of 9

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Which report made by a 58-year-old male patient is a possible symptom of hypertension?

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  • “My vision is a little blurry.”Patients often have no signs or symptoms until the later stages of hypertension. Signs and symptoms include headache, dizziness, blurred vision, blackouts, irritability, angina, dyspnea, and fatigue.
• • “I’m having some hearing problems.”Hearing problems are not directly associated with hypertension.
• • “My back seems stiff in the morning.”Back pain is not directly associated with hypertension.
• • “I’m not sleeping as well as I used to.”Sleep disturbances are not directly associated with hypertension.

Question 3 of 9

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For a patient with cardiovascular disease, which statement indicates a need for further teaching about ways to decrease sodium in the diet? Select all that apply. One, some, or all responses may be correct.

• Correct
  • “I will only eat catsup on my hot dogs.”The patient would need further teaching about increased sodium levels of certain foods because catsup and hot dogs can be high in sodium.
• • “I will use lemon pepper instead of salt.”The use of lemon pepper instead of salt is an action to reduce sodium.
• • “I will check soft drinks for sodium content.”Checking the sodium content of soft drinks is an action to reduce sodium.
• • “Buying frozen instead of canned foods is a better choice.”Buying frozen instead of canned foods is an action to reduce sodium.
• Correct
  • “Eating a turkey cold cut sandwich is a safe choice to reduce sodium.”The patient would need further teaching about increased sodium levels of certain foods because lunch meat (even turkey) can be high in sodium.

Question 4 of 9

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The nurse is caring for a patient prescribed a thiazide diuretic for hypertension. Which intervention is appropriate for this patient?

• • Track the patient’s weight weekly.Patients taking diuretics should monitor their weight daily, not weekly, to check the effectiveness of the medication.
• • Monitor for signs of hypoglycemia.The nurse should monitor the patient taking a thiazide diuretic for hyperglycemia, not hypoglycemia.
• • Administer the medication with dinner.Diuretics should be administered as early in the day as possible to prevent the need to urinate overnight.
• Correct
  • Provide quick assistance with urination.Patients taking diuretics often need to urinate quickly, so it is important for the nurse to provide assistance and answer call lights in a timely manner.

Question 5 of 9

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The nurse is providing discharge education to a patient newly prescribed a loop diuretic for hypertension. Which patient statement indicates understanding of the teaching?

• • “I will try to limit foods high in potassium in my diet.”Patients taking loop diuretics should increase their dietary intake of potassium because this type of medication can cause hypokalemia.
• Correct
  • “I will sit on the edge of the bed before standing up.”Patients taking loop diuretics should sit on the side of the bed for one minute before standing and change positions slowly to avoid orthostatic hypotension.
• • “This medication may cause my blood sugar to drop.”Loop diuretics may cause hyperglycemia, not hypoglycemia.
• • “Decreased hearing is a normal side effect of this drug.”Decreased hearing is a serious side effect of loop diuretics and should be reported to the provider immediately.

Question 6 of 9

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A patient newly prescribed hydralazine for hypertension asks the nurse how the medication works. Which statement by the nurse is correct?

• • “Water excretion is increased as urine with use of this drug.”Diuretics increase the excretion of water as urine to improve blood pressure.
• Correct
  • “Hydralazine dilates your vessels, which causes your blood pressure to drop.”Hydralazine is a direct-acting vasodilator, which causes blood vessels to dilate, resulting in decreased blood pressure.
• • “This drug inhibits kidney secretions, which results in a lower blood pressure.”Direct renin inhibitors act by inhibiting renin secretion from the kidneys, which reduces angiotensin I and angiotensin II, inhibiting vasoconstriction and lowering blood pressure.
• • “This medication blocks electrolyte reabsorption to decrease your blood pressure.”Certain diuretics block electrolyte reabsorption in the kidneys to decrease blood pressure.

Question 7 of 9

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The nurse is caring for a patient who presents to the emergency department with a severe headache and blurry vision. The patient’s blood pressure is 225/105 mm Hg. Which is the priority action by the nurse?

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  • Administer labetalol as ordered.The patient is presenting with hypertensive crisis, which warrants immediate treatment with labetalol.
• • Administer acetaminophen for the headache.The nurse may eventually administer medication for the headache, but attempts to lower the blood pressure should come first, which may improve the headache.
• • Plan to monitor the blood pressure every hour.The nurse would plan to monitor the patient’s blood pressure every 5 to 15 minutes because they have a hypertensive emergency.
• • Attempt to lower the blood pressure as quickly as possible.The goal for blood pressure reduction is 160/100 mm Hg in the first 2 hours, not as quickly as possible.

Question 8 of 9

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Which snack option is best for a patient taking furosemide?

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  • BananaA banana is a healthy option that is high in potassium. Because hypokalemia can occur with use of furosemide, it is important for the patient to consume enough potassium in the diet.
• • Potato chipsPotato chips are high in sodium, which should be avoided by patients taking loop diuretics.
• • Chocolate barChocolate contains caffeine, which should be limited in patients taking loop diuretics.
• • Turkey sandwichTurkey is high in sodium, which should be avoided by patients taking loop diuretics.

Question 9 of 9

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The nurse is educating a patient about complications of uncontrolled hypertension. Which complication would the nurse include in the teaching? Select all that apply. One, some, or all responses may be correct.

• Correct
  • RetinopathyHypertension damages the arteries of the eye, which can result in retinopathy.
• • Liver diseaseLiver disease is a not a complication of uncontrolled hypertension.
• Correct
  • Aortic aneurysmHypertension can cause damage to arteries, which can result in an aortic aneurysm.
• Correct
  • Hemorrhagic strokeWith high blood pressure, weakened areas in blood vessels may rupture, resulting in hemorrhagic stroke.
• Correct
  • Myocardial infarctionDamage to arteries from hypertension can result in myocardial infarction.