ATI LPN
Lewis's Medical Surgical Nursing in Canada, 5th Edition
Chapter 35 Questions
Question 1 of 5
Which of the following actions should the nurse in the hypertension clinic take in order to obtain an accurate baseline blood pressure (BP) for a new patient?
Correct Answer: C
Rationale: The patient should be seated to assess the initial BP and pulse. The BP is obtained in both arms, but the results of the two arms are not averaged. The patient does not need to be in the supine position. The cuff should be deflated at 2-3 mm Hg/second.
Question 2 of 5
The nurse obtains this information from a patient with pre-hypertension. Which of the following findings is most important to address with the patient?
Correct Answer: B
Rationale: The recommendations for preventing hypertension include exercising aerobically for 30-60 minutes four to seven days a week. A BMI of 23 kg/m^2 is within the normal BMI range. The Dietary Approaches to Stop Hypertension (DASH) diet is high in fibre, but increasing fibre alone will not prevent hypertension from developing. The patient's alcohol intake will not increase the hypertension risk.
Question 3 of 5
The nurse is caring for a patient with hypertension and has just administered the initial dose of labetalol. Which of the following actions should the nurse take?
Correct Answer: C
Rationale: Labetalol decreases sympathetic nervous system activity by blocking both ?±- and β-adrenergic receptors, leading to vasodilation and a decrease in heart rate, which can cause severe orthostatic hypotension. Heart palpitations, dehydration, and headaches are possible adverse effects of other antihypertensives.
Question 4 of 5
The nurse is teaching a patient with stage I hypertension about diet modifications that should be implemented. Which of the following diet choices indicates that the teaching has been effective?
Correct Answer: D
Rationale: The Dietary Approaches to Stop Hypertension (DASH) recommendations for prevention of hypertension include increasing the intake of calcium-rich foods. Caffeine restriction and decreased protein intake are not included in the recommendations. Nuts are high in beneficial nutrients and 4-5 servings weekly are recommended in the DASH diet.
Question 5 of 5
The nurse is caring for a patient who has just diagnosed with hypertension and has a new prescription for captopril. Which of the following information is important to include when teaching the patient?
Correct Answer: D
Rationale: The angiotensin-converting enzyme (ACE) inhibitors frequently cause orthostatic hypotension, and patients should be taught to change position slowly to allow the vascular system time to compensate for the position change. Increasing fluid intake may counteract the effect of the medication, and the patient is taught to use gum or hard candy to relieve dry mouth. The BP does not need to be checked at home by the patient before taking the medication. Because ACE inhibitors cause potassium retention, increased intake of high-potassium foods is inappropriate.