A nurse takes a 40-year-old client's blood pressure in the doctor's office during a routine follow up for a blood pressure check. The client's systolic pressure is 160 and the diastolic is 90. What type of hypertension is the client exhibiting if this is the third result at this level?

Correct Answer: A

Rationale: The correct answer is A) Stage 2 hypertension. In this scenario, the client's blood pressure reading of 160/90 falls into the Stage 2 hypertension category according to the American Heart Association guidelines. Stage 2 hypertension is characterized by a systolic pressure of 140 mmHg or higher and a diastolic pressure of 90 mmHg or higher. This level of hypertension indicates a significantly elevated blood pressure that requires intervention to prevent complications such as heart disease, stroke, and kidney damage. Option B) Prehypertension is incorrect because the client's blood pressure reading exceeds the range for prehypertension, which typically falls between 120-139/80-89 mmHg. Option C) Stage 1 hypertension is also incorrect as the client's blood pressure exceeds the criteria for Stage 1 hypertension, which is defined as a systolic pressure of 130-139 mmHg or a diastolic pressure of 80-89 mmHg. Option D) Hypertensive heart disease is not the correct answer as it refers to a condition where long-standing high blood pressure leads to complications in the heart, such as left ventricular hypertrophy or heart failure. While the client may be at risk for hypertensive heart disease if their hypertension is not managed, the blood pressure reading provided does not specifically indicate this condition. Educationally, understanding the classification of hypertension levels is essential for healthcare professionals to accurately assess and manage patients' blood pressure readings. Recognizing the various stages of hypertension helps guide treatment decisions and interventions to reduce the risk of complications associated with high blood pressure. Regular monitoring and appropriate management of hypertension are crucial in promoting cardiovascular health and preventing adverse outcomes.

Correct Answer: B

Rationale: In this scenario, the correct answer is B) increased central venous pressure. When distended jugular veins are observed in a patient in a supine position, it is indicative of increased pressure in the central venous system. This can be due to various conditions such as fluid overload, right-sided heart failure, or pulmonary hypertension. Option A, decreased venous return, is incorrect as distended jugular veins actually suggest the opposite - a problem with venous blood returning to the heart effectively. Option C, increased pulmonary artery capillary pressure, is not directly related to the visible distended jugular veins. Option D, left-sided heart failure, typically presents with pulmonary congestion and edema rather than distended jugular veins. Educationally, understanding the significance of jugular vein distension is crucial for nurses and healthcare providers in assessing and managing patients with cardiovascular issues. Recognizing this clinical sign can prompt further diagnostic evaluations and appropriate interventions to address the underlying cause of increased central venous pressure.

Correct Answer: B

Rationale: The correct answer is B) clarifying when cardiac rehabilitation will begin. This option demonstrates effective understanding of discharge teaching following coronary artery bypass surgery because cardiac rehabilitation is a crucial component of recovery. It helps patients improve cardiovascular health, increase physical activity, and learn about heart-healthy habits. By asking about the timing of cardiac rehabilitation, the patient shows awareness of the importance of structured exercise and education in their recovery process. Option A is incorrect because smoking, even one cigarette per day, is detrimental to cardiovascular health and can impede the healing process post-surgery. Option C is incorrect because relaxing in a hot tub can increase the heart rate and blood pressure, which may not be safe during the initial recovery period. Option D is incorrect because driving too soon after surgery can pose a risk to the patient's safety and hinder the healing process. In an educational context, it is important for patients post-coronary artery bypass surgery to be well-informed about their discharge instructions to ensure a successful recovery. Understanding the role of cardiac rehabilitation, following a heart-healthy lifestyle, and adhering to restrictions are vital for optimal outcomes. Patients should be encouraged to ask questions and seek clarification on any aspect of their care to promote their well-being.

Correct Answer: D

Rationale: In this scenario, the correct answer is option D) The man, because his cholesterol-to-HDL ratio is higher. This is the highest cardiac risk factor among the given options. The cholesterol-to-HDL ratio is a strong predictor of cardiovascular risk as it reflects the balance between "bad" (LDL) and "good" (HDL) cholesterol levels. A higher ratio indicates a higher risk of cardiovascular disease. Option A is incorrect because while low HDL is a risk factor, the ratio is a more comprehensive indicator. Option B is incorrect because having higher HDL is actually beneficial for cardiovascular health. Option C is also incorrect as total cholesterol alone does not provide the full picture of cardiac risk. Educationally, this question highlights the importance of considering multiple factors when assessing cardiovascular risk. It emphasizes the significance of not only individual lipid values but also their ratios in determining a patient's risk profile. Understanding these concepts is crucial for healthcare providers in making informed decisions regarding patient care and risk management strategies.

Correct Answer: D

Rationale: In the management of a patient with hypertensive urgency, the nursing responsibility often includes instructing the patient to follow up with a healthcare professional within 24 hours after outpatient treatment (Option D). This is the correct answer because patients with hypertensive urgency require close monitoring and follow-up to ensure their condition is properly managed and any potential complications are addressed promptly. Option A is incorrect because hourly urine output monitoring is not typically a primary nursing responsibility in managing hypertensive urgency. Option B is also incorrect as titration of IV drug dosages every 2 to 3 minutes is too frequent and not standard practice in this scenario. Option C is not a primary nursing responsibility as continuous ECG monitoring is not typically required for the management of hypertensive urgency. Educationally, it is important for nurses to understand the appropriate interventions and follow-up care required for patients with hypertensive urgency to prevent complications. By instructing patients to follow up within 24 hours, nurses ensure continuity of care, medication adherence, and the early detection of any worsening symptoms, contributing to better patient outcomes.