A patient with primary hypertension complains of dizziness with ambulation.

The patient is
currently on an alpha-adrenergic blocker and the nurse assesses characteristic signs and
symptoms of postural hypotension. When teaching this patient about risks associated with
postural hypotension, what should the nurse emphasize?

Select one:
a. Taking medication first thing in the morning
b. Increasing fluids to maintain BP
c. Rising slowly from a lying or sitting position
d. Stopping medication if dizziness persists

Question 2
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A nurse is teaching an adult female patient about the risk factors for hypertension. What
should the nurse explain as risk factors for primary hypertension?

Select one:
a. Diabetes and use of oral contraceptives
b. Obesity and high intake of sodium and saturated fat
c. Renal disease and coarctation of the aorta
d. Metabolic syndrome and smoking

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The nursing lab instructor is teaching student nurses how to take blood pressure. To ensure
accurate measurement, the lab instructor would teach the students to avoid which of the
following actions?

Select one:
a. Using a bare forearm supported at heart level on a firm surface
b. Using a cuff with a bladder that encircles at least 80% of the limb
c. Taking the BP at least 10 minutes after nicotine or coffee ingestion
d. Measuring the BP after the patient has been seated quietly for more than 5 minutes

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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?

Select one:
a. Closer adherence to medical regimen
b. Hyperlipidemia
c. A family history of hypertension
d. Excessive alcohol intake

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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?

Select one:
a. Tobacco use increases the patient's concurrent risk of heart disease.
b. Quitting smoking will cause the patient's hypertension to resolve.
c. Tobacco use causes ventricular hypertrophy.
d. Tobacco use is associated with a sedentary lifestyle.

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The nurse is providing care for a patient with a diagnosis of hypertension. The nurse should
consequently assess the patient for signs and symptoms of which other health problem?

Select one:
a. Atherosclerosis
b. Atrial-septal defect
c. Migraines
d. Thrombocytopenia

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A patient newly diagnosed with hypertension asks the nurse what happens when
uncontrolled hypertension is prolonged. The nurse explains that a patient with prolonged,
uncontrolled hypertension is at risk for developing what health problem?
Select one:
a. Anemia
b. Glaucoma
c. Renal failure
d. Right ventricular hypertrophy

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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?

Select one:
a. Glaucoma
b. Retinal blood vessel damage
c. Cranial nerve damage
d. Hypertensive emergency

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A patient with secondary hypertension has come into the clinic for a routine check-up. The
nurse is aware that the difference between primary hypertension and secondary
hypertension is which of the following?

Select one:
a. Secondary hypertension does not normally respond to antihypertensive drug therapy.
b. Secondary hypertension has a specific cause.
c. Secondary hypertension does not cause target organ damage.
d. Secondary hypertension has a more gradual onset than primary hypertension.

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The staff educator is teaching ED nurses about hypertensive crisis. The nurse educator
should explain that hypertensive urgency differs from hypertensive emergency in what way?

Select one:
a. Hypertensive emergencies are associated with evidence of target organ damage.
b. The BP is always higher in a hypertensive emergency.
c. Hypertensive urgency is treated with rest and benzodiazepines to lower BP.
d. Vigilant hemodynamic monitoring is required during treatment of hypertensive
emergencies.

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The nurse is planning the care of a patient who has been diagnosed with hypertension, but
who otherwise enjoys good health. When assessing the response to an antihypertensive
drug regimen, what blood pressure would be the goal of treatment?

Select one:
a. Average of 2 BP readings of 150/80 mm Hg
b. 120/80 mm Hg or lower
c. 156/96 mm Hg or lower
d. 140/90 mm Hg or lower

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A patient in a hypertensive emergency is admitted to the ICU. The nurse anticipates that the
patient will be treated with IV vasodilators, and that the primary goal of treatment is what?

Select one:
a. Reduce the BP to R 120/75 mm Hg as quickly as possible.
b. Lower the BP to reduce onset of neurologic symptoms, such as headache and vision
changes.
c. Decrease the mean arterial pressure between 20% and 25% in the first hour of treatment.
d. Decrease the BP to a normal level based on the patient's age.

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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?

Select one:
a. Increasing fluids to avoid extracellular volume depletion from the diuretic effect of the
beta-blocker
b. Use of strategies to prevent falls stemming from postural hypotension
c. Maintaining a diet high in dairy to increase protein necessary to prevent organ damage
d. Limiting exercise to avoid injury that can be caused by increased intracranial pressure

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The nurse is caring for an older adult with a diagnosis of hypertension who is being treated
with a diuretic and beta-blocker. Which of the following should the nurse integrate into the
management of this client's hypertension?

Select one:
a. Pay close attention to hydration status because of increased sensitivity to extracellular
volume depletion.
b. Carefully assess for weight loss because of impaired kidney function resulting from
normal aging.
c. Recognize that an older adult is less likely to adhere to his or her medication regimen
than a younger patient.
d. Ensure that the patient receives a larger initial dose of antihypertensive medication due to
impaired absorption.

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The nurse is developing a nursing care plan for a patient who is being treated for
hypertension. What is a measurable patient outcome that the nurse should include?

Select one:
a. Patient will reduce Na+ intake to no more than 2.4 g daily.
b. Patient will have a stable BUN and serum creatinine levels.
c. Patient will maintain a normal body weight.
d. Patient will abstain from fat intake and reduce calorie intake.

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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?

Select one:
a. "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."
b. "You have no need to worry. Your pressure is probably elevated because you are being
tested."
c. "Yes. Hypertension is prevalent among men; it is fortunate we caught this during your
routine examination."
d. "We will need to reevaluate your blood pressure because your age places you at high risk
for hypertension."

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The nurse is providing care for a patient with a new diagnosis of hypertension. How can the
nurse best promote the patient's adherence to the prescribed therapeutic regimen?

Select one:
a. Emphasize the dire health outcomes associated with inadequate BP control.
b. Encourage the patient to lose weight and exercise regularly.
c. Screen the patient for visual disturbances regularly.
d. Have the patient participate in monitoring his or her own BP.

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A patient has come to the clinic for a follow-up assessment that will include a BP reading. To
ensure an accurate reading, the nurse should confirm that the patient has done which of the
following?

Select one:
a. Refrained from smoking for at least 8 hours
b. Tried to rest quietly for 5 minutes before the reading is taken
c. Drunk adequate fluids during the day prior
d. Avoided drinking coffee for 12 hours before the visit

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A patient has been prescribed antihypertensives. After assessment and analysis, the nurse
has identified a nursing diagnosis of risk for ineffective health maintenance related to
nonadherence to therapeutic regimen. When planning this patient's care, what desired
outcome should the nurse identify?

Select one:
a. Patient is able to describe modifiable risk factors for hypertension.
b. Patient's BP remains consistently below 140/90 mm Hg.
c. Patient denies signs and symptoms of hypertensive urgency.
d. Patient takes medication as prescribed and reports any adverse effects.

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The nurse is assessing a patient new to the clinic. Records brought to the clinic with the
patient show the patient has hypertension and that her current BP readings approximate the
readings from when she was first diagnosed. What contributing factor should the nurse first
explore in an effort to identify the cause of the client's inadequate BP control?

Select one:
a. Possibility of medication interactions
b. Progressive target organ damage
c. Possible heavy alcohol use or use of recreational drug
d. Lack of adherence to prescribed drug therapy