Chapter 19: Care of Patients with Hypertension and Peripheral Vascular Disease

Chapter 19: Care of Patients with Hypertension and Peripheral Vascular Disease

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. Hypertension is diagnosed by the finding of a blood pressure reading greater than:

a.	120/80 twice, 2 weeks apart.
b.	140/90 twice, 2 weeks apart.
c.	120/80 on 3 consecutive days.
d.	140/90 every day for a week.

 

 

ANS:  B

A diagnosis of hypertension is made if the systolic pressure is equal to or greater than 140 mm Hg and the diastolic pressure is equal to or greater than 90 mm Hg at least twice on two different occasions 2 weeks apart.

 

DIF:    Cognitive Level: Comprehension     REF:   398                OBJ:   10 (theory)

TOP:   Hypertension: Diagnosis                  KEY:  Nursing Process Step: Assessment

MSC:  NCLEX: Health Promotion and Maintenance

 

2. Because of reduced sensitivity of the baroreceptors in the older adult who is also on a diuretic, the nurse instructs the patient to:

a.	walk for 20 minutes a day.
b.	reduce sodium in the diet.
c.	sit on the side of the bed before standing.
d.	use a walker for all ambulation.

 

 

ANS:  C

Reduced sensitivity of the baroreceptors along with taking a diuretic predisposes the older adult to orthostatic hypotension; therefore, the nurse should caution the patient to change postures slowly to prevent becoming faint and falling.

 

DIF:    Cognitive Level: Application           REF:   400 | Elder Care Points

OBJ:   5 (clinical)      TOP:   Orthostatic Hypotension

KEY:  Nursing Process Step: Implementation

MSC:  NCLEX: Safe, Effective Care Environment: Safety and Infection Control

 

3. The home health nurse is alarmed that the hypertensive patient’s blood pressure has risen to 200/160, but he denies any discomfort. The nurse interprets these assessments as being indicative of:

a.	malignant hypertension.
b.	hypertensive crisis.
c.	essential hypertension.
d.	secondary hypertension.

 

 

ANS:  A

The diastolic pressure rising to readings between 140 and 170 and the patient being asymptomatic indicate malignant hypertension.

 

DIF:    Cognitive Level: Comprehension     REF:   401                OBJ:   3 (theory)

TOP:   Malignant Hypertension                  KEY:  Nursing Process Step: Assessment

MSC:  NCLEX: Physiological Integrity: Physiological Adaptation

 

4. The nurse adds an intervention to the care plan of a patient who has just been prescribed a thiazide diuretic, which is to increase:

a.	intake of foods containing potassium.
b.	carbohydrates in the diet.
c.	foods high in sodium.
d.	fluid intake.

 

 

ANS:  A

The thiazide diuretics are potent diuretics that flush out water, sodium, and potassium quickly. Potassium should be replaced, if not by prescription of oral potassium salts, then by modifying the diet.

 

DIF:    Cognitive Level: Application           REF:   402 | Table 19-3

OBJ:   3 (theory)       TOP:   Thiazide Diuretics

KEY:  Nursing Process Step: Planning

MSC:  NCLEX: Physiological Integrity: Pharmacological Therapies

 

5. The patient has been prescribed a low-sodium diet. Which food omissions from the diet will indicate the patient has an adequate understanding of the recommended diet?

a.	Fresh spinach
b.	Hot dogs
c.	Pasta
d.	Grapefruit

 

 

ANS:  B

Hot dogs and all other processed meats contain large amounts of sodium. Fresh fruits, vegetables, and pasta are allowed on a low-sodium diet.

 

DIF:    Cognitive Level: Application           REF:   405 | Nutrition Considerations

OBJ:   3 (theory)       TOP:   Low-Sodium Diet

KEY:  Nursing Process Step: Assessment   MSC:  NCLEX: Health Promotion and Maintenance