Chapter 33: Nursing Management: Hypertension

Chapter 33: Nursing Management: Hypertension

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

MULTIPLE CHOICE
1. Which action will the nurse in the hypertension clinic take in order to obtain an accurate
baseline blood pressure (BP) for a new patient?
a. Obtain a BP reading in each arm and average the results.
b. Deflate the BP cuff at a rate of 5 to 10 mm Hg per second.
c. Have the patient sit in a chair with the feet flat on the floor.
d. Assist the patient to the supine position for BP measurements.
ANS: C
The patient should be seated with the feet flat on the floor. 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 to 3 mm Hg per second.
DIF: Cognitive Level: Comprehension REF: 754
TOP: Nursing Process: Assessment MSC: NCLEX: Health Promotion and Maintenance
2. The nurse obtains this information from a patient with prehypertension. Which finding is
most important to address with the patient?
a. Low dietary fiber intake
b. No regular aerobic exercise
c. Weight 5 pounds above ideal weight
d. Drinks wine with dinner once a week
ANS: B
The recommendations for preventing hypertension include exercising aerobically for 30
minutes most days of the week. A weight that is 5 pounds over the ideal body weight is
not a risk factor for hypertension. The Dietary Approaches to Stop Hypertension (DASH)
diet is high in fiber, but increasing fiber alone will not prevent hypertension from
developing. The patient’s alcohol intake will not increase the hypertension risk.
DIF: Cognitive Level: Application REF: 745-746 TOP: Nursing Process:
Planning
MSC: NCLEX: Health Promotion and Maintenance
3. After giving a patient the initial dose of oral labetalol (Normodyne) for treatment of
hypertension, which action should the nurse take?
a. Encourage oral fluids to prevent dry mouth or dehydration.
b. Instruct the patient to ask for help if heart palpitations occur.
c. Ask the patient to request assistance when getting out of bed.
d. Teach the patient that headaches may occur with this medication.
ANS: C
Test Bank 33-2
Labetalol decreases sympathetic nervous system activity by blocking both α- 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 side effects of other antihypertensives.
DIF: Cognitive Level: Application REF: 748-751
TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity
4. After the nurse teaches the patient with stage 1 hypertension about diet modifications that
should be implemented, which diet choice indicates that the teaching has been effective?
a. The patient avoids eating nuts or nut butters.
b. The patient restricts intake of dietary protein.
c. The patient has only one cup of coffee in the morning.
d. The patient has a glass of low-fat milk with each meal.
ANS: D
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 to 5 servings weekly are recommended in the DASH diet.
DIF: Cognitive Level: Application REF: 745 TOP: Nursing Process:
Evaluation
MSC: NCLEX: Physiological Integrity