Chapter 38: Hypertension
Linton: Introduction to Medical–Surgical Nursing, 6th Edition
MULTIPLE CHOICE
1. A patient inquires if his blood pressure is normal. What is the nurse’s most accurate response
regarding the definition of normal blood pressure?
a.
Less than 144/90 mm Hg
b.
Less than 138/86 mm Hg
c.
Less than126/82 mm Hg
d.
Less than 120/80mm Hg
2. An obese African American man reports that he smokes. How should the nurse stage this
patient’s hypertension?
a.
Grade A
b.
Grade B
c.
Grade C
d.
Grade D
3. Which is true regarding hypertension in older adults?
a.
It is age related.
b.
It is unavoidable.
c.
It is progressively disabling.
d.
It improves with treatment.
4. A patient is being evaluated every week for possible hypertension and is classified as
prehypertensive. Which assessment would support this conclusion?
a.
Blood pressure reading over 120/80 mm Hg for two consecutive visits
b.
Blood pressure reading over 130/85 mm Hg for over 2 months
c.
Blood pressure reading over 140/95 mm Hg for 2 months
d.
Blood pressure reading over 144/100 mm Hg at one visit
5. A patient with hypertension reports the symptom of headache. How do headaches related to
hypertension characteristically occur?
a.
Frontal in the afternoon
b.
Temporal on exertion
c.
Occipital on arising
d.
Frontal at night
6. What does treatment for essential hypertension focus on?
a.
Daily medication with mild diuretics
b.
Low-dose vasodilators
c.
Reduction of modifiable risks
d.
Combination of vasodilators and diuretics
7. What is the focus of treatment for secondary hypertension?
a.
Smoking cessation program
b.
Strenuous exercise program
c.
Weight-loss program designed to reduce weight rapidly
d.
Specific etiologic disease
8. What do blood pressure readings need to exceed for a patient to be diagnosed with
hypertension?
a.
120/80 mm Hg
b.
130/90 mm Hg
c.
140/90 mm Hg
d.
150/100 mm Hg
9. A patient is taking hydrochlorothiazide (HydroDIURIL) for hypertension. When providing
dietary teaching what should the nurse encourage the patient to increase the intake of?
a.
Bananas
b.
Apple juice
c.
Sugar-free foods
d.
Low-fat milk
10. An obese 38-year-old African American patient with diabetes is being evaluated for the use of
propranolol (Inderal) in controlling hypertension. What is a contraindication for the use of
propranolol (Inderal) in this patient?
a.
Race
b.
Age
c.
Diabetes
d.
Weight
11. An 89-year-old patient is taking an antihypertensive medication. What should the nurse
include when providing home care teaching?
a.
Get up out of bed slowly.
b.
Take hot baths.
c.
Report sexual dysfunction immediately.
d.
Stop taking the drug if side effects occur.
12. What should a nurse instruct a patient who has been started on verapamil (Calan) for elevated
blood pressure to monitor?
a.
Urine output
b.
Pulse
c.
Stool for blood
d.
Edema
13. A patient is prescribed an angiotensin-converting enzyme (ACE) inhibitor, enalapril
(Vasotec). What is an appropriate instruction for the nurse to provide?
a.
Monitor potassium intake.
b.
Report asthma symptoms.
c.
Return for follow-up visits.
d.
Assess blood sugar closely.
14. An 87-year-old patient is taking furosemide (Lasix) for elevated blood pressure. What should
the nurse know that older patients are at risk for?
a.
Falls
b.
Hypokalemia
c.
Reflex tachycardia
d.
Neutropenia
15. A nurse is providing patient education regarding a low-sodium diet. In addition to the use of
spices, what should the nurse recommend to help decrease sodium in the diet?
a.
Catsup
b.
Garlic
c.
Soy sauce
d.
Cheese
16. Which lifestyle change has the greatest effect on reducing hypertension?
a.
Sodium restriction
b.
Reduction in alcohol consumption
c.
Daily aerobic exercise
d.
Weight reduction
17. A nurse is educating a group of patients regarding Dietary Approaches to Stop Hypertension
(DASH) diet. What recommendation should the nurse include as a source of protein and fat?
a.
Lean red meat
b.
Whole grains
c.
Low fiber
d.
Sugar
18. Which antihypertensive medication is contraindicated in patients who have chronic
obstructive pulmonary disease (COPD) and asthma?
a.
Propranolol (Inderal): beta-adrenergic receptor blocker
b.
Hydrochlorothiazide (HydroDIURIL): diuretic
c.
Diltiazem (Cardizem): calcium antagonist
d.
Captopril (Capoten): ACE inhibitor
19. A nurse is caring for a patient who is taking antihypertensive therapy. The patient reports
fatigue and has a pulse of 54 beats/min. Which medication administered is most likely the
cause of these symptoms?
a.
Diltiazem (Cardizem)
b.
Furosemide (Lasix)
c.
Hydrochlorothiazide (HydroDIURIL)
d.
Methyldopa (Aldomet)
20. What should a nurse include when developing a teaching plan for a patient with hypertension?
a.
Stop medications if side effects occur.
b.
Maintain a diet high in unsaturated fat.
c.
Advise no further visits if no other symptoms occur.
d.
Encourage relaxation techniques.
21. A patient reports drowsiness after initiating atenolol (Tenormin) for the treatment of
hypertension. What is the nurse’s best response when educating this patient about atenolol
(Tenormin)?
a.
Take the medication at bedtime.
b.
Reduce the dose of the medication until the desired effect occurs.
c.
Avoid activities that require alertness.
d.
Talk to the physician because drowsiness is not an anticipated side effect.
22. A patient taking methyldopa (Aldomet) for hypertension reports to the emergency department
with a severe headache, blurred vision, and a blood pressure reading of 200/94 mm Hg. What
should the nurse suspect is happening to this patient?
a.
Hyperglycemia
b.
Ineffective coping with sedation
c.
Abrupt cessation of medication
d.
Sexual dysfunction
23. Which patient is at the highest risk for malignant hypertension?
a.
White postmenopausal women
b.
Obese Asians
c.
Young African American adults
d.
Older Latino men
24. A patient with hypertension comes to the emergency department and is experiencing nausea
and vomiting and is restless and confused. Vital signs are assessed at blood pressure, 220/130
mm Hg; pulse, 120 beats/min; and respirations, 32 breaths/min. What should the nurse
conclude the patient is experiencing based on these assessments?
a.
Hypertension crisis from the cessation of a drug
b.
Stroke from increased blood pressure
c.
Adverse drug reaction
d.
Onset of diabetes
25. What should be the nursing priority when caring for a patient with a hypertensive crisis?
a.
Suctioning secretions
b.
Monitoring for seizure activity
c.
Monitoring fluid volume
d.
Preventing hyperthermia
MULTIPLE RESPONSE
26. What are the advantages of hydrochlorothiazide (HydroDIURIL)? (Select all that apply.)
a.
Is potassium sparing
b.
Is effective for African Americans
c.
Consistently controls blood pressure
d.
Has no side effects
e.
Decreases heart rate
27. A nurse is providing care to a patient diagnosed with essential hypertension. What should the
nurse know is included in a first-line therapeutic approach to lowering this patient’s blood
pressure? (Select all that apply.)
a.
Smoking cessation
b.
Beta-blockers
c.
Exercise programs
d.
Weight loss
e.
Decreased sodium intake
28. Which conditions are considered potential causes of secondary hypertension? (Select all that
apply.)
a.
Renal disease
b.
Coarctation of the aorta
c.
Colon cancer
d.
Increased intracranial pressure (ICP)
e.
Rheumatoid arthritis
COMPLETION
29. A nurse explains that the force against which the left ventricle must work to force the blood
into the circulation is called _____.
OTHER
30. A nurse explains that hypertension occurs when a chain reaction of events takes place: (Place
the following options in the appropriate sequence. Separate letters by a comma and space as
follows: A, B, C, D.)
A. Ephedrine constricts vessels and increases the heart rate.
B. Renin constricts vessels and decreases the blood flow to the kidneys.
C. Angiotensin constricts vessels in response to renin.
D. Norepinephrine constricts vessels, increasing peripheral vascular resistance.
E. The adrenal cortex produces aldosterone, causing fluids and sodium to be retained.
