Chapter 33 Nursing Management Hypertension

3539 Words Mar 5th, 2015 15 Pages
Chapter 33: Nursing Management: Hypertension
Test Bank
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. Deflate the BP cuff at a rate of 5 to 10 mm Hg per second.
b. Have the patient sit in a chair with the feet flat on the floor.
c. Assist the patient to the supine position for BP measurements.
d. Obtain two BP readings in the dominant arm and average the results.
ANS: B

The patient should be seated with the feet flat on the floor. The BP is obtained in both arms, and 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.
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Increasing fluid intake may counteract the effect of the medication, and the patient is taught to use gum or hard candy to relieve dry mouth. The BP should be taken in the nondominant arm by newly diagnosed patients in the morning, before taking the medication, and in the evening. Because ACE inhibitors cause potassium retention, increased intake of high-potassium foods is inappropriate.
DIF: Cognitive Level: Apply (application)
REF:
719
TOP: Nursing Process: Implementation
MSC: NCLEX: Physiological Integrity
6. Propranolol (Inderal) is prescribed for a patient diagnosed with hypertension. The nurse

should consult with the health care provider before giving this medication when the patient reveals a history of
a. asthma.
b. daily alcohol use.
c. peptic ulcer disease.
d. myocardial infarction (MI).
ANS: A

Nonselective β-blockers block β1- and β2-adrenergic receptors and can cause bronchospasm, especially in patients with a history of asthma. β-Blockers will have no effect on the patient’s peptic ulcer disease or alcohol use. β-Blocker therapy is recommended after MI.

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DIF: Cognitive Level: Apply (application)
REF:
718
TOP: Nursing Process: Assessment
MSC: NCLEX: Physiological Integrity
7. A 56-year-old patient who has no previous history of hypertension or other health problems

suddenly develops a blood pressure (BP) of 198/110 mm Hg. After reconfirming the BP, it
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