HTN Quiz 2

• Normal systolic blood pressure in healthy adults is less than 120 mmHg.
• Diastolic pressure is the lowest pressure when the heart is at rest between beats.
• Primary (essential) hypertension has no known cause.
• Primary hypertension accounts for 95% of all hypertension cases.
• A hallmark sign of a hypertensive emergency is diastolic BP > 120 mmHg.
• Nitroprusside is a direct-acting IV vasodilator used for hypertensive crises.
• Nocturia is a common symptom seen in early stages of hypertension, though early hypertension is often asymptomatic.
• The liver is less commonly affected by chronic hypertension compared to the heart, brain, and kidneys.
• Stress reduction is a recommended non-pharmacologic lifestyle modification for hypertension.
• EKG is used to assess organ damage from hypertension and may show left ventricular hypertrophy, indicating heart damage.

Level 2: Understanding

• Weight loss can lower resistance in blood vessels, addressing why a patient needs to lose weight for blood pressure.
• Secondary hypertension is hypertension due to an underlying condition, like kidney disease.
• Monitoring daily weight is important in hypertension to assess for fluid retention.
• Dizziness in clients on antihypertensives is often due to orthostatic hypotension from the medications.
• Referring a hypertensive patient to a dietitian is done to plan a low-sodium, heart-healthy diet, such as the DASH diet.
• Short-term goals for non-adherent patients improve confidence and adherence to medications.
• "I need to avoid salty foods and exercise regularly" indicates an understanding of hypertension management.
• Retinal changes are concerning in a newly diagnosed hypertension patient and may indicate end-organ damage.
• Nurses promote health maintenance for hypertension by identifying knowledge deficits and planning education.
• The nurse should respond to an overwhelmed patient by saying “Let's talk about your concerns and simplify things," to promote understanding and reduce anxiety.

Level 3: Applying

• For a patient with BP 190/124 mmHg, headache, and visual disturbances, the priority nursing action is to administer IV antihypertensives, since this is a hypertensive emergency.
• A nurse should include “Stress management techniques can help lower BP” in a class on lifestyle modifications.
• The dietary recommendation the nurse should make for a hypertensive client is to follow the DASH diet, which is evidence-based for BP control.
• If a client is skipping antihypertensive medications due to side effects, then the nurse should educate about medication benefits and side effects to improve adherence.
• Monitoring sodium intake is a nursing intervention that helps reduce fluid volume in hypertension because sodium reduction decreases fluid retention.
• Helping create reminders for medication schedules can best promote medication adherence in a hypertensive patient.
• For a patient with BP 182/120 and papilledema, the nurse's priority assessment is neurological status because neurological signs indicate possible organ damage from hypertensive crisis.
• "I'll take it every day even if I feel fine,” indicates effective teaching in a patient starting antihypertensives. Medications must be taken consistently for BP control.
• If a patient with HTN gains 5 lbs in 3 days, the priority action is to notify the healthcare provider, since rapid weight gain suggests fluid retention.
• The most appropriate referral for a patient with poor dietary habits and uncontrolled HTN is a dietitian because a dietitian helps with nutrition planning.

Level 4: Applying & Analyzing

• Nursing actions that should be included in the care plan for a patient with hypertension and fluid volume excess are monitoring intake and output, weighing the patient daily, and educating on diuretic use, as these help monitor fluid balance, reflect fluid status, and promote adherence and safety.
• Retinal hemorrhages on fundoscopic exam require further investigation in a newly diagnosed hypertension patient because they suggest target organ damage from uncontrolled hypertension.
• Food choices that indicate correct understanding of the DASH diet are grilled salmon, fresh fruits and vegetables, and whole grains, as these are low in sodium, high in fiber, and lean proteins.
• If a client with hypertension says, "If I miss a dose, I'll double the next one.", that statement requires intervention to correct that medication should not be doubled.
• If a patient's BP is 186/122 mmHg with restlessness and blurred vision, then the appropriate interventions are to assess neurological status, notify the provider immediately, and administer the ordered IV antihypertensive.
• " Let's talk about why consistent medication use is important,” is the most therapeutic response to a patient that states, “I feel fine, so I stopped taking my meds" to promote patient-centered care and address non-adherence respectfully.
• Findings in a hypertensive patient that indicate possible end-organ damage are proteinuria, retinal changes, left ventricular hypertrophy on ECG, and headache.
• "Do not stop this medication abruptly." is an essential nursing instruction for a client prescribed a beta-blocker for hypertension, because abrupt discontinuation can lead to rebound hypertension or cardiac events.
• If a nurse assesses a client with a BP of 200/130 mmHg and papilledema, then the organ system that is most likely to be impacted first is neurologic because papilledema and extremely elevated BP suggest brain involvement (e.g., stroke, encephalopathy).
• The education topics the nurse should prioritize for a hypertensive patient being discharged include medication adherence, lifestyle changes, reading food labels, and the importance of routine follow-up, as these are core components of outpatient hypertension management.