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WorksheetsHypertension
Total questions: 28
Worksheet time: 28mins
Name
Class
Date
1.
The nurse is reviewing the laboratory test results for a patient who has recently been diagnosed with hypertension. Which result is most important to communicate to the health care provider?
a)
Serum creatinine of 2.8 mg/dL
b)
Serum potassium of 4.5 mEq/L
c)
Serum hemoglobin of 14.7 g/dL
d)
Blood glucose level of 96 mg/dL
2.
Which action should the nurse take when administering the initial dose of oral labetalol (Normodyne) to a patient with hypertension?
a)
Encourage the use of hard candy to prevent dry mouth.
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.
3.
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 chicken and fish.
c)
The patient has two cups of coffee in the morning.
d)
The patient has a glass of low-fat milk with each meal.
4.
A patient has just been diagnosed with hypertension and has been started on captopril (Capoten). Which information is important to include when teaching the patient about this medication?
a)
Check blood pressure (BP) in both arms before taking the medication.
b)
Increase fluid intake if dryness of the mouth is a problem.
c)
Include high-potassium foods such as bananas in the diet.
d)
Change position slowly to help prevent dizziness and falls.
5.
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).
6.
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 is appropriate for the nurse to tell the patient that
a)
a BP recheck should be scheduled in a few weeks.
b)
dietary sodium and fat content should be decreased.
c)
there is an immediate danger of a stroke and hospitalization will be required.
d)
diagnosis of a possible cause, treatment, and ongoing monitoring will be needed.
7.
During change-of-shift report, the nurse obtains the following information about a hypertensive patient who received the first dose of nadolol (Corgard) during the previous shift. Which information indicates that the patient needsimmediate intervention?
a)
The patient’s most recent blood pressure (BP) reading is 158/91 mm Hg.
b)
The patient’s pulse has dropped from 68 to 57 beats/minute.
c)
The patient has developed wheezes throughout the lung fields.
d)
The patient complains that the fingers and toes feel quite cold.
8.
The nurse on the intermediate care unit received change-of-shift report on four patients with hypertension. Which patient should the nurse assess first?
a)
43-year-old with a (blood pressure (BP) of 160/92 who is complaining of chest pain
b)
52-year-old with a BP of 212/90 who has intermittent claudication
c)
50-year-old with a BP of 190/104 who has a creatinine of 1.7 mg/dL
d)
48-year-old with a BP of 172/98 whose urine shows microalbuminuria
9.
A patient with a history of hypertension treated with a diuretic and an angiotensin-converting enzyme (ACE) inhibitor arrives in the emergency department complaining of a severe headache and nausea and has a blood pressure (BP) of 238/118 mm Hg. Which question should the nurse ask first?
a)
“Did you take any acetaminophen (Tylenol) today?”
b)
“Have you been consistently taking your medications?”
c)
“Have there been any recent stressful events in your life?”
d)
“Have you recently taken any antihistamine medications?”
10.
The nurse is assessing a patient who has been admitted to the intensive care unit (ICU) with a hypertensive emergency. Which finding is most important to report to the health care provider?
a)
Urine output over 8 hours is 250 mL less than the fluid intake.
b)
The patient cannot move the left arm and leg when asked to do so.
c)
Tremors are noted in the fingers when the patient extends the arms.
d)
The patient complains of a headache with pain at level 8/10 (0 to 10 scale).
11.
While caring for a 23-year-old patient with mitral valve prolapse (MVP) without valvular regurgitation, the nurse determines that discharge teaching has been effective when the patient states that it will be necessary to
a)
take antibiotics before any dental appointments.
b)
limit physical activity to avoid stressing the heart.
c)
take an aspirin a day to prevent clots from forming on the valve.
d)
avoid use of over-the-counter (OTC) medications that contain stimulant drugs.
12.
While assessing a 68-year-old with ascites, the nurse also notes jugular venous distention (JVD) with the head of the patient’s bed elevated 45 degrees. The nurse knows this finding indicates
a)
decreased fluid volume.
b)
jugular vein atherosclerosis.
c)
increased right atrial pressure.
d)
incompetent jugular vein valves.
13.
Which topic will the nurse plan to include in discharge teaching for a patient with systolic heart failure and an ejection fraction of 33%?
a)
Need to begin an aerobic exercise program several times weekly
b)
Use of salt substitutes to replace table salt when cooking and at the table
c)
Benefits and side effects of angiotensin-converting enzyme (ACE) inhibitors
d)
Importance of making an annual appointment with the primary care provider
14.
A patient who has chronic heart failure tells the nurse, “I was fine when I went to bed, but I woke up in the middle of the night feeling like I was suffocating!” The nurse will document this assessment finding as
a)
orthopnea.
b)
pulsus alternans.
c)
paroxysmal nocturnal dyspnea.
d)
acute bilateral pleural effusion.
15.
The nurse working on the heart failure unit knows that teaching an older female patient with newly diagnosed heart failure is effective when the patient states that
a)
she will take furosemide (Lasix) every day at bedtime.
b)
the nitroglycerin patch is applied when any chest pain develops.
c)
she will call the clinic if her weight goes from 124 to 128 pounds in a week.
d)
an additional pillow can help her sleep if she is feeling short of breath at night.
16.
Following an acute myocardial infarction, a previously healthy 63-year-old develops clinical manifestations of heart failure. The nurse anticipates discharge teaching will include information about
a)
digitalis preparations
b)
b-adrenergic blockers.
c)
calcium channel blockers.
d)
angiotensin-converting enzyme (ACE) inhibitors.
17.
Which diagnostic test will be most useful to the nurse in determining whether a patient admitted with acute shortness of breath has heart failure?
a)
Serum troponin
b)
Arterial blood gases
c)
B-type natriuretic peptide
d)
12-lead electrocardiogram
18.
A patient with chronic heart failure who is taking a diuretic and an angiotensin-converting enzyme (ACE) inhibitor and who is on a low-sodium diet tells the home health nurse about a 5-pound weight gain in the last 3 days. The nurse’s priority action will be to
a)
have the patient recall the dietary intake for the last 3 days.
b)
ask the patient about the use of the prescribed medications.
c)
assess the patient for clinical manifestations of acute heart failure.
d)
teach the patient about the importance of restricting dietary sodium.
19.
After receiving change-of-shift report on a heart failure unit, which patient should the nurse assess first?
a)
A patient who is cool and clammy, with new-onset confusion and restlessness
b)
A patient who has crackles bilaterally in the lung bases and is receiving oxygen.
c)
A patient who had dizziness after receiving the first dose of captopril (Capoten)
d)
A patient who is receiving IV nesiritide (Natrecor) and has a blood pressure of 100/62
20.
Which assessment finding in a patient admitted with acute decompensated heart failure (ADHF) requires the most immediate action by the nurse?
a)
Oxygen saturation of 88%
b)
Weight gain of 1 kg (2.2 lb)
c)
Heart rate of 106 beats/minute
d)
Urine output of 50 mL over 2 hours
21.
A patient has recently started on digoxin (Lanoxin) in addition to furosemide (Lasix) and captopril (Capoten) for the management of heart failure. Which assessment finding by the home health nurse is a priority to communicate to the health care provider?
a)
Presence of 1 to 2+ edema in the feet and ankles
b)
Palpable liver edge 2 cm below the ribs on the right side
c)
Serum potassium level 3.0 mEq/L after 1 week of therapy
d)
Weight increase from 120 pounds to 122 pounds over 3 days
22.
After receiving change-of-shift report on a heart failure unit, which patient should the nurse assess first?
a)
Patient who is taking carvedilol (Coreg) and has a heart rate of 58
b)
Patient who is taking digoxin and has a potassium level of 3.1 mEq/L
c)
Patient who is taking isosorbide dinitrate/hydralazine (BiDil) and has a headache
d)
Patient who is taking captopril (Capoten) and has a frequent nonproductive cough
23.
A patient at the clinic says, “I have always taken a walk after dinner, but lately my leg cramps and hurts after just a few minutes of starting. The pain goes away after I stop walking, though.” The nurse should
a)
check for the presence of tortuous veins bilaterally on the legs.
b)
ask about any skin color changes that occur in response to cold.
c)
assess for unilateral swelling, redness, and tenderness of either leg.
d)
assess for the presence of the dorsalis pedis and posterior tibial pulses.
24.
The nurse performing an assessment with a patient who has chronic peripheral artery disease (PAD) of the legs and an ulcer on the right second toe would expect to find
a)
dilated superficial veins.
b)
swollen, dry, scaly ankles.
c)
prolonged capillary refill in all the toes.
d)
a serosanguineous drainage from the ulcer.
25.
Which topic should the nurse include in patient teaching for a patient with a venous stasis ulcer on the left lower leg?
a)
Need to increase carbohydrate intake
b)
Methods of keeping the wound area dry
c)
Purpose of prophylactic antibiotic therapy
d)
Application of elastic compression stockings
26.
A 67-year-old patient is admitted to the hospital with a diagnosis of venous insufficiency. Which patient statement is most supportive of the diagnosis?
a)
“I can’t get my shoes on at the end of the day.”
b)
“I can’t seem to ever get my feet warm enough.”
c)
“I have burning leg pains after I walk two blocks.”
d)
“I wake up during the night because my legs hurt.”
27.
While working in the outpatient clinic, the nurse notes that a patient has a history of intermittent claudication. Which statement by the patient would support this information?
a)
When I stand too long, my feet start to swell.”
b)
“I get short of breath when I climb a lot of stairs.”
c)
My fingers hurt when I go outside in cold weather.”
d)
“My legs cramp whenever I walk more than a block.”
28.
When developing a teaching plan for a 76-year-old patient newly diagnosed with peripheral artery disease (PAD), which instructions should the nurse include?
a)
Exercise only if you do not experience any pain.”
b)
“It is very important that you stop smoking cigarettes.”
c)
Try to keep your legs elevated whenever you are sitting.”
d)
“Put elastic compression stockings on early in the morning.”
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