Midterm FULL

chapter inclided: 23, 24, 25, 26 MISSING CH.40

The nurse has provided client education about the function of the renal system. Which statements made by the client indicate an understanding of the teaching?
Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.
1. "Kidneys help the heart by balancing potassium."
2. "Kidneys balance the fluid and electrolytes in my body."
3. "Kidneys keep blood pressure from getting too low."
4. "Kidneys help decrease infections by excreting bacteria."
5. "Kidneys help regulate the oxygen levels in my blood."

1. "Kidneys help the heart by balancing potassium."
2. "Kidneys balance the fluid and electrolytes in my body."
3. "Kidneys keep blood pressure from getting too low."

Which should the nurse recognize are important safety precautions when administering a prescription to a client with renal failure?
Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.
1. The client will require lower dosages.
2. Some prescriptions increase fluid retention.
3. Measure hourly intake and output.
4. Some prescriptions are nephrotoxic.
5. Some prescriptions are bound to plasma proteins

1. The client will require lower dosages.
3. Measure hourly intake and output.
4. Some prescriptions are nephrotoxic.

Which should the nurse suspect after noting the presence of protein on a routine urinalysis?
1. Acute kidney injury
2. Structural damage
3. Kidney infection
4. Chronic kidney injury

2. Structural damage

Which conditions should the nurse anticipate the healthcare provider to possibly prescribe a diuretic?
Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.
1. Heart failure
2. Cerebrovascular accident
3. Hypertension
4. Acute kidney injury
5. Ketoacidosis

1. Heart failure
3. Hypertension
4. Acute kidney injury

The nurse suspects a client receiving chlorothiazide (Diuril) is experiencing side effects from the prescription. Which assessment finding supports the nurse's suspicion?
1. Ataxia and frequent diarrhea
2. Serum potassium level of 3.0 mEq/L and low blood pressure
3. Serum sodium level of 160 mEq/L and headaches
4. Mental confusion and dependent edema

2. Serum potassium level of 3.0 mEq/L and low blood pressure

A client prescribed bumetanide (Bumex) asks the nurse how the drug works. Which response should the nurse provide the client?
1. "This prescription causes your kidneys to reabsorb potassium."
2. "This prescription causes your kidneys to block the reabsorption of sodium."
3. "This prescription causes your kidneys to reabsorb calcium."
4. "This prescription causes your kidneys to reabsorb chloride."

3. "This prescription causes your kidneys to reabsorb calcium."

The healthcare provider has prescribed hydrochlorothiazide (HCTZ) for a client with chronic renal failure. Which assessment finding indicates the treatment is ineffective?
1. Weak pulses
2. Hypotension
3. Poor skin turgor
4. Wheezing

4. Wheezing

The nurse has completed the dietary teaching for a client prescribed spironolactone (Aldactone). Which statement made by the client indicates further teaching is required?
1. "I am really happy that I can have my cranberry juice."
2. "I can still have my orange juice and bananas for breakfast."
3. "I usually eat an apple a day to stay regular."
4. "I love to eat eggs and toast in the morning."

2. "I can still have my orange juice and bananas for breakfast."

Which information should the nurse include when providing education for an older client prescribed chlorothiazide (Diuril)?
1. "Take the medication early in the morning."
2. "Avoid foods that are high in potassium."
3. "It is alright to have a glass of wine with this medication."
4. "Take the medication on an empty stomach."

1. "Take the medication early in the morning."

A client prescribed spironolactone (Aldactone) asks the nurse which fluids they should drink to prevent dehydration. Which response should the nurse provide?
1. "Citrus juices are very good for rehydration."
2. "Any kind of fluid is okay, but avoid alcohol."
3. "Plain water is really the best."
4. "Electrolyte-replacement drinks like sports drinks."

3. "Plain water is really the best."

A patient receiving chlorothiazide (Diuril) has developed hypokalemia. Which assessment findings support the diagnosis?
1. Hyperglycemia
2. Heart palpitations
3. Increased urine output
4. Diarrhea

2. Heart palpitations

Which prescription is nephrotoxic if an overdose occurs?
1. Lorazepam (Ativan)
2. Amitriptyline (Elavil)
3. Ibuprofen (Advil)
4. Quetiapine (Seroquel)

3. Ibuprofen (Advil)

The nurse is preparing the education for a client prescribed chlorothiazide (Diuril). Which information should the nurse include in the teaching?
1. Consumption of foods high in potassium
2. Assessment of blood glucose daily
3. Daily weights with a report of a gain of more than 1 pound in 24 hours
4. Report change in hearing

1. Consumption of foods high in potassium

An older adult receiving ethacrynic acid (Edecrin) tells the nurse he or she doesn't hear as well as he or she used to. Which statement should the nurse include in the response?
1. "You may be dehydrated; are you drinking enough fluid?"
2. "I will let your healthcare provider know about this; it could be a side effect of your medication."
3. "How long have you been having difficulty hearing?"
4. "I will schedule a hearing exam; this could be a side effect of your medication."

2. "I will let your healthcare provider know about this; it could be a side effect of your medication."

1) Which is the client at risk for that is receiving spironolactone (Aldactone)?
1. Pancytopenia
2. Aplastic anemia
3. Hyperkalemia
4. Hyponatremia

3. Hyperkalemia

Which is the primary functional unit of the kidney?
1. Loop of Henle
2. Bowman's capsule
3. Nephron
4. Distal tubule

3. Nephron

1) Which is the most appropriate food for the nurse to recommend to a client to eat that is prescribed a loop diuretic?
1. Meat
2. Bananas
3. Cheese
4. Yogurt

2. Bananas

1) Which general adverse effect is associated with the use of diuretics?
1. Constipation
2. Orthostatic hypotension
3. Weight gain
4. Hypertension

2. Orthostatic hypotension

The nurse is reviewing the medical history of a client prescribed hydrochlorothiazide (Microzide). Which condition should the nurse be concerned about?
1. Hypertension
2. Asthma
3. Gout
4. Hypothyroidism

1. Hypertension

Which initial treatment prescribed should the nurse anticipate for the client that has overdosed on hydrochlorothiazide?
1. Electrolyte replacement
2. Intravenous normal saline
3. Vasopressor
4. Furosemide (Lasix)

3. Vasopressor

Which diuretic is most effective in reducing the mortality of a client with heart failure?
1. Chlorothiazide (Diuril)
2. Acetazolamide (Diamox)
3. Furosemide (Lasix)
4. Spironolactone (Aldactone)

4. Spironolactone (Aldactone)

The nurse has provided education for a client with diabetes type I prescribed hydrochlorothiazide (Microzide). Which statement made by the client indicates an understanding of the information?
1. "I expect my blood glucose to be elevated."
2. "I anticipate to monitor my blood glucose more frequently."
3. "I can expect my hemoglobin A1C to be elevated."
4. "I expect I will need more insulin to help control my glucose."

1. "I expect my blood glucose to be elevated."

Which should the nurse recognize a client with acute renal failure cannot effectively regulate?
Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.
1. Fluid balance
2. Electrolyte balance
3. The pH of body fluids
4. Heart rate
5. Blood pressure

1. Fluid balance
2. Electrolyte balance
3. The pH of body fluids
5. Blood pressure

Which should the nurse recognize is associated with chronic kidney disease (CKD)?
Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.
1. Hypertension
2. Inflammation
3. Diabetes
4. Hypoperfusion
5. Sepsis

1. Hypertension
3. Diabetes

The educator is preparing to review the diuretics that do not require potassium supplements with a nurse. Which diuretics should the educator include?
Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.
1. Furosemide (Lasix)
2. Chlorothiazide (Diuril)
3. Amiloride (Midamor)
4. Mannitol (Osmitrol)
5. Spironolactone (Aldactone)

3. Amiloride (Midamor)
5. Spironolactone (Aldactone)

The nurse has provided dietary education for a client prescribed furosemide (Lasix). Which statement made by the client indicates an understanding of the information?
1. "I will increase my consumption of green, leafy vegetables."
2. "I will increase my consumption of poultry."
3. "I will try and eat an orange daily."
4. "I will try and incorporate more grains in my diet."

3. "I will try and eat an orange daily."

Which vital signs should the nurse assess prior to the administration of a diuretic?
Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.
1. Temperature
2. Pulse
3. Respirations
4. Blood pressure
5. Pain

2. Pulse
4. Blood pressure

The nurse is preparing to provide education on daily self-monitoring for a client with congestive heart failure prescribed a diuretic. Which information should the nurse plan to include in the teaching?
Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.
1. Weight
2. Pulse
3. Temperature
4. Blood pressure
5. Respiratory rate

1. Weight
2. Pulse
4. Blood pressure

The educator is reviewing the physiology of the renal system with a nurse. Which statement made by the nurse indicates further teaching is required?
1. "The kidneys stimulate white blood cell production."
2. "The kidneys help regulate blood pressure."
3. "The kidneys regulate the acid-base balance of body fluids."
4. "The kidneys produce the active form of vitamin D."

1. "The kidneys stimulate white blood cell production."

The nurse is reviewing the laboratory reports for a client with chronic kidney failure. Which lab should the nurse understand reflects the progression of the kidney disease?
1. Glomerular filtration rate (GFR)
2. Serum creatinine
3. Blood urea nitrogen (BUN)
4. Urinalysis

1. Glomerular filtration rate (GFR)

The client states to the nurse, "My healthcare provider says I have heart disease and I need to decrease the cholesterol in my diet. I don't understand how this happened." Which response should the nurse provide the client?
1. "The arteries around your heart are narrowed by low density lipoprotein (LDL) cholesterol buildup in them."
2. "Low density lipoprotein (LDL) cholesterol is converted to saturated fat, which is stored in your coronary arteries."
3. "It is a good idea to decrease low density lipoprotein (LDL) cholesterol in your diet, although current research has not proven a correlation yet."
4. "Too much low density lipoprotein (LDL) cholesterol narrows all the arteries in your body so your heart does not receive enough blood to be healthy."

1. "The arteries around your heart are narrowed by low density lipoprotein (LDL) cholesterol buildup in them."

The nurse is providing education about lipids for a client with hyperlipidemia. Which information should the nurse include in the education?
1. High density lipoprotein (HDL) is called good cholesterol because it removes cholesterol from the body and gets rid of it in the liver.
2. High density lipoprotein (HDL) is called good cholesterol because it increases the oxygen content in the arteries and reduces the amount of plaque buildup.
3. High density lipoprotein (HDL) decreases the bad cholesterol (low density lipoprotein [LDL]), and promotes excretion of it through the kidneys.
4. High density lipoprotein (HDL) decreases low density lipoprotein (LDL) and prevents it from converting to very low density lipoprotein (VDRL), which is the worst kind of cholesterol in the body.

1. High density lipoprotein (HDL) is called good cholesterol because it removes cholesterol from the body and gets rid of it in the liver.

Which information about the dietary intake of lipids should the nurse provide a client?
Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.
1. "Phospholipids will help prevent Alzheimer's disease."
2. "Phospholipids are essential to building plasma membranes."
3. "Cholesterol is a building block for estrogen and testosterone."
4. "Triglycerides are the major form of fat in the body."
5. "Cholesterol in the diet is unnecessary as the liver synthesizes it."

2. "Phospholipids are essential to building plasma membranes."
3. "Cholesterol is a building block for estrogen and testosterone."
4. "Triglycerides are the major form of fat in the body."
5. "Cholesterol in the diet is unnecessary as the liver synthesizes it."

The nurse reviewing a client's serum cholesterol levels notes the following:
Low density lipoprotein (LDL) \= 105 mg/dl
High density lipoprotein (HDL) \= 37 mg/dl
Low density lipoprotein (LDL)/high density lipoprotein (HDL) ratio \= 4.1
Which should the nurse identify as the priority outcome in the client's plan of care?
1. Maintenance of normal lipid levels without the use of pharmacotherapy
2. Education about diet and exercise
3. Validate that the client understands the importance of lifestyle changes
4. The client's achievement of normal lipid levels through compliance with medications

1. Maintenance of normal lipid levels without the use of pharmacotherapy

The nurse has completed nutritional teaching for a client with a high low density lipoprotein (LDL) level. Which menu choice made by the client indicates an understanding of the teaching?
1. Beef tenderloin with gravy and noodles, fruit salad with apples and grapefruit, slice of rye bread, and apple pie
2. Grilled chicken salad with strawberries and pecans, baked macaroni and cheese, and low-fat brownie
3. Grilled chicken with rice and broccoli, tossed salad with walnuts and sliced apples, slice of whole-wheat bread, and low-fat chocolate pudding
4. Low-fat hamburger with whole-wheat bun, tossed salad with walnuts and olive oil, and raisin-oatmeal cookie

3. Grilled chicken with rice and broccoli, tossed salad with walnuts and sliced apples, slice of whole-wheat bread, and low-fat chocolate pudding

The patient is receiving cholestyramine (Questran) and complains of constipation. The physician orders bisacodyl (Dulcolax) tablets. When is the best time for the nurse to administer the bisacodyl (Dulcolax) tablets?
1. The drugs can be administered together.
2. Four hours after administration of cholestyramine (Questran).
3. Bisacodyl (Dulcolax) can be given any time but must be taken with food.
4. One hour after administration of cholestyramine (Questran).

2. Four hours after administration of cholestyramine (Questran).

The nurse has completed the education for a client prescribed gemfibrozil (Lopid). Which statement made by the client indicates an understanding of the information?
1. "I should take this medication on an empty stomach to help it absorb better."
2. "I must take this medication with food or I can have heartburn."
3. "My physician said it really doesn't matter how I take this medication."
4. "Taking this medication with yogurt will help it to absorb better."

2. "I must take this medication with food or I can have heartburn."

A client tells the nurse they will need a prescription for high cholesterol but does not know which would be best. Which information should the nurse provide the client?
Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.
1. "The best drugs to raise the high density lipoprotein (HDL) levels are the fibric acid drugs."
2. "The statin drugs are good but will cause a lot of flushing if you swallow them with warm fluids."
3. "The bile resins keep cholesterol from being absorbed but have some side effects."
4. "The statin drugs inhibit the making of cholesterol and are considered the best choice."
5. "Fibric acid drugs will decrease triglycerides, but your low density lipoprotein (LDL) will still be high."

3. "The bile resins keep cholesterol from being absorbed but have some side effects."
4. "The statin drugs inhibit the making of cholesterol and are considered the best choice."
5. "Fibric acid drugs will decrease triglycerides, but your low density lipoprotein (LDL) will still be high."

1) A client asks the nurse how fat is carried in the blood. Which response should the nurse provide?
1. "Fats in your blood are carried inside small molecules called phospholipids."
2. "Fats travel in the blood on little proteins called lipoproteins."
3. "Fats are free floating in your circulatory system."
4. "Fats are encapsulated inside little bags known as lecithin."

2. "Fats travel in the blood on little proteins called lipoproteins."

Which assessment data obtained from a client receiving a statin is a priority for the nurse to report to the healthcare provider?
1. "My calves hurt, and I had a hard time walking to the bathroom."
2. "I know I just started this medicine yesterday, but my stomach really is upset."
3. "Will you call my healthcare provider? I have a really bad headache."
4. "My heart rate really went up this morning."

1. "My calves hurt, and I had a hard time walking to the bathroom."

Which assessment finding for a client receiving a statin is a priority for the nurse to report to the healthcare provider?
1. Bowel sounds markedly increased in all four quadrants of the abdomen
2. Urine output of 200 mL/hour
3. Urine output of 20 mL/hour
4. Moderate elevation in liver function tests (LFTs)

3. Urine output of 20 mL/hour

Which assessment is a nursing priority for a client receiving cholestyramine (Questran)?
1. Auscultation of heart sounds
2. Auscultation of bowel sounds in all four abdominal quadrants
3. Assessment of 24-hour urine output
4. Palpation for peripheral edema in the lower extremities

2. Auscultation of bowel sounds in all four abdominal quadrants

Which information should the nurse include in the education for a client prescribed niacin to lower lipid levels?
1. "Be sure to take your niacin on an empty stomach as soon as you arise."
2. "Take one aspirin 30 minutes before you take your niacin."
3. "Take your niacin tablet with food and at least one full glass of water."
4. "It may be time to ask your healthcare provider about switching to another drug."

2. "Take one aspirin 30 minutes before you take your niacin."

Which is the priority action of the nurse when caring for a client receiving a statin with elevated creatine kinase (CK) levels?
1. Hold the prescription and obtain another creatine kinase (CK) level in 6 hours.
2. Administer the prescription and continue to assess for muscle pain.
3. Administer the prescription and obtain another creatine kinase (CK) level in 6 hours.
4. Hold the prescription and notify the healthcare provider.

4. Hold the prescription and notify the healthcare provider.

Which lipid type is associated with the highest risk for the development of atherosclerosis?
1. Phospholipids
2. Lecithins
3. Steroids
4. Triglycerides

3. Steroids

Which type of lipid serves as fuel for the body when energy is needed?
1. Phospholipids
2. Triglycerides
3. Steroids
4. Lecithins

2. Triglycerides

Which type of lipoprotein is often referred to as "the good type?"
1. Triglycerides
2. HDL
3. LDL
4. VLDL

2. HDL

Which statement provides the best rationale for monitoring HDL and LDL as opposed to total cholesterol?
1. HDL and LDL monitoring is less expensive than measuring total cholesterol.
2. Total cholesterol does not differentiate the amounts of "good" cholesterol and "bad" cholesterol.
3. HDL and LDL measurements are more general and frequently used to assess clients that are not at risk for heart disease.
4. Total cholesterol measurements are often inaccurate and not as reliable as HDL and LDL.

2. Total cholesterol does not differentiate the amounts of "good" cholesterol and "bad" cholesterol.

The nurse reviewing records should determine that which client's lab values are associated with the highest risk of developing heart disease?
1. Total 200, LDL 104, HDL 30
2. Total 210, LDL 135, HDL 58
3. Total 220, LDL 162, HDL 20
4. Total 186, LDL 125, HDL 54

3. Total 220, LDL 162, HDL 20

Which statement correctly identifies why restricting dietary intake of cholesterol generally will not result in a significant reduction of blood cholesterol?
1. Most clients are not compliant with the dietary restriction.
2. Cholesterol is found in nearly all foods, and it is not possible to eliminate it from the diet.
3. Cholesterol is made within the body and cannot be absorbed via external sources.
4. The liver reacts to a low-cholesterol diet by making more cholesterol.

4. The liver reacts to a low-cholesterol diet by making more cholesterol.

Which describes the mechanism of atorvastatin's (Lipitor) ability to lower blood cholesterol levels?
1. Binds exogenous cholesterol and excreting it in the feces
2. Increases excretion by activating enzymes within the hepatic system
3. Prevents dietary absorption within the GI tract
4. Inhibits an enzyme that is essential for cholesterol synthesis

4. Inhibits an enzyme that is essential for cholesterol synthesis

Which statement is accurate regarding the use of nicotinic acid (Niacin) for lowering blood cholesterol levels?
1. Works primarily by lowering LDL and HDL levels.
2. Due to adverse effects, niacin should not be used with statins.
3. Niacin may also reduce triglyceride levels.
4. High doses of 25-30 mg per day are often necessary.

3. Niacin may also reduce triglyceride levels.

The educator is preparing education about the different types of lipids for a nurse. Which should the educator include in the presentation?
Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.
1. Triglycerides
2. Phospholipids
3. Steroids
4. Lecithins
5. Bile acids

1. Triglycerides
2. Phospholipids
3. Steroids

The nurse has provided education for a client prescribed fenofibrate (Lofibra). Which statement made by the client indicates further teaching is required?
1. "I will expect to see a change in color of my stool."
2. "I will take my prescription on an empty stomach."
3. "I will monitor myself for bruising."
4. "I will report nausea and vomiting to my healthcare provider."

2. "I will take my prescription on an empty stomach."

The nurse has provided client education regarding therapeutic lifestyle changes to help control cholesterol levels. Which statement made by the client indicates an understanding of the information?
Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.
1. "I will maintain an optimal weight."
2. "I will implement a medically supervised exercise plan."
3. "I will increase saturated fat in my diet."
4. "I will increase insoluble fiber in my diet."
5. "I will eliminate tobacco use."

1. "I will maintain an optimal weight."
2. "I will implement a medically supervised exercise plan."
5. "I will eliminate tobacco use."

The nurse is preparing to provide education for a client prescribed a statin. Which serious adverse effects should the nurse include in the teaching?
Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.
1. Headache
2. Abdominal pain
3. Myopathy
4. Muscle or joint pain
5. Rhabdomyolysis

3. Myopathy
5. Rhabdomyolysis

Which anatomical location is Ezetimibe (Zetia) effective in blocking the absorption of cholesterol?
1. Stomach
2. Gallbladder
3. Liver
4. Jejunum

4. Jejunum

The educator is reviewing the classifications of prescriptions used to decrease blood cholesterol levels with a nurse. Which prescriptions should the educator include in the discussion of fibric acid agents?
Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.
1. Tricor
2. Zetia
3. Lopid
4. Colestid
5. Zocor

1. Tricor
3. Lopid

The nurse is discussing with a client, the dietary intake of omega-3 and CoQ10-rich foods to control lipid levels. Which foods should the nurse include in the discussion?
Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.
1. Sardines
2. Shrimp
3. Almonds
4. Olive oil
5. Carrots

1. Sardines
3. Almonds
4. Olive oil

A patient has been prescribed gemfibrozil (Lopid). Which laboratory tests should the nurse schedule for the client on the next clinic appointment?
Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.
1. Blood glucose
2. Liver enzymes
3. Potassium
4. Hemoglobin and hematocrit
5. Urinalysis

1. Blood glucose
2. Liver enzymes
4. Hemoglobin and hematocrit

A client receiving hydrochlorothiazide (Microzide) asks the nurse why they are urinating so frequently. Which statement should the nurse provide the client?
1. "Hydrochlorothiazide (Microzide) enhances kidney function causing you to urinate more and that decreases your blood pressure."
2. "Hydrochlorothiazide (Microzide) decreases the fluid in your bloodstream and this lowers your blood pressure."
3. "Hydrochlorothiazide (Microzide) dilates your blood vessels so you urinate more and your blood pressure decreases."
4. "Hydrochlorothiazide (Microzide) increases your heart rate; this pumps blood faster to your kidneys so you urinate more and your blood pressure decreases."

2. "Hydrochlorothiazide (Microzide) decreases the fluid in your bloodstream and this lowers your blood pressure."

The nurse is providing education for nonpharmacological interventions to manage hypertension. Which information should the nurse include?
Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.
1. Increase your dietary intake of fruits and vegetables.
2. Decrease the consumption of alcohol.
3. Reduce the dietary intake of potassium.
4. Increase physical activity.
5. Restrict your intake of sodium.

1. Increase your dietary intake of fruits and vegetables.
2. Decrease the consumption of alcohol.
4. Increase physical activity.
5. Restrict your intake of sodium.

Which clients should the nurse anticipate will require a pharmacological intervention to manage their blood pressure?
Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.
1. A 30-year-old female whose blood pressure is 138/88 mmHg who is otherwise healthy
2. A 61-year-old man whose blood pressure is 144/90 mmHg who also has type 2 diabetes
3. A 56-year-old woman whose blood pressure is 135/84 mmHg who also has Cushing's disease
4. A 65-year-old man whose blood pressure is 148/88 mmHg who is otherwise healthy
5. A 61-year-old woman whose blood pressure is 153/92 mmHg who is otherwise healthy

2. A 61-year-old man whose blood pressure is 144/90 mmHg who also has type 2 diabetes
5. A 61-year-old woman whose blood pressure is 153/92 mmHg who is otherwise healthy

For which conditions is a client with hypertension at risk?
Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.
1. Kidney damage
2. Stroke
3. Liver failure
4. Heart failure
5. Blindness

1. Kidney damage
2. Stroke
4. Heart failure
5. Blindness

The nurse reviewing the records of a client diagnosed with hypertension notes a weight of 200 lbs, height 5' 4", dietary intake includes primarily starches, an alcohol intake of three beers per week, and stressors include 60-hour workweeks. Based on this information, which should the nurse identify as a priority outcome?
1. Patient will eliminate alcohol from the diet.
2. Patient will decrease stress by limiting work to 40 hours/week.
3. Patient will balance diet according to the food pyramid.
4. Patient will achieve and maintain optimum weight.

4. Patient will achieve and maintain optimum weight.

Which electrolytes should the nurse anticipate monitoring for a client prescribed losartan (Cozaar)?
Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.
1. Potassium
2. Sodium
3. Calcium
4. Chloride
5. Magnesium

1. Potassium
2. Sodium

The nurse has prescribed dietary education for a client prescribed nifedipine (Procardia XL). Which dietary choice should the nurse recognize requires further education?
1. Whole-wheat pancakes with syrup, and bacon, oatmeal, and orange juice
2. Eggs, whole-wheat toast with butter, cereal, milk, and grapefruit juice
3. Eggs and sausage, a biscuit with margarine, coffee with cream, and cranberry juice
4. Egg and cheese omelet, tea with sugar and lemon, hash brown potatoes, and prune juice

2. Eggs, whole-wheat toast with butter, cereal, milk, and grapefruit juice

Which statement made by a client newly prescribed a beta-adrenergic blocker should the nurse be concerned about?
1. "I don't handle stress well; I have a lot of diarrhea."
2. "When I have a migraine headache, I need to have the room darkened."
3. "My father died of a heart attack when he was 48 years old."
4. "I have always had problems with my asthma."

4. "I have always had problems with my asthma."

Which is a priority nursing intervention for a client who is newly prescribed enalapril (Vasotec)?
1. Monitor the client for headaches.
2. Take the client's blood pressure.
3. Order a sodium-restricted diet for the client.
4. Review the client's lab results for hypokalemia.

2. Take the client's blood pressure.

Which is the nurse's priority assessment for a client treated with intravenous hydralazine (Apresoline)?
1. Hypotension and bradycardia
2. Hypotension and hyperthermia
3. Hypotension and tachycardia
4. Hypotension and tachypnea

3. Hypotension and tachycardia

The nurse has completed the education for a client prescribed hydrochlorothiazide (Microzide). Which statement made by the client indicates an understanding of the teaching?
1. "I really need to avoid grapefruit juice when I take this medication."
2. "I need to avoid salt substitutes and potassium-rich foods."
3. "I take my medication early in the morning."
4. "If I develop a cough, I should call my physician."

3. "I take my medication early in the morning."

The nurse has discussed lifestyle modifications to help manage the client's hypertension. Which statement made by the client indicates an understanding of the information?
1. "I need to get started on my medications right away."
2. "My father had hypertension, did nothing, and lived to be 90 years old."
3. "I know I need to give up my cigarettes and alcohol."
4. "I won't be able to run in the marathon race anymore."

3. "I know I need to give up my cigarettes and alcohol."

For which assessment findings should the nurse hold enalapril (Vasotec)?
Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.
1. Cough
2. Lightheadedness on ambulation
3. Periorbital edema
4. Sneezing
5. Difficulty swallowing

3. Periorbital edema
5. Difficulty swallowing

The nurse notes that a client experiencing heart failure has been receiving nifedipine (Procardia). Which is a priority assessment for the nurse?
1. Review recent lab results for hypokalemia.
2. Assess urinary output.
3. Assess level of orientation.
4. Auscultate breath sounds for crackles.

4. Auscultate breath sounds for crackles.

A client prescribed doxazosin (Cardura) asks how the medication works. Which information should the nurse provide the client?
1. "Doxazosin causes the kidneys to excrete more urine."
2. "Doxazosin helps the heart work more efficiently."
3. "Doxazosin helps dilate the blood vessels."
4. "Doxazosin decreases the release of the stress hormones."

3. "Doxazosin helps dilate the blood vessels."

The nurse is preparing to administer clevidipine (Cleviprex) to a client experiencing a hypertensive crisis. Which interventions should the nurse implement?
Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.
1. Monitor bowel sounds
2. Administer the drug intravenously
3. Continually monitor blood pressure
4. Crush caplets for administration
5. Infuse prescription in normal saline at 125 mL/h

2. Administer the drug intravenously
3. Continually monitor blood pressure

Which factors are responsible for blood pressure?
1. Blood volume, heart rate, and stroke volume
2. Cardiac output, blood volume, and peripheral vascular resistance
3. Age, weight, and race
4. Body mass index, diet, and genetics

2. Cardiac output, blood volume, and peripheral vascular resistance

The nurse educator is reviewing the physiological regulation blood pressure. Which should the educator identify as initially involved?
1. Production of angiotensin II
2. Action of renin
3. Antidiuretic hormone
4. Production of angiotensin I

2. Action of renin

Which changes are sensed by the baroreceptors and relayed to the vasomotor center?
1. Oxygenation
2. Blood pressure
3. Carbon dioxide
4. Blood pH

2. Blood pressure

Which statement is accurate in regard to secondary hypertension?
1. There is no known cause.
2. It can result from chronic renal impairment.
3. It is also known as idiopathic.
4. It accounts for 90% of all hypertensive cases.

2. It can result from chronic renal impairment.

Which intervention is the highest priority for a 30-year-old female with a BMI of 20 who smokes and has a blood pressure of 137/88?
1. Smoking-cessation program
2. Diuretic therapy
3. Weight-loss program
4. Stress management

1. Smoking-cessation program

Which electrolyte imbalance should the nurse be concerned about for the client who is prescribed a thiazide diuretic?
1. Magnesium
2. Calcium
3. Chloride
4. Potassium

4. Potassium

Which prescription should the nurse be concerned about a pregnant client receiving?
1. Enalapril (Vasotec)
2. Potassium supplement
3. Doxazosin (Cardura)
4. Hydrochlorothiazide (HCTZ)

1. Enalapril (Vasotec)

The nurse has provided education for a client prescribed nifedipine (Adalat CC). Which statement made by the client indicates an understanding of the teaching?
Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.
1. "If I drink alcohol while taking this medication, I will get very sick to my stomach."
2. "I should stop taking my melatonin sleep medication."
3. "I should no longer drink grapefruit juice."
4. "I should no longer drink sports drinks with caffeine in them."
5. "I should stop taking my vitamin C supplement."

1. "If I drink alcohol while taking this medication, I will get very sick to my stomach."

The nurse is educating a patient whose blood pressure is 140/90 mmHg on ways to lower blood pressure and avoid hypertension. Which lifestyle choices may eliminate the need for pharmacotherapy in this patient?
Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.
1. "I have incorporated yoga into my exercise program."
2. "I will monitor my daily sodium intake."
3. "I will drink a glass of red wine daily to help lower my blood pressure."
4. "I am receiving acupuncture to help me stop smoking."

1. "I have incorporated yoga into my exercise program."
2. "I will monitor my daily sodium intake."
4. "I am receiving acupuncture to help me stop smoking."

A male client states to the nurse, "I am going to stop taking my metoprolol (Lopressor). I have been experiencing problems having sex." Which responses should the nurse include in the discussion with the client?
Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.
1. "I understand sexual dysfunction can be a common problem with this drug."
2. "Perhaps it would be better if you took atenolol (Tenormin)."
3. "I cannot stop you from discontinuing the drug."
4. "Stopping the prescription abruptly may cause your blood pressure to elevate even higher."
5. "Try taking the drug early in the morning."

1. "I understand sexual dysfunction can be a common problem with this drug."
4. "Stopping the prescription abruptly may cause your blood pressure to elevate even higher."

A client experiencing syncope is suspected of taking a losartan (Cozaar) overdose? Which intervention should the nurse anticipate?
1. Administer a calcium infusion
2. Administer a loop diuretic
3. Administer a vasopressor
4. Administer an intravenous solution of normal saline

4. Administer an intravenous solution of normal saline

Which medical condition should the nurse be concerned about for a client prescribed hydralazine?
1. Asthma
2. Angina
3. Diabetes
4. Hyperthyroidism

2. Angina

The nurse is preparing to discuss the use of primary hypertensive agents with a client. Which prescriptions should the nurse include?
Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.
1. Thiazide diuretics
2. Angiotensin-II receptor blockers (ARBs)
3. Beta-adrenergic antagonists
4. Direct-acting vasodilators
5. Peripheral adrenergic antagonists

1. Thiazide diuretics
2. Angiotensin-II receptor blockers (ARBs)

Which physiological systems should the nurse recognize are most at risk for a client in a hypertensive crisis?
Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.
1. Cardiac
2. Respiratory
3. Integumentary
4. Gastrointestinal
5. Renal

1. Cardiac
5. Renal

The nurse plans to teach the client with acquired immune deficiency syndrome (AIDS) about bacterial infections. Which information should the nurse include in this teaching?
Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. "If just a few bacteria make you sick, this is virulence.""Most bacteria have developed antibiotic resistance.""Pathogens are divided into two classes, bacteria and viruses.""Pathogenicity means the bacteria can cause an infection.""Actually, most bacteria will not harm us."

"If just a few bacteria make you sick, this is virulence.""Pathogenicity means the bacteria can cause an infection.""Actually, most bacteria will not harm us."

Which information should the nurse include in the teaching about bacteria with a client?
Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. Bacteria are either aerobic or anaerobic.Bacteria are multicellular organisms.E. coli are gram-negative bacteria.Gram staining is one way to identify bacteria.Spherical-shaped bacteria are called cocci.

E. coli are gram-negative bacteria.Gram staining is one way to identify bacteria.Spherical-shaped bacteria are called cocci.

A client tells the nurse they do not understand why their prescribed antibiotic did not kill the bacteria that caused their infection. Which response should the nurse provide the client? "Some antibiotics work with your body's ability to help kill the infection.""Your healthcare provider will most likely prescribe a different type of antibiotic.""Your healthcare provider will want additional blood work to identify type of bacteria.""Your infection is not a serious one and over time your body should be able to kill the bacteria."

"Some antibiotics work with your body's ability to help kill the infection."

Which is a priority nursing assessment for the client receiving multiple antibiotics? Assessing blood cultures for the presence of bacteriaAssessing changes in stool, white patches in the mouth, and urogenital itching or rashAssessing renal and liver function testsAssessing whether or not the client has adequate food and fluid intake

Assessing changes in stool, white patches in the mouth, and urogenital itching or rash

Which statement should the nurse include when discussing antibiotic resistance with a client? "Resistance to antibiotics most often occurs when a client has a suppressed immune system.""Resistance to antibiotics can occur by the common use for nosocomial infections.""Resistance to antibiotics most often occurs when prescribed to treat the wrong organism.""Resistance to antibiotics can occur any time they are prophylactic prescribed."

"Resistance to antibiotics can occur by the common use for nosocomial infections."

Which laboratory test should the nurse anticipate prescribed to help identify the correct antibiotic to be used for the treatment of a client with a fever of 104°F? Liver function testsComplete blood count (CBC)UrinalysisBlood for culture and sensitivity

Blood for culture and sensitivity

Which is a nursing priority action for the client receiving gentamicin (Garamycin) intravenously? Monitor the client for hearing loss.Draw daily blood chemistries.Decrease the fluids for the client during therapy.Place the client on isolation precautions.

Monitor the client for hearing loss.

The nurse notes a client that has received intravenous vancomycin (Vancocin) develops an upper body rash and has a decreased urine output. In addition to notifying the healthcare provider, which is the nurse's priority action? Hold the next dose of vancomycin (Vancocin).Obtain a stat x-ray.Administer an antihistamine.Obtain a sterile urine specimen.

Hold the next dose of vancomycin (Vancocin).

A client with tuberculosis asks why they are prescribed multiple drugs. Which information should the nurse include in the education? "Current research indicates that the most effective way to treat tuberculosis is with multiple drugs.""Multiple drugs are necessary because the bacteria are likely to develop resistance to just one drug.""Treatment for tuberculosis is complex, and multiple drugs must be continued for as long as you are contagious.""Multiple drug treatment is necessary to help develop an immunity to tuberculosis."

"Multiple drugs are necessary because the bacteria are likely to develop resistance to just one drug."

Which priority nursing actions should the nurse take prior to administering penicillin G benzathine (Bicillin LA) to a client?
Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. Have the client lie down and assess vital signs.Inquire about a history of allergies to penicillin.Inform the client that they will need be observed for 30 minutes after the injection.Inform the client that they will need someone to drive them home.Advise the client to rest for the remainder of the day.

Inquire about a history of allergies to penicillin.Inform the client that they will need be observed for 30 minutes after the injection.