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A 60-year-old patient with a history of hypertension presents to the clinic for a routine check-up. Which of the following findings would indicate poor management of hypertension?
(Select All that Apply.)

Frequent headaches

Blood pressure consistently at goal

Normal renal function tests

Steady weight with no recent gain

Proteinuria on urinalysis

Left ventricular hypertrophy on echocardiogram

Absence of retinal changes on fundoscopic exam

Answer and Explanation

Correct Answer : E,F

A.   Frequent headaches can be a symptom of hypertension but are not specific to poorly managed hypertension.
B.   Blood pressure consistently at goal indicates good management of hypertension.
C.   Normal renal function tests suggest that there has been no damage to the kidneys, a common consequence of poorly controlled hypertension.
D.   Steady weight with no recent gain suggests good management of overall health, which can contribute to better blood pressure control.
E.   Proteinuria indicates kidney damage, often a result of uncontrolled hypertension.
F.   Left ventricular hypertrophy (LVH) is a sign of chronic hypertension and indicates poor management, as it results from the heart working harder to pump blood against increased pressure.
G.   Absence of retinal changes on fundoscopic exam indicates that there is no evidence of hypertensive retinopathy, suggesting good hypertension management.

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Correct Answer is B

Explanation

A. Almond milk can be a good source of calcium, but it is often lower in calcium compared to dairy products unless fortified.
B. Low-fat milk is an excellent source of calcium and is also easy for most people to digest.
C. Whole milk contains calcium, but it is higher in fat, which is not ideal for individuals at risk for osteoporosis.
D. Soy milk can be a good source of calcium if fortified, but it does not always contain as much calcium as low-fat milk.

A. Flush the NG tube with 60 mL of water before starting the feeding. B. Administer the feeding with the patient lying flat to ensure comfort. C. Increase the feeding rate to ensure the patient receives adequate nutrition. D. Position the patient in a semi-Fowler's position during and after feeding.

Correct Answer is D

Explanation

A. Flushing the NG tube with 60 mL of water before feeding is not sufficient to reduce aspiration risk.
B. Administering the feeding with the patient lying flat increases the risk of aspiration and should be avoided.
C. Increasing the feeding rate could cause discomfort and increase the risk of aspiration if the stomach becomes overdistended.
D. Positioning the patient in a semi-Fowler's position (head of the bed elevated 30 to 45 degrees) reduces the risk of aspiration during and after feeding.

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A 60-year-old patient with a history of hypertension presents to the clinic for a routine check-up. Which of the following findings would indicate poor management of hypertension? (Select All that Apply.)

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A 60-year-old patient with a history of hypertension presents to the clinic for a routine check-up. Which of the following findings would indicate poor management of hypertension?
(Select All that Apply.)