A nurse is caring for a patient who is returning for a repeat blood pressure to determine if white coat syndrome occurred during the first clinical visit. Which diagnostic test will be used to confirm a diagnosis of hypertension?

A renal ultrasound

A cardiac stress test

A manual blood pressure cuff

Ambulatory blood pressure measurement

Answer and Explanation

The Correct Answer is D

Answer: D

Rationale:

A) A renal ultrasound: A renal ultrasound is not typically used to confirm a diagnosis of hypertension. While renal artery stenosis can contribute to hypertension in some cases, it is not the primary diagnostic test for hypertension.

B) A cardiac stress test: A cardiac stress test is not used to confirm a diagnosis of hypertension. It is primarily used to assess cardiovascular function and detect coronary artery disease or cardiac arrhythmias.

C) A manual blood pressure cuff: While manual blood pressure measurements can provide accurate readings, they are subject to potential inaccuracies due to factors such as observer bias and white coat syndrome. Therefore, they may not be the most reliable method for confirming a diagnosis of hypertension.

D) Ambulatory blood pressure measurement: Ambulatory blood pressure measurement involves obtaining multiple blood pressure readings over a 24-hour period using a portable monitor. It is considered the gold standard for diagnosing hypertension, as it provides a more comprehensive assessment of blood pressure variability and reduces the impact of white coat syndrome. Therefore, it is the preferred diagnostic test in this scenario to confirm whether the patient has hypertension outside of the clinical setting.

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Correct Answer is C

Explanation

A. Monitors the patient's temperature, heart rate, respiratory rate, and blood pressure:
Monitoring vital signs is crucial for assessing the patient's overall condition, including respiratory status. However, while changes in vital signs may indicate respiratory distress, they do not directly address the need to ensure clear breath sounds. This intervention alone does not actively promote airway clearance or improve breath sounds.

B. Educates the patient to avoid handling pet excreta or cleaning litter boxes, birdcages, or aquariums:
This intervention focuses on reducing the risk of exposure to potential pathogens that could worsen the patient's respiratory condition. While important for infection control, it does not directly address the need to ensure clear breath sounds. Environmental precautions, although necessary, do not actively promote airway clearance or improve breath sounds.

C. Encourages the patient to perform cough, deep breathing, and postural drainage every 2 to 4 hours:
This intervention directly targets promoting airway clearance and improving breath sounds in a patient with pneumonia. Coughing helps mobilize secretions, deep breathing promotes lung expansion and ventilation, and postural drainage assists in the drainage of secretions from different lung segments. Regular performance of these interventions prevents secretion accumulation, thereby improving breath sounds and respiratory function.

D. Provides nutritional support if the patient is unable to take sufficient amounts by mouth:
While nutritional support is important for overall patient care, especially during illness or compromised nutritional intake, it does not directly address the need to ensure clear breath sounds in a patient with pneumonia. Although adequate nutrition supports immune function and overall recovery, it does not directly impact respiratory clearance or breath sounds.

A. Drink purified water B. Avoid crowded, enclosed spaces C. Complete the vaccination series D. Avoid sharing utensils

Correct Answer is C

Explanation

A. Drink purified water: While drinking purified water is important for preventing various waterborne diseases, it is not a preventive measure specifically targeted at hepatitis B virus (HBV) transmission. HBV is primarily transmitted through exposure to infected blood or body fluids, such as during unprotected sex, sharing needles, or from mother to child during childbirth. Drinking purified water does not protect against these modes of HBV transmission.

B. Avoid crowded, enclosed spaces: Avoiding crowded, enclosed spaces may reduce the risk of respiratory infections, but it does not specifically prevent HBV transmission. HBV is not transmitted through the air like respiratory viruses. Instead, it is spread through direct contact with infected blood or body fluids. While avoiding crowded spaces may be a general infection control measure, it is not a targeted preventive measure for HBV.

C. Complete the vaccination series: This is the correct preventive measure for HBV. The hepatitis B vaccine is highly effective in preventing HBV infection. It is administered as a series of shots, typically given in three doses over a period of several months. Completing the vaccination series provides long-term immunity against HBV infection and is recommended for all individuals, including travelers to regions where HBV is common. Vaccination not only protects the individual but also contributes to reducing the overall prevalence of HBV in the community.

D. Avoid sharing utensils: While avoiding sharing utensils can reduce the risk of transmitting certain infections, such as colds or flu, it is not specifically aimed at preventing HBV transmission. HBV is primarily transmitted through activities involving exposure to infected blood or body fluids, rather than through sharing utensils. While practicing good hygiene and avoiding behaviors that may result in exposure to blood or body fluids are important preventive measures for HBV, completing the vaccination series is the most effective way to prevent infection.

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