A nurse is screening a community group for hypertension. Which person should be referred for immediate treatment?

A 20-year-old client who has a blood pressure of 125/60 mm Hg.

A 40-year-old client who has a blood pressure of 138/98 mm Hg.

A 55-year-old client who has a blood pressure of 142/68 mm Hg.

A 70-year-old client who has a blood pressure of 150/78 mm Hg.

Answer and Explanation

The Correct Answer is B

A 40-year-old client who has a blood pressure of 138/98 mm Hg should be referred for immediate treatment. This is because this client has grade 1 hypertension according to the International Society of Hypertension (ISH) guidelines, which define hypertension as a systolic blood pressure (SBP) of 140 mm Hg or higher and/or a diastolic blood pressure (DBP) of 90 mm Hg or higher in the office or clinic. This client also has a high risk of cardiovascular complications due to their age and elevated DBP.

Choice A is wrong because a 20-year-old client who has a blood pressure of 125/60 mm Hg does not have hypertension. This client has normal blood pressure according to the ISH guidelines, which define normal blood pressure as an SBP of less than 130 mm Hg and a DBP of less than 85 mm Hg in the office or clinic. This client also has a low risk of cardiovascular complications due to their age and low DBP.

Choice C is wrong because a 55-year-old client who has a blood pressure of 142/68 mm Hg does not need immediate treatment. This client has grade 1 hypertension according to the ISH guidelines, but their DBP is normal. The ISH guidelines recommend lifestyle interventions for three to six months before medication in patients with grade 1 hypertension and no comorbidities.

This client may have other risk factors that need to be assessed, such as obesity, diabetes, or smoking, but they do not require urgent referral.

Choice D is wrong because a 70-year-old client who has a blood pressure of 150/78 mm Hg does not need immediate treatment. This client has grade 1 hypertension according to the ISH guidelines, but their DBP is normal. The ISH guidelines recommend a target blood pressure of less than 140/90 mm Hg within three months for patients older than 65 years, and after three months reduce the target to less than 130/80 mm Hg.

This client may have other risk factors that need to be assessed, such as chronic kidney disease, heart failure, or atrial fibrillation, but they do not require urgent referral.

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Correct Answer is C

Explanation

Orient the client to the arrangement of the room to promote independence. This strategy helps the client who is blind to navigate the environment safely and confidently. It also shows respect for the client’s autonomy and dignity.

Choice A is wrong because speaking loudly is not necessary for a client who is blind, unless they also have hearing impairment. Speaking loudly may imply that the client is less intelligent or capable, which is not true.

Choice B is wrong because touching the client prior to speaking may startle or frighten them. It is better to identify oneself verbally and ask for permission before touching the client.

Choice D is wrong because keeping the bed in the highest position may increase the risk of injury if the client tries to get out of bed alone. It also restricts the client’s mobility and independence, which may affect their self-esteem and quality of life.

A. Decreases risk of skin breakdown behind the knee. B. Eliminates pain of arthritis of the lower legs. C. Prevents pressure on the popliteal artery. D. Avoids irritation of the knee joints.

Correct Answer is C

Explanation

The popliteal artery is a major blood vessel that runs behind the knee and supplies blood to the lower leg. Sitting with knees crossed can compress this artery and reduce blood flow to the leg.

This can cause numbness, tingling, or pain in the leg. It can also increase the risk of blood clots or varicose veins.

Choice A is wrong because sitting with knees crossed does not decrease the risk of skin breakdown behind the knee. In fact, it may increase the risk by causing friction or pressure on the skin.

Choice B is wrong because sitting with knees crossed does not eliminate the pain of arthritis in the lower legs.

Arthritis is a joint inflammation that causes pain, stiffness, and swelling. Sitting with knees crossed can worsen these symptoms by putting more stress on the knee joints.

Choice D is wrong because sitting with knees crossed does not avoid irritation of the knee joints.

On the contrary, it can cause irritation by overstretching the knee ligaments and muscles

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A nurse is screening a community group for hypertension. Which person should be referred for immediate treatment?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Which strategy should a nurse include when communicating with a client who is blind?

Correct Answer is C

Explanation

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Correct Answer is C

Explanation

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