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

A two-hour postprandial glucose test is done to check your blood sugar level two hours after you eat a meal.

This test helps to diagnose diabetes or monitor its treatment. A normal blood sugar level for this test is less than 140 mg/dL.

Choice A is wrong because fasting means not eating for at least eight hours before the test. This is done for a fasting blood glucose test, not a postprandial one.

Choice B is wrong because before breakfast means before you eat anything in the morning. This is also done for a fasting blood glucose test, not a postprandial one.

Choice D is wrong because before glucose is consumed means before you drink a sugary liquid for a glucose tolerance test. This test measures how your body handles glucose after drinking it, not after eating a meal.

A. The client has frequent coughing spells. B. The client reports mild abdominal cramps. C. The client has high-pitched bowel sounds. D. The client reports one to two soft bowel movements per day.

Correct Answer is A

Explanation

This is because coughing can indicate aspiration of the feeding into the lungs, which can lead to pneumonia and other serious complications. Aspiration is reported in up to 89% of patients receiving nasogastric tube feeding.

Therefore, the nurse should prioritize assessing the client for signs of aspiration and ensuring proper tube placement.

Choice B is wrong because mild abdominal cramps are a common side effect of nasogastric tube feeding and do not require immediate intervention unless they are severe or persistent.

Choice C is wrong because high-pitched bowel sounds are normal and indicate peristalsis and digestion.

They do not indicate a problem with the tube feeding.

Choice D is wrong because one to two soft bowel movements per day are desirable and indicate adequate nutrition and hydration.

They do not indicate a problem with the tube feeding.

Normal ranges for gastric residual volume are less than 200 mL for adults and less than 100 mL for children. Normal ranges for pH of gastric aspirate are 1 to 5.

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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

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Correct Answer is C

Explanation

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Correct Answer is A

Explanation

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