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 ["B","C","D"]

Explanation

The nurse should acknowledge the need for intimacy and value themselves in sexual relationships, ask if sexual experiences cause any kind of physical or emotional discomfort, and discuss any changes in sexual experience or satisfaction since beginning new treatments ordered by care providers.

These actions show respect, empathy, and professionalism towards the client’s sexuality.

Choice A is wrong because waiting for the client to volunteer information about any sexual problems they are having may imply that the nurse is uncomfortable or uninterested in addressing sexuality.

The nurse should initiate the conversation and create a safe and supportive environment for the client to express their concerns.

A. “It wouldn’t have mattered what you had worn.”. B. “The current styles are an invitation to disaster.”. C. “Never mind about blame. D. That will be determined by the court.”.

Correct Answer is A

Explanation

“It wouldn’t have mattered what you had worn.” This response by a nurse is appropriate because it validates the client’s feelings and helps to reduce self-blame. It also conveys that rape is not caused by the victim’s clothing or behavior, but by the perpetrator’s violence and lack of respect.

Choice B. “The current styles are an invitation to disaster.” is wrong because it implies that the client is responsible for the rape and that she could have prevented it by dressing differently. This response is judgmental and insensitive, and may increase the client’s guilt and shame.

Choice C. “Never mind about blame.

That will be determined by the court.” is wrong because it dismisses the client’s feelings and does not address her emotional needs.

It also suggests that the nurse does not believe the client or support her. This response may make the client feel isolated and distrustful.

Choice D. “Some people don’t have very good self-control.

We have to help them all we can.” is wrong because it excuses the perpetrator’s behavior and shifts the blame to the victim.

It also implies that rape is a result of sexual desire, rather than an act of violence and domination. This response may make the client feel powerless and helpless.

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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

When a client reports altered sexuality patterns, the nurse should: (Select all that apply).

Correct Answer is ["B","C","D"]

Explanation

A client in the emergency department who has been raped says repeatedly, “if only I hadn’t worn that sexy dress.” Which response by a nurse is appropriate?

Correct Answer is A

Explanation

A client has been newly diagnosed with hypothyroidism. What symptoms or signs would be expected with this diagnosis? Select all that apply.

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What pain description is the client with renal calculi most likely to report during an assessment?

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