A nurse is teaching a client with hypertension about dietary modifications. Which recommendation is most appropriate to reduce blood pressure?

Increase sodium intake to maintain electrolyte balance

Consume a diet high in saturated fats

Follow a DASH diet rich in fruits and vegetables

Limit potassium-rich foods to prevent fluid retention

Answer and Explanation

The Correct Answer is C

Choice A reason: Increasing sodium intake raises blood pressure by promoting fluid retention, increasing vascular volume, and straining the cardiovascular system. Hypertensive clients need sodium restriction to reduce fluid overload and vascular resistance, making this recommendation harmful, as it exacerbates hypertension rather than controlling it.

Choice B reason: A diet high in saturated fats contributes to atherosclerosis, increasing vascular resistance and blood pressure. It also raises LDL cholesterol, worsening cardiovascular risk. Hypertensive clients require heart-healthy diets low in saturated fats to reduce blood pressure and protect against heart disease, making this inappropriate.

Choice C reason: The DASH (Dietary Approaches to Stop Hypertension) diet, rich in fruits, vegetables, and low-fat dairy, reduces blood pressure by providing potassium, magnesium, and fiber. These nutrients lower vascular resistance and promote vasodilation, improving cardiovascular health. It is evidence-based and recommended for hypertension management, making it the best choice.

Choice D reason: Limiting potassium-rich foods is not recommended for hypertension, as potassium promotes vasodilation and reduces blood pressure by counteracting sodium’s effects. Potassium-rich foods, like fruits, are part of the DASH diet, which helps control hypertension, making this recommendation incorrect for blood pressure management.

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Correct Answer is B

Explanation

Choice A reason: pH 7.48, PaCO2 40 mmHg, HCO3- 24 mEq/L indicates alkalosis, not acidosis. Diabetic ketoacidosis (DKA) causes metabolic acidosis due to ketone accumulation, lowering pH and bicarbonate. Normal PaCO2 and HCO3- rule out DKA, as compensatory hyperventilation would lower PaCO2 in response to acidosis.

Choice B reason: pH 7.30, PaCO2 30 mmHg, HCO3- 18 mEq/L indicates metabolic acidosis with respiratory compensation. In DKA, ketone production lowers pH and bicarbonate, while hyperventilation reduces PaCO2 to compensate. These values align with DKA’s acid-base imbalance, reflecting the body’s attempt to correct acidosis through increased respiration.

Choice C reason: pH 7.50, PaCO2 45 mmHg, HCO3- 30 mEq/L indicates metabolic alkalosis, not acidosis. DKA causes acidosis from ketone accumulation, not alkalosis. Elevated bicarbonate and normal PaCO2 suggest a different condition, like vomiting-induced alkalosis, making this inconsistent with the metabolic acidosis seen in DKA.

Choice D reason: pH 7.35, PaCO2 38 mmHg, HCO3- 22 mEq/L indicates normal acid-base balance. DKA results in metabolic acidosis with low pH and bicarbonate due to ketone production. Normal values do not reflect the acidotic state of DKA, where compensatory mechanisms would alter PaCO2 and HCO3- significantly.

A. Instruct them to take a long walk an hour before bedtime B. Arrange with laboratory to draw blood outside of sleep hours C. Encourage patients to fall asleep while watching television D. Close the door to patients’ rooms at bedtime E. Provide a warm green tea or coffee with evening meal

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

Explanation

Choice A reason: A long walk an hour before bedtime may stimulate the body, increasing heart rate and alertness, which can delay sleep onset. Physical activity is beneficial earlier in the day to promote sleep, but close to bedtime, it may disrupt the body’s wind-down process, reducing sleep quality in hospitalized patients.

Choice B reason: Arranging blood draws outside sleep hours minimizes nighttime disruptions, which are critical for restorative sleep. Hospital environments often interrupt sleep with procedures, increasing stress and fatigue. This intervention supports the sleep-wake cycle by ensuring uninterrupted rest, promoting better recovery and reducing physiological stress in patients.

Choice C reason: Watching television before sleep exposes patients to blue light, which suppresses melatonin production, a hormone essential for sleep. This can delay sleep onset and reduce sleep quality. Hospitalized patients need a calm, low-stimulation environment to promote rest, making television an inappropriate intervention for sleep promotion.

Choice D reason: Closing the door at bedtime reduces noise and light from hospital corridors, creating a quieter, darker environment conducive to sleep. This minimizes disruptions, supporting the body’s circadian rhythm and melatonin production. A calm environment is essential for hospitalized patients, who often face sleep challenges due to hospital activity.

Choice E reason: Green tea or coffee contains caffeine, a stimulant that inhibits sleep by blocking adenosine receptors, increasing alertness. Consuming these near bedtime can delay sleep onset and reduce sleep quality. Hospitalized patients require interventions that promote relaxation, not stimulation, making this an inappropriate choice for sleep promotion.

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A nurse is teaching a client with hypertension about dietary modifications. Which recommendation is most appropriate to reduce blood pressure?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client with diabetic ketoacidosis. Which arterial blood gas result is most consistent with this condition?

Correct Answer is B

Explanation

Which nursing interventions are appropriate to include in a plan of care to promote sleep for patients who are hospitalized? (Select all that apply)

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

Explanation

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