A patient with a history of hypertension treated with a diuretic and an angiotensin-converting enzyme (ACE) inhibitor arrives in the emergency department complaining of headache and blurred vision and has a blood pressure (BP) of 192/108 mmHg. Which question should the nurse ask to follow up on these findings?
"Have you recently taken any antihistamines?"
"Did you take any acetaminophen (Tylenol) today?"
"Have there been recent stressful events in your life?
"Have you consistently taken your medications?"
The Correct Answer is D
A. Antihistamines can raise blood pressure, but this is less likely to be the primary cause compared to medication non-adherence.
B. Acetaminophen is generally safe for use in hypertensive patients and is unlikely to contribute to the high blood pressure in this scenario.
C. Stress can contribute to elevated blood pressure, but non-adherence to medications is a more likely cause of the severe BP elevation in this case.
D. Poor medication adherence is a common cause of elevated blood pressure despite treatment. If the client has not been consistently taking their antihypertensive medications, this could explain the elevated BP and symptoms (headache, blurred vision).
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. Nitroglycerin is often taken preventatively before activities that may trigger chest pain, in addition to being used when chest pain occurs. The statement is incorrect because nitroglycerin can be used both preventatively and acutely.
B. A headache is a common side effect of nitroglycerin due to vasodilation. However, the client’s primary concern should be relief of chest pain, and the statement does not demonstrate a proper response to the medication’s therapeutic effect.
C. This statement indicates understanding of the correct action if chest pain is unrelieved after taking the maximum recommended dose of nitroglycerin (three tablets, 5 minutes apart). If pain persists, it may indicate a myocardial infarction, and the client should seek emergency medical help immediately by calling an ambulance.
D. Nitroglycerin may cause vasodilation and potentially reduce respiratory rate, but it does not directly reduce the respiratory rate in a therapeutic sense. This statement misrepresents the expected effect of the drug.
Correct Answer is D
Explanation
A. A fasting blood glucose level of 98 mg/dL is within the normal range (70–99 mg/dL), indicating no immediate concern for diabetes.
B. An HDL cholesterol level of 58 mg/dL is considered protective against CAD, as higher HDL levels are associated with a lower risk of heart disease.
C. Triglyceride levels of 120 mg/dL are within the normal range (less than 150 mg/dL), so they do not require follow-up.
D. A total cholesterol level of 210 mg/dL is slightly above the recommended level of less than 200 mg/dL. Elevated cholesterol, particularly LDL cholesterol, is a key modifiable risk factor for coronary artery disease (CAD).
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