Based on annual physical assessments, an older adult female's blood pressure readings have changed from 120/82 to 155/86 mm Hg over the past two years. The practical nurse (PN) should recognize which factors in the client's history are likely to be associated with this finding? (Select all that apply.)
History of diabetes mellitus.
Hyperlipidemia.
Leads an aerobics class.
Increase in age.
Body mass index of 22.
Correct Answer : A,B,D
A. History of diabetes mellitus: Diabetes contributes to vascular damage and decreased arterial elasticity, which can elevate blood pressure over time. Poor glucose control increases atherosclerotic risk, making hypertension more likely in older adults.
B. Hyperlipidemia: Elevated lipid levels promote plaque formation within arterial walls, reducing vessel flexibility and increasing systemic vascular resistance. This process contributes to the gradual development of hypertension.
C. Leads an aerobics class: Regular aerobic exercise typically improves cardiovascular health by lowering blood pressure and enhancing vessel elasticity. This lifestyle factor would more likely protect against hypertension rather than cause it.
D. Increase in age: Aging naturally causes vascular stiffening and decreased arterial compliance, leading to higher systolic blood pressure. This physiological change is a major risk factor for developing hypertension in older adults.
E. Body mass index of 22: A BMI within the normal range (18.5–24.9) indicates a healthy weight, which generally supports normal blood pressure. Obesity, not a normal BMI, is a key contributor to hypertension.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Confirm that the client is using the correct technique: Observing a return demonstration allows the PN to verify that the client can perform pursed-lip breathing correctly. Confirming proper technique ensures the client can use this method effectively to improve ventilation and control dyspnea.
B. Review each step of the breathing technique with the client: Reviewing steps is appropriate if the client demonstrates errors or uncertainty. If the demonstration is correct, repeated review is unnecessary and may not add value.
C. Demonstrate how to breathe in more slowly and effectively: Additional demonstration is only needed if the client’s technique is incorrect or inefficient. Unneeded repetition may cause confusion when the client is already performing correctly.
D. Remind the client to cough deeply to loosen secretions: While coughing can help clear secretions, it is not part of pursed-lip breathing instruction. Introducing unrelated techniques may distract from mastering the intended breathing method.
Correct Answer is A
Explanation
A. Watch the client for abnormal bleeding: Thrombocytopenia increases the risk of spontaneous bleeding and hemorrhage. Monitoring for signs such as petechiae, ecchymosis, or bleeding from mucous membranes is the most critical safety measure.
B. Obtain the client's blood pressure frequently: While important for overall assessment, frequent BP monitoring does not directly prevent or detect bleeding unless invasive procedures are performed.
C. Maintain protective isolation precautions: Protective isolation primarily prevents infection, which is crucial for neutropenic clients but does not address the bleeding risk associated with low platelets.
D. Observe for signs of dehydration: Hydration is important in chemotherapy care but is secondary to preventing life-threatening bleeding in a client with thrombocytopenia.
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