The nurse is assessing a patient with chronic hypertension whose blood pressure has been 160/90 for the last three clinic visits. What new symptom indicates that the patient may be experiencing target organ damage?

Muscle cramps

Bounding pulses

Vision changes

Increased energy

Answer and Explanation

The Correct Answer is C

A. Muscle cramps: While muscle cramps can occur with hypertension, they are not specific indicators of target organ damage. Muscle cramps are more commonly associated with electrolyte imbalances or peripheral vascular disease.

B. Bounding pulses: Bounding pulses can indicate increased stroke volume and cardiac output, which may occur in response to chronic hypertension. However, they are not direct indicators of target organ damage.

C. Vision changes: Vision changes, such as blurred vision or vision loss, can be indicative of hypertensive retinopathy, a complication of chronic hypertension affecting the blood vessels in the retina. These changes may manifest as decreased visual acuity, floaters, or even sudden vision loss and are considered signs of target organ damage.

D. Increased energy: Increased energy is not typically associated with target organ damage in the context of chronic hypertension. It may be a result of various factors unrelated to hypertension, such as improved sleep quality or changes in lifestyle habits.

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Correct Answer is A

Explanation

A. Using appropriate personal protective equipment (PPE): Standard precautions include the use of PPE such as gloves, masks, gowns, and eye protection when caring for all patients, regardless of their known or suspected infectious status. This helps prevent the transmission of pathogens between the patient and the healthcare provider.

B. Placing patient in positive pressure isolation room: Placing a patient in a positive pressure isolation room is not a component of standard precautions. Positive pressure rooms are typically used for patients with compromised immune systems to protect them from exposure to airborne pathogens. Standard precautions should be followed regardless of the patient's room type.

C. Placing patient in contact precautions: Contact precautions involve specific measures to prevent the transmission of pathogens through direct or indirect contact with the patient or their environment. While contact precautions may be necessary for certain infectious diseases, they are not a component of standard precautions.

D. Wearing gloves at all times: While wearing gloves is part of standard precautions, it is not the only key element. Standard precautions also include other forms of PPE such as masks, gowns, and eye protection, as well as other infection control practices such as hand hygiene and environmental cleaning.

A. Loss of hair over toes. B. Tenderness in the thigh. C. Rest pain. D. Auscultation of bruit over pedal pulse.

Correct Answer is B

Explanation

A. Loss of hair over toes:
Loss of hair over the toes is not typically associated with deep vein thrombosis (DVT). Instead, it may be indicative of peripheral arterial disease (PAD) or poor peripheral circulation. In DVT, symptoms are more related to venous congestion and inflammation rather than hair loss.

B. Tenderness in the thigh:
Tenderness in the thigh is a common clinical manifestation of deep vein thrombosis (DVT). It occurs due to the presence of a thrombus within the deep veins of the thigh, causing local inflammation and irritation of the vessel wall. This tenderness may be elicited by palpation along the course of the affected vein.

C. Rest pain:
Rest pain is not typically associated with deep vein thrombosis (DVT). Rest pain is more commonly seen in conditions such as peripheral arterial disease (PAD), where inadequate blood supply to the extremities leads to ischemic pain at rest, especially during periods of reduced blood flow.

D. Auscultation of bruit over pedal pulse:
Auscultation of a bruit over the pedal pulse is not typically associated with deep vein thrombosis (DVT). A bruit is an abnormal sound caused by turbulent blood flow through a narrowed or obstructed vessel, commonly heard in arterial conditions such as atherosclerosis. In DVT, venous obstruction does not typically produce bruits.

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The nurse is assessing a patient with chronic hypertension whose blood pressure has been 160/90 for the last three clinic visits. What new symptom indicates that the patient may be experiencing target organ damage?

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