The nurse is caring for a client newly diagnosed with hypertension. Which statement by the client indicates the need for further teaching?

"If I take my blood pressure and it is normal, I don't have to take my blood pressure pills."

"When getting up from bed, I will sit for a short period before standing up."

"I will consult a dietician to help get my weight under control."

"I think I'm going to sign up for a yoga class twice a week to help reduce my stress."

Answer and Explanation

The Correct Answer is A

A. "If I take my blood pressure and it is normal, I don't have to take my blood pressure pills": This statement reflects a misunderstanding of hypertension management. Blood pressure medications are typically prescribed to help control blood pressure over the long term, regardless of individual blood pressure readings. Stopping medication without consulting a healthcare provider can be dangerous and is not recommended.

B. "When getting up from bed, I will sit for a short period before standing up": This statement demonstrates an understanding of orthostatic hypotension prevention, which is important for clients with hypertension and can be a side effect of certain medications.

C. "I will consult a dietician to help get my weight under control": This statement indicates the client's awareness of the importance of weight management in hypertension control and is a positive step toward healthy lifestyle changes.

D. "I think I'm going to sign up for a yoga class twice a week to help reduce my stress": This statement shows the client's proactive approach to stress reduction, which is beneficial for hypertension management as stress can contribute to elevated blood pressure.

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Correct Answer is C

Explanation

A. Whether the client and involved family members understand dietary changes and the role of nutrition:

This assessment is important as diet plays a crucial role in managing coronary artery disease (CAD) and preventing further complications. Understanding dietary changes, such as reducing saturated fats, sodium intake, and incorporating heart-healthy foods like fruits, vegetables, and whole grains, is essential. Nutrition education can help clients and their families make informed choices that promote heart health and improve overall well-being. However, while understanding dietary changes is significant, it may not be the most critical determination during the initial intake assessment, especially when compared to immediate concerns like recognizing acute cardiac symptoms.

B. Whether the client and involved family members understand the role of genetics in the etiology of the disease:

Understanding the genetic factors contributing to coronary artery disease can provide valuable insights into the client's risk factors and potential hereditary predispositions. This knowledge can help guide screening, prevention, and management strategies tailored to the client's specific genetic profile. While genetic factors are important considerations in CAD, they typically require a more detailed evaluation and may not be the primary focus during the initial intake assessment, especially compared to immediate concerns related to symptom recognition and response.

C. Whether the client and involved family members are able to recognize symptoms of an acute cardiac problem and respond appropriately:

This is a crucial assessment because recognizing symptoms such as chest pain, shortness of breath, nausea, sweating, and arm or jaw pain is essential in identifying a potential heart attack or unstable angina. Knowing when to seek emergency medical assistance and how to respond appropriately can significantly impact outcomes and reduce the risk of complications. Immediate response to acute cardiac symptoms is a critical aspect of CAD management, making it a top priority during the intake assessment.

D. Whether the client and involved family members understand the importance of social support and community agencies:

Social support and community resources play a valuable role in CAD management, providing emotional support, access to education programs, rehabilitation services, and other supportive resources. Understanding the importance of social support and knowing how to access community agencies can enhance the client's overall well-being and facilitate long-term management.

A. Anxiety B. Sleep C. Fever D. Hyperglycemia E. Blood loss

Correct Answer is ["A","C","E"]

Explanation

A. Anxiety:

Anxiety can lead to an increased heart rate due to the activation of the sympathetic nervous system. When a person is anxious, their body releases stress hormones like adrenaline, which can stimulate the heart to beat faster. This increased sympathetic activity can cause sinus tachycardia, where the heart rate is faster than normal.

B. Sleep:

While sleep can affect heart rate variability, causing fluctuations in heart rate during different stages of sleep, it typically does not cause a significant and sustained increase in heart rate like sinus tachycardia. Sleep is more likely to influence heart rate patterns rather than directly cause sinus tachycardia.

C. Fever:

Fever, especially in response to infection or inflammation, can lead to an elevated heart rate. The body's response to fever includes increased metabolic activity, which can raise the heart rate as part of the physiological stress response. Fever-induced sinus tachycardia is a common finding in individuals with infections.

D. Hyperglycemia:

While hyperglycemia (high blood sugar levels) can have cardiovascular effects over time, such as contributing to atherosclerosis and heart disease, it is not typically a direct cause of sinus tachycardia. Sinus tachycardia is more commonly associated with acute stressors like anxiety, fever, or hypovolemia (such as from blood loss).

E. Blood loss:

Significant blood loss, such as during surgery or due to trauma, can result in hypovolemia, where there is a decrease in blood volume circulating in the body. In response to hypovolemia, compensatory mechanisms kick in, including an increase in heart rate (sinus tachycardia), to maintain blood pressure and perfusion to vital organs.

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The nurse is caring for a client newly diagnosed with hypertension. Which statement by the client indicates the need for further teaching?

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Naxlex Comprehensive Predictor Exams

The nurse is performing an intake assessment on a client with a new diagnosis of coronary artery disease. What would be the most important determination to make during this intake assessment?

Correct Answer is C

Explanation

The nurse receives a client from the post-anesthesia unit with a new onset of sinus tachycardia and a heart rate of 118 beats per minute. To which reasons does the nurse relate the increased heart rate? (Select All that Apply.)

Correct Answer is ["A","C","E"]

Explanation

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