The nurse is evaluating a client at a one-month check-up who is being treated for hypertension through lifestyle modifications.
Which of the following findings would be a priority for the nurse to follow up?

The client is obese and has been exercising for 20 minutes per day twice each week.

The client has reduced sodium intake from 5 grams per day to 3.5 grams per day.

The client drinks 1 to 2 glasses of wine with dinner a few nights per week.

The client has reduced smoking cigarettes from 2 packs per day to 1.5 packs per day.

Answer and Explanation

The Correct Answer is A

Choice A rationale

Obesity and minimal exercise contribute significantly to hypertension due to increased vascular resistance and poor cardiac health. Recommendations for hypertension management include regular physical activity at least 30 minutes daily, five times per week. Current exercise efforts are insufficient, indicating a need for intervention to optimize blood pressure reduction.

Choice B rationale

Sodium intake reduction to 3.5 grams daily is an improvement but still exceeds the recommended limit of 2.3 grams. Excess sodium contributes to hypertension by increasing fluid retention and vascular resistance, though this change alone does not prioritize follow-up over sedentary behavior, which has a larger impact.

Choice C rationale

Alcohol consumption can elevate blood pressure by affecting vascular tone and increasing sympathetic nervous system activity. While 1-2 glasses per day may be within moderation, prioritizing increased physical activity would have a greater benefit on hypertension management than reducing alcohol intake alone.

Choice D rationale

Reducing cigarette smoking from 2 packs to 1.5 packs per day lowers nicotine exposure but still significantly contributes to hypertension through vasoconstriction and arterial damage. Exercise intervention is more impactful for cardiovascular health and blood pressure management in this context.

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

Explanation

Choice A rationale

Malaise is more associated with systemic conditions, such as upper urinary tract infections or generalized illness, rather than isolated lower urinary tract infections. Lower UTIs tend to present with localized urinary symptoms rather than systemic effects.

Choice B rationale

Chills suggest systemic involvement and are characteristic of pyelonephritis or upper urinary tract infections. Lower UTIs typically do not produce systemic signs like chills, as the infection is confined to the bladder and urethra.

Choice C rationale

Dysuria is a classic symptom of lower UTIs. It results from inflammation of the bladder mucosa due to the presence of pathogenic organisms. The irritation of the urinary tract leads to painful or difficult urination, confirming the diagnosis of lower UTI.

Choice D rationale

High fever, like chills, is indicative of upper urinary tract infections, such as pyelonephritis. Lower UTIs are generally afebrile, presenting more with localized urinary symptoms rather than systemic manifestations.

Choice E rationale

Urinary frequency is another hallmark symptom of lower UTIs, caused by bladder irritation. The infection leads to an increased urge to urinate, even when little urine is produced. This symptom is specific to lower UTIs and supports the diagnosis when present.

A. Over-the-counter Sudafed should not be taken while I am taking this medication. B. I will stop taking the medication if I have any signs or symptoms of infection. C. I will not combine this medication with any type of antidepressant medications. D. Retention of urine can occur while taking the medication and should be reported.

Correct Answer is A

Explanation

Choice A rationale

Over-the-counter Sudafed contains pseudoephedrine, which can cause urinary retention by stimulating alpha-adrenergic receptors, exacerbating symptoms treated by oxybutynin. Avoiding this combination reduces the risk of adverse effects, indicating correct client understanding.

Choice B rationale

Stopping the medication due to signs of infection is incorrect. Oxybutynin addresses bladder muscle control and is not associated with infection management. Reporting adverse effects is required, but discontinuation must follow medical advice.

Choice C rationale

Antidepressants like tricyclics have anticholinergic effects similar to oxybutynin, potentially increasing adverse effects. However, abrupt contraindication is incorrect unless specified by a healthcare provider, indicating a misunderstanding.

Choice D rationale

Urinary retention is a known side effect of oxybutynin. Reporting symptoms is correct, but this statement lacks broader understanding of the medication’s use and side effect profile. .

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The nurse is evaluating a client at a one-month check-up who is being treated for hypertension through lifestyle modifications.Which of the following findings would be a priority for the nurse to follow up?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is assessing a client suspected of having a lower urinary tract infection (UTI). Which of the following findings should the nurse expect?

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

Explanation

The nurse has taught a client with urinary incontinence about taking prescribed oxybutynin chloride.Which of the following statements by the client would indicate a correct understanding of the teaching?

Correct Answer is A

Explanation

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The nurse is evaluating a client at a one-month check-up who is being treated for hypertension through lifestyle modifications.
Which of the following findings would be a priority for the nurse to follow up?