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.
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale
Avoiding exposure to cold climates is not specific to thalassemia prevention. While cold environments may exacerbate general vasoconstriction, they do not influence the genetic and hematologic basis of thalassemia symptoms.
Choice B rationale
Increasing fluid intake does not directly address thalassemia pathophysiology. While hydration is vital, it does not correct the primary anemia or the compromised oxygen delivery stemming from abnormal hemoglobin synthesis.
Choice C rationale
Iron and vitamin B12-rich foods are beneficial for conditions involving deficiency anemia. However, thalassemia involves a genetic defect in hemoglobin chains, so excess iron could even result in iron overload complications.
Choice D rationale
Medications and substances that exacerbate hemolysis, such as sulfonamides or antimalarials, should be avoided in thalassemia. Awareness and prevention of exposure are key to minimizing symptoms and complications in affected individuals. .
Correct Answer is A
Explanation
Choice A rationale
Corticosteroids are used in thrombocytopenia because they suppress the immune response, particularly in immune thrombocytopenic purpura (ITP). They reduce platelet destruction by inhibiting autoantibody formation and increasing platelet lifespan. Normal platelet count ranges from 150,000 to 400,000/µL. Thrombocytopenia occurs when platelets drop below 150,000/µL, increasing bleeding risk. Corticosteroids can also decrease capillary permeability, minimizing petechiae and ecchymoses.
Choice B rationale
Diphenhydramine, an antihistamine, is used for allergic reactions but has no role in treating thrombocytopenia. It does not address the underlying immune or hematologic causes of low platelet counts. Its primary actions include H1 receptor antagonism, reducing histamine-mediated symptoms like itching and swelling. However, it lacks immunosuppressive or hematologic-stimulating effects essential for managing thrombocytopenia.
Choice C rationale
Desmopressin (DDAVP) is a synthetic antidiuretic hormone analog used for certain bleeding disorders like von Willebrand disease or mild hemophilia A. It increases factor VIII and von Willebrand factor levels, improving clotting. However, it is not indicated for thrombocytopenia as it does not address platelet count deficiencies or immune-mediated platelet destruction.
Choice D rationale
Hydrochlorothiazide (HCTZ) is a thiazide diuretic used for hypertension and edema. Its mechanism of action involves inhibiting sodium reabsorption in the distal tubule, promoting diuresis. HCTZ has no effect on platelet counts or immune mechanisms and is not used in thrombocytopenia. Its side effects, like electrolyte imbalances, may complicate patient management.
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