The nurse is evaluating the blood pressure for a client with hypertension who is taking a prescribed diuretic, an angiotensin-converting enzyme (ACE) inhibitor, and an angiotensin II receptor blocker (ARB). The client's first blood pressure is 145/92 mm Hg and the second measurement obtained is 150/89 mm Hg. Which of the following actions should the nurse take first?

Explain that the client should return in one month to be reevaluated.

Assess the client's adherence to lifestyle modifications and medication therapy.

Explain to the client that the health care provider will increase the dose of one of the medications already prescribed.

Discuss adding a prescribed calcium-channel blocker to the client's medication regimen.

Answer and Explanation

The Correct Answer is B

Choice A rationale

Delaying follow-up without immediate intervention may result in the client's blood pressure remaining uncontrolled, increasing the risk of complications like cardiovascular events. Reevaluation in one month without assessing adherence neglects the urgent need for optimizing management.

Choice B rationale

Assessing adherence to both lifestyle modifications and medication therapy is crucial as noncompliance may explain the suboptimal blood pressure control. Ensuring adherence and addressing any barriers are necessary steps in evaluating the effectiveness of treatment.

Choice C rationale

Increasing medication dosage without first assessing the client's adherence to current prescriptions or lifestyle modifications may be premature. Nonadherence to therapy could render dosage adjustments ineffective, leading to unnecessary changes to the regimen.

Choice D rationale

Adding a calcium-channel blocker without assessing adherence disregards the importance of compliance. Treatment should be optimized based on existing therapy before considering additional pharmacological interventions. .

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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. The client reports an increase in tolerating daily activities. B. The client reports a decrease in feeling of paresthesias in the feet. C. The client's white blood cell count has improved. D. The client's balance has improved.

Correct Answer is A

Explanation

Choice A rationale

Improved tolerance for daily activities suggests increased energy levels and improved oxygen delivery to tissues, both indicative of effective iron deficiency anemia treatment. Normal hemoglobin levels are 12-16 g/dL for females and 14-18 g/dL for males, supporting enhanced activity tolerance.

Choice B rationale

Decreased paresthesia indicates improved nerve function but is not directly linked to iron deficiency anemia treatment outcomes. Iron deficiency primarily impacts oxygen transport, and improvements in energy levels and activity tolerance are better indicators of therapeutic success.

Choice C rationale

Improved white blood cell count suggests better immune function but does not directly assess anemia treatment efficacy. Iron therapy aims to normalize hemoglobin and hematocrit levels rather than leukocyte parameters, which are unrelated to anemia management.

Choice D rationale

Enhanced balance may indicate improved neuromuscular function but is not directly correlated with anemia treatment. Balance is influenced by multiple factors, including neurological or musculoskeletal health, rather than oxygenation improvements specific to anemia.

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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 is evaluating the outcomes for a client who is being treated for iron deficiency anemia.Which of the following findings would indicate that the treatment is effective?

Correct Answer is A

Explanation

The nurse is performing a health screening for a client at a local clinic and the client states, "I have noticed changes in my vision recently and I have also had some bad headaches.”. Which of the following actions should be a priority for the nurse to take?

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 nurse is monitoring the results of laboratory tests for a client suspected of having heart failure.Which of the following tests would provide key diagnostic information for the nurse?

The nurse is assessing four clients at the neighborhood clinic.Which of these clients should the nurse identify to be at risk for the development of pernicious anemia?

The nurse is planning care for a female client with a lower urinary tract infection (UTI). Which of the following interventions should be the priority for the nurse to include in the client's plan of care?

The nurse has taught a client with urinary incontinence about managing the problem.Which of the following statements by the client would indicate the need for more teaching?

The nurse is assessing a client suspected of having renal calculi who reports severe, wavelike pain that radiates down the thigh and to the genital area and a sensation of needing to void, but only small amounts are voided.The nurse should explain which of the following information to the client?

The nurse is following up with a male client, diagnosed 3 months ago, with erectile dysfunction who attempted lifestyle modifications as the first line of treatment.The client reports having continued symptoms.The nurse should discuss which of the following types of treatment with the client next?