The nurse who is providing instructions to a client with hypertension will stress that it is most important to:

Choice A reason: Increasing calcium in the diet is not the most important instruction for a client with hypertension. Calcium is a mineral that helps maintain bone health and muscle contraction, but it does not have a significant effect on blood pressure. The nurse should advise the client to limit sodium, fat, and alcohol intake, and to eat more fruits, vegetables, and whole grains.

Choice B reason: Obtaining blood pressure checks twice a year is not the most important instruction for a client with hypertension. This frequency is too low for a client who has a chronic condition that requires close monitoring and treatment. The nurse should advise the client to check their blood pressure regularly, preferably at home, and to report any abnormal readings to their health care provider.

Choice C reason: Monitoring weight on a weekly basis is not the most important instruction for a client with hypertension. Weight is a factor that can influence blood pressure, but it is not the only one. The nurse should advise the client to maintain a healthy weight and to lose weight if they are overweight or obese, but not to focus on the scale alone.

Choice D reason: Getting regular physical activity is the most important instruction for a client with hypertension. Physical activity can lower blood pressure by strengthening the heart, improving blood circulation, reducing stress, and preventing or managing other risk factors, such as obesity, diabetes, and high cholesterol. The nurse should advise the client to engage in moderate aerobic exercise for at least 30 minutes a day, five days a week, and to consult their health care provider before starting any new exercise program.

Choice A reason: The Schilling test is not used to diagnose G6PD anemia, which is a genetic disorder that causes red blood cells to break down when exposed to certain substances. The Schilling test is used to measure how well the body absorbs vitamin B12 from the intestine. ¹²

Choice B reason: The Schilling test does not require the patient to be NPO (nothing by mouth) for 12 hours prior to the test. The patient can drink water, but should avoid food for 8 hours before the test. ²

Choice C reason: The Schilling test is a 24-hour urine specimen collection test. The patient is given a dose of radioactive vitamin B12 by mouth and another dose of nonradioactive vitamin B12 by injection. The urine is collected for 24 hours to measure how much of the radioactive vitamin B12 is excreted. This indicates how well the body absorbs vitamin B12 from the intestine. ¹²

Choice D reason: The Schilling test does not entail administration of methylcellulose prior to the test. Methylcellulose is a type of laxative that can interfere with the absorption of vitamin B12. The patient should avoid taking any laxatives, antacids, or antibiotics before the test. ²³