Hypertension and Angina

Every question here, with the answer

1. A client with a blood pressure of 150/94 mm Hg at three visits says, "I feel fine, so I can't have high blood pressure." What is the nurse's best response?

   1. Your readings are normal for your age.
   2. Hypertension often has no symptoms for years, so regular checks matter.
   3. You only need treatment once you feel dizzy.
   4. You are right; hypertension always causes headaches.

   Answer: Hypertension often has no symptoms for years, so regular checks matter.

   Symptoms of hypertension may not occur for years and are often silent, so feeling well does not rule it out. The readings are above normal, and waiting for symptoms delays treatment while organ damage can develop.

2. A client with a history of stable angina calls the clinic and says chest pain started while resting on the couch, does not follow his usual pattern, and has lasted longer than usual. How should the nurse interpret this?

   1. A normal response to the client's medication
   2. Typical stable angina that will pass with rest
   3. Possible unstable angina, which is a medical emergency
   4. Microvascular angina that needs no urgent care

   Answer: Possible unstable angina, which is a medical emergency

   Unstable angina is unpredictable, usually occurs at rest, does not follow a pattern, and may last longer; it is a medical emergency. Stable angina is predictable and follows a pattern, so this picture does not fit it.

3. A client with hypertension says she cannot manage 30–40 minutes of exercise four times a week because of her work schedule. What should the nurse do?

   1. Advise her to rely on medication instead of exercise.
   2. Tell her to exercise only on weekends for several hours.
   3. Tell her exercise will not help unless she does the full amount.
   4. Suggest an alternate exercise plan and explain that some activity is better than none.

   Answer: Suggest an alternate exercise plan and explain that some activity is better than none.

   When a client cannot meet the recommended amount, the nurse suggests an alternate exercise plan and emphasizes that some physical activity is better than none. Dismissing exercise or replacing it with medication is not supported by the section.

4. A client is diagnosed with variant (Prinzmetal) angina. Which explanation of the cause is accurate?

   1. Low blood pressure after meals
   2. Coronary artery disease blocking blood flow during exercise
   3. A spasm in the heart's arteries that temporarily decreases blood flow, usually at rest
   4. Disease of the heart valves

   Answer: A spasm in the heart's arteries that temporarily decreases blood flow, usually at rest

   Variant (Prinzmetal) angina is not caused by coronary artery disease but by a spasm in the heart's arteries that temporarily decreases blood flow and almost always occurs at rest. The other options describe other causes.

5. A nurse is planning lifestyle teaching for a client newly diagnosed with primary hypertension. Which changes should the nurse include? Select all that apply.

   1. Increased physical activity
   2. Adding salt to replace fluid lost through sweating
   3. Smoking cessation
   4. Reduced alcohol intake
   5. Diet modification with less sodium

   Answer: Increased physical activity, Smoking cessation, Reduced alcohol intake, Diet modification with less sodium

   Nonpharmacologic treatment includes diet modification with a low-sodium diet, more physical activity, smoking cessation, and reduced alcohol intake. Adding salt goes against the low-sodium recommendation.

6. Which findings would the nurse recognise as symptoms associated with hypertension? Select all that apply.

   1. Decreased level of consciousness
   2. Headaches
   3. Increased appetite
   4. Visual disturbances
   5. Productive cough with fever

   Answer: Decreased level of consciousness, Headaches, Visual disturbances

   Symptoms associated with hypertension include headaches, dizziness, nausea, vomiting, visual disturbances, and neurological disturbances such as a decreased level of consciousness. Increased appetite and a productive cough with fever are not listed.