Blood Pressure Flashcards
Which of the following best describes primary (essential) hypertension?
A) It is caused by an identifiable medical condition, such as kidney disease
B) It is typically due to a genetic predisposition and lifestyle factors
C) It is a temporary increase in blood pressure due to stress or dehydration
D) It occurs as a result of a sudden drop in blood volume
B) It is typically due to a genetic predisposition and lifestyle factors
Rationale: Primary (essential) hypertension is the most common form of high blood pressure and develops without a specific underlying cause. Risk factors include genetics, diet, obesity, smoking, and stress.
A 55-year-old male patient with a history of untreated hypertension is admitted with a severe headache, blurred vision, and a blood pressure reading of 210/120 mmHg. The provider orders IV antihypertensive therapy. What is the priority nursing consideration?
A) Lower blood pressure rapidly to prevent further complications
B) Assess for signs of end-organ damage, such as chest pain or confusion
C) Administer IV fluids to counteract the effects of vasodilation
D) Encourage the patient to relax and recheck blood pressure in 30 minutes
B) Assess for signs of end-organ damage, such as chest pain or confusion
Rationale: A hypertensive crisis (BP >180/120 mmHg) can cause end-organ damage (e.g., stroke, myocardial infarction, renal failure). Blood pressure should be lowered gradually to prevent ischemia from a sudden drop. Assessing for end-organ damage is the priority.
Which of the following factors contributes to an increase in afterload in a patient with hypertension?
A) Increased blood viscosity
B) Decreased cardiac output
C) Increased preload
D) Decreased arterial resistance
A) Increased blood viscosity
Rationale: Afterload refers to the pressure the heart must work against to eject blood. Increased blood viscosity (thicker blood, which may be due to dehydration or other factors) causes increased resistance in the vasculature, thus increasing afterload.
The nurse is educating a patient with newly diagnosed primary hypertension about lifestyle changes. Which of the following modifications would have the most significant impact on reducing blood pressure?
A) Decrease sodium intake
B) Increase potassium intake
C) Increase physical activity
D) Limit alcohol consumption
A) Decrease sodium intake
Rationale: Decreasing sodium intake has the most direct and significant impact on lowering blood pressure. Excess sodium contributes to fluid retention, which increases blood volume and pressure. While other options may help, reducing sodium intake has the greatest evidence of efficacy for lowering hypertension.
A 63-year-old female with a history of poorly controlled hypertension presents to the ER with chest pain. Her blood pressure is 180/110 mmHg, and she reports feeling dizzy and short of breath. What is the most likely complication of her hypertension?
A) Myocardial infarction (MI)
B) Cerebrovascular accident (CVA)
C) Aortic aneurysm rupture
D) Acute left-sided heart failure
A) Myocardial infarction (MI)
Rationale: Uncontrolled hypertension is a major risk factor for coronary artery disease, which can lead to myocardial infarction (MI). This patient presents with chest pain, dizziness, and shortness of breath, all of which are concerning for an MI. Hypertension increases the workload on the heart, causing damage to coronary arteries.
A patient with chronic hypertension presents with an abnormal EKG showing left ventricular hypertrophy (LVH). What is the most likely cause of this finding?
A) Increased myocardial oxygen demand due to hypertrophy
B) Chronic pressure overload in the left ventricle
C) Decreased afterload resulting from vasodilation
D) Electrolyte imbalances secondary to diuretic use
B) Chronic pressure overload in the left ventricle
Rationale: Chronic hypertension creates a constant pressure overload on the left ventricle, leading to left ventricular hypertrophy (LVH). As the heart works harder to overcome the increased resistance in the systemic circulation, the left ventricle thickens to manage the workload.
A nurse is caring for a patient with hypertensive urgency. Which of the following interventions would be most appropriate in the initial management of this patient?
A) Administer intravenous antihypertensive medication to lower blood pressure quickly
B) Monitor blood pressure every 15 minutes and initiate oral antihypertensive medication
C) Perform a thorough physical assessment for signs of end-organ damage
D) Provide pain relief and monitor for signs of myocardial infarction
C) Perform a thorough physical assessment for signs of end-organ damage
Rationale: Hypertensive urgency involves significantly elevated blood pressure without evidence of acute end-organ damage. The initial priority is to assess for any potential complications, such as stroke, heart failure, or renal failure, rather than rapidly lowering the blood pressure. Gradual management is preferred
Which of the following mechanisms is most likely responsible for the development of secondary hypertension in a patient with chronic kidney disease?
A) Decreased renal blood flow activates the renin-angiotensin-aldosterone system (RAAS)
B) Decreased baroreceptor sensitivity leads to vasodilation
C) Increased sodium excretion causes fluid loss and hypotension
D) Increased sympathetic nervous system activity causes decreased heart rate
A) Decreased renal blood flow activates the renin-angiotensin-aldosterone system (RAAS)
Rationale: Chronic kidney disease (CKD) leads to decreased renal blood flow, which activates the RAAS, causing vasoconstriction and fluid retention, both of which increase blood pressure. This is a common cause of secondary hypertension.
