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Chapter 104: Hypertension Buttaro: Primary Care: A Collaborative Practice, 6th Edition
from TEST BANK; Buttaro: Primary Care Interprofessional Collaborative Practice 6TH EDITION. All Chapters
by StudyGuide
Multiple Choice
1. A 55-year-old patient has a blood pressure of 138/85 on three occasions. The patient denies headaches, palpitations, snoring, muscle weakness, and nocturia and does not take any medications. What will the provider do next to evaluate this patient?
a. Assess serum cortisol levels b. Continue to monitor blood pressure at each health maintenance visit c. Order urinalysis, CBC, BUN, and creatinine d. Refer to a specialist for a sleep study
ANS: C a. Add a beta blocker to the patient’s regimen. b. Admit to the hospital for evaluation and treatment. c. Increase the dose of the thiazide medication.
This patient has prehypertension levels and should be evaluated. UA, CBC, BUN, and creatinine help to evaluate renal function and are in the initial workup. Serum cortisol levels are performed if pheochromocytoma is suspected, which would cause headache. The patient does not have snoring, so a sleep study is not indicated at this time. It is not correct to continue to monitor without assessing possible causes of early hypertension.
2. An African-American patient who is being treated with a thiazide diuretic for chronic hypertension reports blurred vision and shortness of breath. The provider notes a blood pressure of 185/115. What is the recommended action for this patient?
NURSINGTB.COM d. Prescribe a calcium channel blocker.
ANS: B
Patients with a blood pressure >180/120 or those with signs of target organ symptoms should be admitted to inpatient treatment with specialist consultation. Changing the medications may be done with consultation, but a hospitalization and stabilization must be done initially.
Multiple Response
1. Which are causes of secondary hypertension (HTN)? (Select all that apply.)
a. Increased salt intake b. Isometric exercises c. Nonsteroidal anti-inflammatory (NSAID) drugs d. Oral contraceptives (OCPs) e. Sleep apnea
ANS: C, D, E
NSAIDs and OCPs can both increase the risk of hypertension. Sleep apnea causes secondary hypertension. Increased salt intake does not cause HTN, but those with HTN are more sensitive to sale. Regular isometric exercise can decrease blood pressure.
