NCLEX Hypertension & Coronary Artery Disease Practice Exam Quiz
Which of the following is the primary risk factor for developing hypertension?
A) Smoking
B) Obesity
C) Age
D) Family history of hypertension
A nurse is teaching a patient about lifestyle changes to control high blood pressure. Which of the following instructions should the nurse include?
A) Increase salt intake to promote fluid balance
B) Engage in regular physical activity
C) Consume more processed foods for extra calories
D) Avoid taking prescribed medications for hypertension
A client with hypertension is prescribed a diuretic. What is the most common side effect of this medication?
A) Hyperkalemia
B) Hypokalemia
C) Dehydration
D) Hypertension
Which of the following is the recommended target blood pressure for adults with hypertension?
A) 150/90 mm Hg
B) 140/90 mm Hg
C) 130/80 mm Hg
D) 120/80 mm Hg
A nurse is assessing a patient who has hypertension. Which of the following is a potential complication of uncontrolled hypertension?
A) Diabetes mellitus
B) Stroke
C) Asthma
D) Glaucoma
A patient is prescribed an ACE inhibitor for hypertension. Which of the following should the nurse monitor for?
A) Hyperkalemia
B) Bradycardia
C) Hyperglycemia
D) Hypokalemia
The nurse is teaching a patient with hypertension about dietary changes. Which of the following foods should the patient avoid?
A) Bananas
B) Whole grain bread
C) Processed meats
D) Fresh vegetables
What is the most common cause of secondary hypertension?
A) Kidney disease
B) Sedentary lifestyle
C) Excessive alcohol consumption
D) High salt intake
Which of the following is the priority nursing action when a patient with hypertension is admitted to the hospital for treatment?
A) Assessing the blood pressure
B) Administering antihypertensive medications
C) Initiating IV fluids
D) Monitoring renal function
A nurse is teaching a patient about home blood pressure monitoring. Which of the following is the most important instruction to give?
A) Measure blood pressure in the morning only
B) Rest for at least 5 minutes before taking a reading
C) Take blood pressure readings after physical activity
D) Use a blood pressure cuff that is too large for your arm
Coronary Artery Disease (CAD)
Which of the following is the leading cause of coronary artery disease (CAD)?
A) Diabetes mellitus
B) Atherosclerosis
C) Hypotension
D) Family history
A patient with coronary artery disease asks about the benefits of exercise. What should the nurse include in the teaching?
A) Exercise will increase the risk of a heart attack.
B) Exercise can help improve circulation and reduce symptoms of CAD.
C) Exercise should be avoided due to the strain on the heart.
D) Exercise only helps with weight management, not CAD.
Which of the following medications is commonly prescribed to reduce the risk of blood clots in patients with coronary artery disease?
A) Beta blockers
B) Antiplatelet agents (e.g., aspirin)
C) Diuretics
D) Calcium channel blockers
A patient with CAD is prescribed nitroglycerin for chest pain. Which of the following is an important nursing consideration when administering nitroglycerin?
A) Monitor the patient for increased blood pressure
B) Ensure the patient is lying flat before administering the medication
C) Monitor for a drop in blood pressure after administration
D) Administer the medication with food to prevent nausea
A patient with coronary artery disease is undergoing coronary angiography. Which of the following is the primary purpose of this procedure?
A) To measure cardiac output
B) To visualize the coronary arteries and assess blockages
C) To measure heart rate variability
D) To assess blood pressure response
Which of the following symptoms is most commonly associated with angina pectoris in a patient with CAD?
A) Dizziness
B) Chest pain or discomfort
C) Nausea and vomiting
D) Shortness of breath
A nurse is caring for a patient who has just had a coronary artery bypass graft (CABG). What is the priority intervention in the immediate postoperative period?
A) Monitoring for signs of infection
B) Encouraging early ambulation
C) Monitoring heart rate and rhythm
D) Administering pain medications as needed
Which of the following lifestyle changes should a nurse recommend to a patient with coronary artery disease?
A) Increase alcohol consumption to reduce stress
B) Quit smoking and follow a heart-healthy diet
C) Avoid all exercise to reduce stress on the heart
D) Use over-the-counter medications to manage pain
Which of the following is the most appropriate treatment for a patient with acute myocardial infarction (MI) and coronary artery disease?
A) Immediate administration of thrombolytics or PCI (percutaneous coronary intervention)
B) Administration of a beta-blocker only
C) Continuous monitoring without medication
D) Encouraging ambulation to improve circulation
A nurse is caring for a patient with stable angina. Which of the following should the nurse teach the patient to do during an angina episode?
A) Take a deep breath and try to relax without medication
B) Rest and take prescribed nitroglycerin as directed
C) Walk around to improve circulation
D) Take an over-the-counter pain reliever
Which of the following is a common complication of untreated coronary artery disease?
A) Hypoglycemia
B) Atrial fibrillation
C) Congestive heart failure
D) Pneumonia
A nurse is preparing a patient for a cardiac catheterization. What should the nurse inform the patient about the procedure?
A) It is a non-invasive procedure that requires no preparation
B) The procedure involves inserting a catheter into a blood vessel to access the heart
C) The procedure is performed only under general anesthesia
D) The procedure is not effective in diagnosing CAD
Which of the following is the goal of drug therapy in coronary artery disease?
A) To reduce the workload of the heart and prevent further plaque buildup
B) To increase heart rate to improve circulation
C) To reduce oxygen supply to the heart muscle
D) To prevent any form of physical activity
A patient is experiencing chest pain and is diagnosed with unstable angina. What is the nurse’s priority intervention?
A) Administering nitroglycerin and monitoring for relief of pain
B) Encouraging the patient to engage in light exercise
C) Administering oral pain medications
D) Monitoring blood pressure every 4 hours
Which of the following is an appropriate nursing action for a patient with a history of coronary artery disease who presents with shortness of breath and dizziness?
A) Administer an antihistamine
B) Perform a chest x-ray
C) Prepare the patient for immediate cardiac evaluation
D) Encourage fluid intake to improve circulation
A nurse is assessing a patient with a history of coronary artery disease. Which of the following symptoms should the nurse report to the healthcare provider immediately?
A) Mild chest discomfort after exercise
B) Dizziness and fainting with activity
C) Frequent episodes of belching
D) Low-grade fever
Which of the following is the most appropriate nursing intervention for a patient with CAD experiencing acute chest pain?
A) Administer oxygen and nitroglycerin as prescribed
B) Encourage the patient to engage in deep breathing exercises
C) Offer the patient a snack to alleviate pain
D) Monitor vital signs every 8 hours
A patient with coronary artery disease asks why their cholesterol levels need to be controlled. What should the nurse explain?
A) High cholesterol contributes to plaque formation and narrowing of the arteries
B) Cholesterol helps the heart function better by increasing circulation
C) High cholesterol reduces the risk of heart attacks and stroke
D) Low cholesterol levels lead to chest pain
A patient is prescribed atorvastatin to manage cholesterol levels. Which of the following side effects should the nurse educate the patient about?
A) Muscle pain and weakness
B) Increased appetite and weight gain
C) Rash and itching
D) Excessive thirst
A patient with coronary artery disease is prescribed a beta-blocker. What is the primary effect of this medication?
A) It decreases heart rate and blood pressure
B) It increases heart rate and blood pressure
C) It improves blood clotting
D) It dilates blood vessels
A nurse is caring for a patient with hypertension who is experiencing a hypertensive crisis. Which of the following is the priority intervention?
A) Administering IV antihypertensive medication
B) Monitoring the patient for hyperglycemia
C) Encouraging the patient to engage in relaxation techniques
D) Monitoring respiratory status for signs of distress
Which of the following signs and symptoms would indicate that a patient with hypertension is experiencing a hypertensive emergency?
A) Severe headache, chest pain, and blurred vision
B) Fatigue and weight gain
C) Shortness of breath and dry cough
D) Increased appetite and dizziness
A nurse is caring for a patient who is taking a calcium channel blocker for hypertension. Which of the following is the most important side effect to monitor for?
A) Hypotension
B) Tachycardia
C) Increased appetite
D) Excessive salivation
A nurse is educating a patient about the DASH (Dietary Approaches to Stop Hypertension) diet. Which of the following foods is recommended on the DASH diet?
A) Red meat and full-fat dairy
B) Whole grains, fruits, and vegetables
C) High-sodium processed foods
D) Fried foods
A nurse is caring for a patient who is prescribed clonidine for hypertension. Which of the following should the nurse include in the teaching plan?
A) Discontinue the medication immediately if dizziness occurs
B) Gradually taper the medication to avoid rebound hypertension
C) Increase fluid intake to prevent dehydration
D) Avoid taking the medication with food
A patient with a history of hypertension is scheduled for a routine checkup. Which of the following is the most important measurement to assess at this visit?
A) Weight
B) Blood pressure
C) Heart rate
D) Blood glucose level
A nurse is assessing a patient with a history of hypertension. Which of the following symptoms is most concerning and should be reported immediately?
A) Occasional headaches
B) Vision changes and dizziness
C) Mild fatigue
D) Occasional palpitations
Which of the following would be the most appropriate first-line treatment for a patient with stage 1 hypertension?
A) Lifestyle changes such as exercise and sodium reduction
B) Immediate initiation of two different antihypertensive medications
C) Bed rest and reducing stress levels
D) Starting a regimen of high-dose diuretics
A nurse is teaching a patient about the risks of uncontrolled hypertension. Which of the following complications should the nurse emphasize?
A) Cancer
B) Stroke and kidney damage
C) Gastrointestinal ulcers
D) Arthritis
Which of the following is the most common side effect of beta-blockers used to treat hypertension?
A) Weight loss
B) Bradycardia
C) Diarrhea
D) Increased energy
Coronary Artery Disease (CAD)
A nurse is caring for a patient with coronary artery disease who is experiencing chest pain. Which of the following actions should the nurse take first?
A) Administer oxygen as prescribed
B) Administer a dose of morphine
C) Obtain an ECG
D) Take a blood sample for cardiac biomarkers
Which of the following is the priority goal for a patient with coronary artery disease and angina?
A) Increase myocardial oxygen demand
B) Reduce myocardial oxygen demand
C) Increase physical activity
D) Promote fluid balance
A patient with coronary artery disease is prescribed aspirin. What is the primary purpose of this medication?
A) To reduce inflammation in the coronary arteries
B) To prevent blood clots and reduce the risk of heart attack
C) To relieve chest pain by reducing blood pressure
D) To decrease the workload of the heart
A patient with coronary artery disease is experiencing severe chest pain. Which of the following actions should the nurse take first?
A) Prepare the patient for surgery
B) Administer prescribed nitroglycerin
C) Have the patient walk around to improve circulation
D) Administer pain relief medication
A patient with coronary artery disease is undergoing coronary artery bypass graft (CABG) surgery. Which of the following is the most common post-operative complication?
A) Stroke
B) Infection at the incision site
C) Pulmonary embolism
D) Dehydration
A nurse is teaching a patient with coronary artery disease about reducing modifiable risk factors. Which of the following should the nurse recommend?
A) Limit physical activity to reduce stress on the heart
B) Quit smoking and engage in regular physical exercise
C) Increase intake of saturated fats and sodium
D) Increase alcohol consumption to improve circulation
A patient who had a myocardial infarction is now stable and recovering. Which of the following is the most important nursing intervention at this time?
A) Encouraging physical activity and early mobilization
B) Limiting fluid intake to prevent edema
C) Administering high doses of vitamin supplements
D) Restricting all food and fluid intake
Which of the following symptoms is most characteristic of unstable angina?
A) Pain that is relieved by rest or nitroglycerin
B) Sudden onset of chest pain that occurs at rest
C) Pain that occurs only with physical exertion
D) Gradual onset of mild chest discomfort
A nurse is teaching a patient with coronary artery disease about the importance of taking statins. Which of the following should the nurse include in the teaching?
A) Statins lower cholesterol levels, which help prevent further plaque buildup
B) Statins increase the risk of blood clots in the arteries
C) Statins should be taken only when symptoms of CAD worsen
D) Statins are only effective when combined with blood thinners
A nurse is caring for a patient following coronary artery bypass graft (CABG) surgery. Which of the following interventions is the highest priority during the postoperative period?
A) Monitoring cardiac rhythm and vital signs
B) Encouraging early ambulation
C) Providing pain management
D) Offering a low-fat diet
Which of the following is the most important preoperative consideration for a patient scheduled for coronary artery bypass graft (CABG) surgery?
A) Smoking cessation
B) Administration of anticoagulant therapy
C) Cardiovascular stress testing
D) Discontinuation of antihypertensive medications
A nurse is caring for a patient who has just been diagnosed with coronary artery disease. Which of the following lifestyle modifications should the nurse recommend to decrease the risk of further complications?
A) Start a low-carb, high-protein diet
B) Begin taking a daily multivitamin
C) Adopt a diet low in saturated fats and engage in regular physical activity
D) Increase sodium intake to balance fluid levels
A patient with coronary artery disease is prescribed a statin medication. Which of the following is an important side effect to monitor for?
A) Chest pain
B) Muscle weakness and pain
C) Weight gain
D) Increased appetite
A nurse is providing discharge instructions to a patient recovering from a myocardial infarction. Which of the following instructions should be prioritized?
A) Limit physical activity to prevent further strain on the heart
B) Engage in regular physical activity as prescribed by the healthcare provider
C) Increase salt intake to improve circulation
D) Discontinue all medications once symptoms subside
Which of the following is the most common diagnostic test for confirming coronary artery disease?
A) Electrocardiogram (ECG)
B) Echocardiogram
C) Coronary angiography
D) Chest x-ray
A patient who had a myocardial infarction is prescribed a beta-blocker. What is the primary effect of this medication?
A) Increased blood pressure
B) Decreased heart rate and oxygen demand
C) Increased heart rate
D) Increased blood clotting
A nurse is caring for a patient with coronary artery disease who is preparing for discharge. Which of the following should the nurse include in the discharge plan?
A) Recommend complete bed rest for the first two weeks
B) Encourage the patient to monitor their weight daily
C) Suggest avoiding physical activity for at least six months
D) Advise the patient to resume normal activities as tolerated, with rest periods as needed
A patient with coronary artery disease is receiving nitroglycerin for chest pain. Which of the following is a common side effect of this medication?
A) Hyperglycemia
B) Dizziness and headache
C) Weight gain
D) Rash
A patient with coronary artery disease is undergoing cardiac rehabilitation. Which of the following is the primary goal of this program?
A) Increase muscle mass
B) Improve cardiovascular endurance and prevent further complications
C) Achieve weight loss
D) Promote psychological therapy
A nurse is providing discharge instructions to a patient who is recovering from a heart attack. Which of the following instructions should the nurse include?
A) Avoid discussing your condition with family members to prevent stress
B) Take your prescribed medications as directed and avoid missing doses
C) Gradually increase the intake of red meat for a healthy heart
D) Use over-the-counter pain relievers for any chest discomfort
A nurse is educating a patient with newly diagnosed hypertension about lifestyle changes. Which of the following recommendations is most important?
A) Increase sodium intake to help balance fluids
B) Avoid exercise to prevent any strain on the heart
C) Limit alcohol consumption and reduce salt in the diet
D) Increase daily caffeine intake for better circulation
A patient with hypertension is prescribed a diuretic. Which of the following lab values should the nurse monitor closely?
A) Potassium
B) Calcium
C) Hemoglobin
D) Phosphorus
A nurse is caring for a patient with a blood pressure reading of 170/90 mmHg. The nurse determines this is indicative of:
A) Normal blood pressure
B) Prehypertension
C) Stage 1 hypertension
D) Stage 2 hypertension
Which of the following is a risk factor for hypertension that can be modified?
A) Family history
B) Age
C) Smoking
D) Gender
A nurse is preparing to administer a calcium channel blocker to a patient with hypertension. The nurse should monitor the patient for which of the following side effects?
A) Bradycardia
B) Hypokalemia
C) Insomnia
D) Dry cough
A nurse is caring for a patient with hypertension who is prescribed lisinopril. Which of the following is a common side effect of this medication?
A) Hyperkalemia
B) Constipation
C) Dry cough
D) Bradycardia
A nurse is teaching a patient with hypertension about the importance of medication adherence. Which of the following statements by the patient indicates the need for further teaching?
A) “I will take my medication every day as prescribed.”
B) “I can stop taking my medication once my blood pressure is normal.”
C) “I should notify my healthcare provider if I experience any dizziness.”
D) “I will monitor my blood pressure at home regularly.”
A nurse is caring for a patient with hypertension who is taking hydrochlorothiazide. The nurse should monitor the patient for which of the following adverse effects?
A) Hyperglycemia
B) Hyperkalemia
C) Hypokalemia
D) Weight loss
A patient with hypertension asks the nurse about the DASH diet. Which of the following should the nurse include in the teaching?
A) The diet includes a high intake of saturated fats and cholesterol
B) The diet emphasizes fruits, vegetables, and low-fat dairy
C) The diet recommends high-sodium foods to promote fluid retention
D) The diet includes a significant amount of processed foods and sugar
A nurse is teaching a patient with hypertension how to monitor blood pressure at home. Which of the following instructions should the nurse give?
A) “Take your blood pressure only once a day, in the morning.”
B) “Take your blood pressure at the same time every day, before taking your medication.”
C) “Take your blood pressure after eating to get an accurate reading.”
D) “Take your blood pressure only when you feel dizzy.”
A nurse is teaching a patient with coronary artery disease (CAD) about risk factors. Which of the following is a modifiable risk factor for CAD?
A) Age
B) Family history
C) Smoking
D) Gender
A patient with coronary artery disease is prescribed atorvastatin. The nurse should monitor which of the following for potential side effects?
A) Muscle pain and weakness
B) Weight gain
C) Increased appetite
D) Swelling of the legs
A nurse is caring for a patient with unstable angina. Which of the following interventions is the priority?
A) Administering nitroglycerin
B) Preparing the patient for coronary artery bypass graft surgery
C) Encouraging the patient to ambulate
D) Administering aspirin to reduce clot formation
Which of the following is the first-line treatment for a patient with stable angina?
A) Thrombolytic therapy
B) Beta-blockers and nitroglycerin
C) Anticoagulants and diuretics
D) Coronary artery bypass grafting (CABG)
A nurse is caring for a patient following coronary artery bypass graft (CABG) surgery. Which of the following interventions is most important in the first 24 hours?
A) Monitoring for signs of infection at the surgical site
B) Encouraging deep breathing and coughing to prevent atelectasis
C) Initiating early mobilization and physical therapy
D) Administering pain medication as prescribed
A nurse is teaching a patient with coronary artery disease about lifestyle changes. Which of the following should the nurse emphasize?
A) Increase intake of trans fats to promote circulation
B) Engage in moderate exercise, such as walking, for at least 30 minutes a day
C) Consume a high-sodium diet to maintain fluid balance
D) Limit fluid intake to reduce cardiac workload
A nurse is caring for a patient with coronary artery disease who is receiving nitroglycerin for chest pain. Which of the following side effects should the nurse monitor for?
A) Hyperkalemia
B) Hypotension
C) Constipation
D) Tachycardia
A nurse is caring for a patient who underwent coronary artery bypass graft (CABG) surgery. The nurse should assess for which of the following complications?
A) Hypothermia
B) Hemorrhage
C) Renal failure
D) Pulmonary embolism
A nurse is teaching a patient with coronary artery disease about the use of aspirin. Which of the following should the nurse include in the teaching?
A) “Aspirin can be stopped if you develop a headache.”
B) “Aspirin is used to reduce the risk of blood clots and prevent heart attacks.”
C) “Aspirin should only be taken when chest pain occurs.”
D) “Aspirin increases the risk of bleeding, so it should be avoided completely.”
A nurse is caring for a patient with coronary artery disease who is prescribed a statin. The nurse should instruct the patient to report which of the following symptoms?
A) Swelling of the ankles
B) Nausea and vomiting
C) Muscle pain and weakness
D) Sore throat
A nurse is providing discharge instructions to a patient who has had a myocardial infarction (MI). Which of the following instructions should the nurse prioritize?
A) “You should avoid any physical activity for at least six months.”
B) “You should limit your intake of fruits and vegetables.”
C) “You should avoid smoking and limit alcohol intake.”
D) “You should take aspirin only when you experience chest pain.”
A patient with coronary artery disease is undergoing an exercise stress test. Which of the following is the primary purpose of this test?
A) To determine the ejection fraction of the heart
B) To assess the patient’s exercise tolerance and detect ischemia
C) To evaluate the effectiveness of medications
D) To identify the need for coronary artery bypass surgery
A nurse is caring for a patient who has had a heart attack and is now stable. Which of the following is the most important factor to consider when planning the patient’s discharge?
A) Pain management
B) Social support and rehabilitation needs
C) Strict bed rest for two weeks
D) Instructing the patient to avoid any physical activity
Which of the following medications is commonly prescribed to a patient with coronary artery disease to reduce the workload of the heart?
A) Calcium channel blockers
B) Antihistamines
C) Diuretics
D) Antidepressants
A patient with coronary artery disease is prescribed clopidogrel. Which of the following is the primary purpose of this medication?
A) To reduce blood clot formation
B) To reduce blood pressure
C) To prevent tachycardia
D) To lower cholesterol levels
A nurse is assessing a patient with newly diagnosed hypertension. Which of the following is a common symptom of hypertension?
A) Dizziness
B) Bradycardia
C) Decreased urine output
D) Orthostatic hypotension
A nurse is teaching a patient with hypertension about the importance of reducing sodium intake. Which of the following is a good alternative for seasoning food?
A) Soy sauce
B) Salt substitutes
C) Table salt
D) Fish sauce
A nurse is assessing a patient with hypertension. The patient asks why they need to monitor their blood pressure regularly. Which of the following is the nurse’s best response?
A) “Monitoring helps to identify any changes and make necessary adjustments to your treatment.”
B) “You need to monitor it so we can increase your medication dosage as needed.”
C) “It helps us track your cholesterol levels.”
D) “It is required by your insurance company.”
A nurse is caring for a patient with hypertension. Which of the following interventions should be included in the patient’s care plan?
A) Limit exercise to prevent increased heart rate
B) Encourage the patient to consume low-fat dairy products
C) Promote increased caffeine intake to elevate blood pressure
D) Teach the patient to monitor blood pressure at home regularly
A patient with hypertension is prescribed hydrochlorothiazide. Which of the following actions should the nurse take when administering this medication?
A) Monitor potassium levels
B) Administer the medication with meals
C) Encourage the patient to drink large amounts of fluids
D) Avoid monitoring blood pressure during medication therapy
A patient with hypertension is concerned about the side effects of their antihypertensive medication. Which of the following is the most common side effect of ACE inhibitors?
A) Cough
B) Drowsiness
C) Hyperkalemia
D) Weight gain
A nurse is educating a patient with hypertension about the DASH diet. Which of the following foods should the nurse encourage the patient to include in their diet?
A) Bacon
B) Leafy green vegetables
C) High-fat dairy products
D) Processed meats
A nurse is caring for a patient who has been prescribed a beta-blocker for hypertension. Which of the following assessments is the nurse’s priority?
A) Assessing the patient’s blood pressure
B) Monitoring the patient’s liver function tests
C) Monitoring the patient’s potassium levels
D) Checking for any signs of peripheral edema
A nurse is teaching a patient with hypertension about lifestyle modifications. Which of the following statements by the patient indicates the need for further teaching?
A) “I will exercise regularly to help manage my blood pressure.”
B) “I should reduce my sodium intake to control my blood pressure.”
C) “I will stop smoking, as it is harmful to my blood vessels.”
D) “I can continue to drink as much alcohol as I want as long as I take my medication.”
A patient with hypertension is prescribed losartan. The nurse should monitor the patient for which of the following side effects?
A) Hypokalemia
B) Hyperglycemia
C) Hyperkalemia
D) Bradycardia
A nurse is caring for a patient with hypertension. Which of the following is the most important long-term strategy for managing hypertension?
A) Weight reduction
B) Increased alcohol intake
C) Avoiding all physical activity
D) Increased sodium intake
Coronary Artery Disease (CAD)
A nurse is assessing a patient with coronary artery disease (CAD) who is experiencing chest pain. Which of the following interventions should the nurse perform first?
A) Administer nitroglycerin
B) Administer oxygen
C) Obtain an ECG
D) Assess pain level
A nurse is caring for a patient with coronary artery disease who is prescribed a statin. Which of the following should the nurse monitor regularly?
A) Serum potassium levels
B) Liver function tests
C) Blood glucose levels
D) Sodium levels
A nurse is educating a patient with coronary artery disease about the use of nitroglycerin for chest pain. Which of the following should the nurse include in the teaching?
A) “Take one tablet every 15 minutes if chest pain persists.”
B) “You can take nitroglycerin with food if you feel nauseous.”
C) “You should lie down when taking nitroglycerin to prevent dizziness.”
D) “Take the tablet only when you experience severe pain.”
A patient with coronary artery disease is scheduled for a cardiac catheterization. The nurse should assess the patient for which of the following allergies?
A) Latex
B) Shellfish or iodine
C) Penicillin
D) Morphine
A patient with coronary artery disease is prescribed clopidogrel to prevent blood clots. Which of the following should the nurse include in the teaching?
A) “Avoid taking aspirin while on clopidogrel.”
B) “Clopidogrel should be taken with meals.”
C) “Clopidogrel can be stopped if you develop a fever.”
D) “Clopidogrel is only needed during episodes of chest pain.”
A nurse is caring for a patient who has just undergone coronary artery bypass graft (CABG) surgery. Which of the following interventions is a priority in the immediate post-operative period?
A) Administering pain medication
B) Monitoring vital signs and cardiac rhythm
C) Encouraging early ambulation
D) Teaching the patient about lifestyle modifications
A nurse is assessing a patient with coronary artery disease. Which of the following findings should the nurse recognize as a sign of worsening angina?
A) Chest pain that occurs with exertion and subsides with rest
B) Chest pain that occurs at rest and lasts longer than 20 minutes
C) Chest pain that is relieved by nitroglycerin
D) Chest pain that occurs with deep breathing and movement
A nurse is caring for a patient with coronary artery disease who is prescribed a beta-blocker. Which of the following side effects should the nurse monitor for?
A) Tachycardia
B) Hypertension
C) Bradycardia
D) Diarrhea
A patient with coronary artery disease is discharged with a prescription for atorvastatin. The nurse should include which of the following in the discharge teaching?
A) “You should have your liver function tested periodically while on this medication.”
B) “You should avoid all exercise while on this medication.”
C) “You should expect to gain weight while taking this medication.”
D) “You can stop this medication if you feel well and have no symptoms.”
A nurse is caring for a patient with coronary artery disease who is experiencing shortness of breath and fatigue. Which of the following is the most likely cause of these symptoms?
A) Hypoxia due to insufficient oxygen supply
B) Dehydration from fluid loss
C) Anxiety from stress
D) Anemia from low hemoglobin levels
A nurse is caring for a patient with coronary artery disease. The nurse should advise the patient to avoid which of the following foods?
A) Whole grain bread
B) Fatty cuts of meat
C) Low-fat yogurt
D) Fresh vegetables
A nurse is providing discharge instructions for a patient with coronary artery disease. Which of the following instructions should the nurse include?
A) “You can resume your normal activities as tolerated, but avoid exercise for six months.”
B) “Gradually increase physical activity and rest frequently.”
C) “Avoid any physical activity for two weeks after discharge.”
D) “Take all your prescribed medications as directed, even if you feel fine.”
A nurse is caring for a patient with coronary artery disease who is prescribed a nitrate for chest pain. Which of the following should the nurse monitor for after administration?
A) Increased blood pressure
B) Tachycardia
C) Hypotension
D) Decreased oxygen saturation
A nurse is teaching a patient with hypertension about the importance of medication adherence. Which of the following is the most common reason patients with hypertension do not take their prescribed medication regularly?
A) Lack of health insurance
B) High cost of medication
C) Absence of symptoms
D) Desire to use natural remedies
A nurse is assessing a patient with hypertension and a family history of heart disease. Which of the following assessments is most important?
A) Check for peripheral edema
B) Assess for any signs of chest pain or dyspnea
C) Assess mental status for confusion
D) Monitor for signs of stroke, such as a change in vision
A nurse is educating a patient with hypertension about the importance of exercise. Which of the following is the most appropriate recommendation for a patient with hypertension?
A) “You should aim for 30 minutes of moderate exercise most days of the week.”
B) “You can exercise as much as you want without restriction.”
C) “You should avoid exercise to prevent stress on the heart.”
D) “You should only engage in strenuous exercise once a week.”
A nurse is preparing to administer an antihypertensive medication to a patient. Which of the following should the nurse monitor before giving the medication?
A) Blood glucose levels
B) Blood pressure
C) Respiratory rate
D) Temperature
A patient with hypertension is prescribed a calcium channel blocker. Which of the following side effects should the nurse monitor for?
A) Bradycardia
B) Hypotension
C) Hypertension
D) Hyperglycemia
A nurse is teaching a patient about lifestyle changes to manage hypertension. Which of the following would be the most effective dietary change to reduce hypertension?
A) Increased red meat consumption
B) Increased sodium intake
C) Reduced intake of saturated fats and cholesterol
D) Drinking more caffeine
A patient is receiving a prescription for an ACE inhibitor. The nurse should teach the patient to report which of the following side effects?
A) Persistent dry cough
B) Excessive sweating
C) Increased appetite
D) Joint pain
A nurse is assessing a patient with hypertension. Which of the following findings would indicate that the patient’s blood pressure is poorly controlled?
A) The patient is asymptomatic
B) The patient complains of headache and dizziness
C) The patient has an increased appetite
D) The patient has normal kidney function
A nurse is caring for a patient with hypertension. Which of the following is the priority nursing intervention?
A) Encourage fluid intake
B) Teach the patient to monitor their blood pressure
C) Administer prescribed antihypertensive medication
D) Restrict physical activity
A nurse is caring for a patient with coronary artery disease (CAD) who has been prescribed aspirin. Which of the following is the nurse’s priority?
A) Teach the patient about the importance of taking aspirin daily
B) Assess for any history of gastrointestinal bleeding
C) Assess for signs of bradycardia
D) Monitor blood pressure regularly
A nurse is caring for a patient with coronary artery disease who is receiving a thrombolytic medication. The nurse should monitor the patient for which of the following?
A) Bleeding
B) Hypertension
C) Dehydration
D) Hypoglycemia
A nurse is caring for a patient with coronary artery disease who is experiencing unstable angina. Which of the following is the nurse’s priority intervention?
A) Administer morphine to relieve pain
B) Administer nitroglycerin as prescribed
C) Administer aspirin as prescribed
D) Place the patient on continuous cardiac monitoring
A nurse is educating a patient with coronary artery disease about smoking cessation. Which of the following is the best rationale for quitting smoking?
A) Smoking is not a significant risk factor for CAD
B) Smoking causes vasoconstriction, which increases the workload on the heart
C) Smoking reduces the effectiveness of medications used to treat CAD
D) Smoking has no effect on CAD but improves lung function
A nurse is caring for a patient with coronary artery disease who is being treated with a statin. Which of the following should the nurse monitor?
A) Blood glucose levels
B) Liver function tests
C) Blood pressure
D) Electrolyte levels
A nurse is caring for a patient post-percutaneous coronary intervention (PCI). The nurse should assess the patient for which of the following complications?
A) Bleeding
B) Hyperglycemia
C) Infection
D) Hypotension
A nurse is teaching a patient with coronary artery disease about a heart-healthy diet. Which of the following foods should the nurse encourage the patient to consume?
A) Fried chicken
B) Whole grains and leafy green vegetables
C) Full-fat dairy products
D) Red meat
A nurse is assessing a patient with coronary artery disease who is experiencing chest pain. The nurse administers nitroglycerin and the patient’s pain is not relieved. Which of the following is the next step?
A) Administer morphine
B) Reassess the patient’s vital signs
C) Administer a second dose of nitroglycerin
D) Contact the healthcare provider immediately
A nurse is caring for a patient with coronary artery disease who is prescribed a beta-blocker. The nurse should monitor the patient for which of the following?
A) Tachycardia
B) Hypoglycemia
C) Bradycardia
D) Weight loss
A nurse is providing discharge instructions for a patient with coronary artery disease. Which of the following statements by the patient indicates a need for further teaching?
A) “I should take my medication as prescribed, even if I feel fine.”
B) “I can stop taking my medications if I experience any side effects.”
C) “I will avoid heavy lifting and strenuous activities for a few weeks.”
D) “I need to follow a heart-healthy diet to reduce my cholesterol levels.”
A nurse is caring for a patient who has undergone coronary artery bypass graft (CABG) surgery. Which of the following is the priority nursing assessment in the immediate postoperative period?
A) Monitoring for signs of infection
B) Monitoring for signs of bleeding
C) Assessing for leg edema
D) Teaching the patient about lifestyle modifications
A nurse is caring for a patient with coronary artery disease and a history of myocardial infarction (MI). Which of the following is the best explanation for why the patient was prescribed an ACE inhibitor?
A) To prevent heart failure
B) To prevent the formation of blood clots
C) To lower blood pressure
D) To reduce cholesterol levels
A nurse is teaching a patient with hypertension about reducing their risk of heart disease. Which of the following recommendations is the most effective in lowering blood pressure?
A) Limiting alcohol intake
B) Drinking at least 8 cups of water per day
C) Engaging in high-intensity exercise
D) Reducing the intake of carbohydrates
A nurse is providing discharge teaching to a patient with hypertension who is prescribed a diuretic. The nurse should advise the patient to report which of the following symptoms?
A) Weight gain
B) Increased urination
C) Dizziness and lightheadedness
D) Constipation
A nurse is caring for a patient with hypertension who is being started on a new beta-blocker. Which of the following should the nurse assess for in the initial hours after administration?
A) Respiratory rate and depth
B) Blood pressure and heart rate
C) Electrolyte levels
D) Gastrointestinal function
A nurse is caring for a patient with hypertension who is taking a thiazide diuretic. Which of the following laboratory values should the nurse monitor regularly?
A) Potassium levels
B) Calcium levels
C) Sodium levels
D) Magnesium levels
A nurse is caring for a patient who has hypertension and reports feeling dizzy after standing up. The nurse should take which of the following actions?
A) Reposition the patient to a sitting position and check blood pressure
B) Administer a higher dose of the antihypertensive medication
C) Increase fluid intake to prevent dehydration
D) Have the patient lie down flat and rest
A nurse is caring for a patient with hypertension and a history of stroke. The nurse should encourage the patient to follow which of the following lifestyle modifications?
A) High-sodium diet to prevent fluid retention
B) Smoking cessation to reduce cardiovascular risks
C) Increased caffeine intake to improve energy levels
D) Decreased exercise to avoid stress on the body
A nurse is caring for a patient with hypertension who is prescribed a calcium channel blocker. Which of the following is an expected side effect of this medication?
A) Tachycardia
B) Headache
C) Dizziness
D) Weight gain
A nurse is caring for a patient with uncontrolled hypertension. Which of the following assessments is most critical for the nurse to perform?
A) Check the patient’s weight
B) Assess for signs of chest pain or shortness of breath
C) Check the patient’s blood glucose levels
D) Assess the patient’s ability to perform activities of daily living
A nurse is assessing a patient with coronary artery disease (CAD) for signs of myocardial infarction (MI). Which of the following findings is most indicative of an MI?
A) Chest pain relieved by rest
B) Crushing chest pain radiating to the left arm
C) Nausea without any chest pain
D) Lightheadedness and dizziness upon standing
A nurse is caring for a patient who is at high risk for coronary artery disease. Which of the following lifestyle modifications would the nurse recommend to reduce the risk of CAD?
A) Decrease fiber intake to avoid gastrointestinal discomfort
B) Engage in aerobic exercise for at least 30 minutes, 3 times per week
C) Increase intake of red meat to improve iron levels
D) Limit fluid intake to reduce the workload on the heart
A nurse is teaching a patient with coronary artery disease about the use of nitroglycerin. The nurse should instruct the patient to take the medication in which of the following situations?
A) Only when chest pain occurs and persists for 15 minutes
B) Every 4 hours, regardless of symptoms
C) At the onset of chest pain and every 5 minutes for up to 3 doses
D) On a regular schedule, even if no chest pain is present
A nurse is providing discharge teaching to a patient with coronary artery disease who is prescribed a statin. Which of the following instructions should the nurse include?
A) “You should avoid drinking grapefruit juice while taking this medication.”
B) “You can take this medication with any food or beverage.”
C) “You should stop taking this medication if you feel dizzy.”
D) “This medication should be taken only in the morning.”
A nurse is assessing a patient with coronary artery disease who has recently undergone coronary artery bypass graft (CABG) surgery. Which of the following should be the priority focus of care during the initial postoperative period?
A) Preventing infection at the surgical site
B) Promoting mobility and range of motion
C) Monitoring for signs of bleeding and maintaining hemodynamic stability
D) Educating the patient about dietary modifications
A nurse is caring for a patient with coronary artery disease who is being started on an anticoagulant. The nurse should monitor the patient for which of the following?
A) Increased risk of infection
B) Decreased appetite
C) Signs of bleeding
D) Elevated blood pressure
A nurse is caring for a patient with coronary artery disease and is educating the patient on the use of an aspirin regimen. Which of the following is the most important reason for taking aspirin daily?
A) To prevent blood clots and reduce the risk of MI
B) To lower blood cholesterol levels
C) To increase oxygen supply to the heart
D) To reduce blood pressure levels
A nurse is caring for a patient with coronary artery disease who is prescribed a beta-blocker. Which of the following should the nurse monitor for as a potential side effect of this medication?
A) Increased blood pressure
B) Heart failure symptoms such as shortness of breath and edema
C) Increased heart rate
D) Decreased appetite
A nurse is educating a patient with coronary artery disease about managing stress. Which of the following interventions would be most beneficial?
A) Engaging in a relaxation technique such as deep breathing or meditation
B) Avoiding physical activity to reduce stress
C) Increasing caffeine intake to stay alert and manage stress
D) Consuming alcohol in moderation to relax after a stressful day
A nurse is caring for a patient with coronary artery disease who is experiencing angina. Which of the following interventions should the nurse prioritize?
A) Administering nitroglycerin as prescribed
B) Providing oxygen to improve myocardial oxygenation
C) Repositioning the patient to a comfortable sitting position
D) Monitoring the patient’s vital signs every 30 minutes
A nurse is assessing a patient with a history of hypertension. Which of the following lifestyle changes is most likely to reduce the patient’s blood pressure?
A) Decreasing intake of fiber
B) Increasing intake of sodium
C) Reducing alcohol consumption
D) Increasing caffeine intake
A nurse is teaching a patient about taking their prescribed antihypertensive medication. The nurse should instruct the patient to avoid which of the following activities?
A) Engaging in aerobic exercise
B) Standing up quickly from a sitting position
C) Taking medication with food
D) Monitoring blood pressure regularly
A nurse is assessing a patient who is taking a calcium channel blocker for hypertension. Which of the following side effects should the nurse educate the patient to report?
A) Swelling in the lower extremities
B) Constipation
C) Dizziness or lightheadedness
D) Insomnia
A nurse is educating a patient with hypertension about sodium restriction. Which of the following foods should the nurse recommend the patient avoid?
A) Fresh vegetables
B) Whole grains
C) Canned soup
D) Fresh fruits
A nurse is caring for a patient who is newly diagnosed with hypertension. The nurse should instruct the patient to monitor which of the following?
A) Oxygen saturation
B) Weight and fluid retention
C) Blood glucose levels
D) Blood pressure regularly
A nurse is caring for a patient with hypertension who is prescribed a diuretic. Which of the following is an important action the nurse should take?
A) Monitor for signs of dehydration
B) Encourage increased fluid intake
C) Administer the medication in the evening
D) Check the patient’s temperature regularly
A nurse is teaching a patient with hypertension about the DASH diet (Dietary Approaches to Stop Hypertension). Which of the following foods should the patient increase in their diet?
A) Red meats
B) Whole grains
C) Full-fat dairy products
D) Fried foods
A nurse is caring for a patient with coronary artery disease (CAD) who is experiencing chest pain. Which of the following interventions should the nurse perform first?
A) Administer oxygen
B) Assess the pain using a pain scale
C) Administer nitroglycerin as prescribed
D) Call for immediate assistance
A nurse is educating a patient with coronary artery disease (CAD) about risk factors. Which of the following risk factors should the nurse emphasize the importance of modifying?
A) Family history of CAD
B) Age over 50
C) Hypertension
D) Gender (male)
A nurse is assessing a patient who underwent a coronary artery bypass graft (CABG). The nurse should monitor the patient for which of the following complications?
A) Infection at the graft site
B) Nausea and vomiting
C) Increased heart rate
D) Hypoglycemia
A nurse is caring for a patient with coronary artery disease (CAD) who is prescribed aspirin. Which of the following is the primary reason for this medication?
A) To lower blood pressure
B) To reduce cholesterol levels
C) To prevent blood clots and reduce the risk of myocardial infarction
D) To relieve pain
A nurse is teaching a patient with coronary artery disease (CAD) about lifestyle modifications. Which of the following instructions should the nurse include?
A) Consume high-fat foods to maintain adequate energy levels
B) Increase intake of fruits, vegetables, and whole grains
C) Avoid physical activity to prevent overexertion
D) Limit fluid intake to reduce the workload on the heart
A nurse is caring for a patient who is being treated for coronary artery disease (CAD) and is prescribed a statin. The nurse should educate the patient about the potential side effect of:
A) Muscle pain or weakness
B) Dizziness and lightheadedness
C) Increased appetite
D) Difficulty breathing
A nurse is monitoring a patient with coronary artery disease (CAD) who is experiencing shortness of breath and tachycardia. Which of the following is the priority intervention?
A) Provide oxygen therapy
B) Administer a pain reliever
C) Increase fluid intake
D) Position the patient in a supine position
A nurse is caring for a patient with coronary artery disease (CAD) who is prescribed a beta-blocker. Which of the following assessments should the nurse perform?
A) Monitor heart rate and blood pressure
B) Assess for signs of dehydration
C) Monitor respiratory rate
D) Measure oxygen saturation levels
A nurse is caring for a patient with coronary artery disease (CAD) who is prescribed a calcium channel blocker. The nurse should assess the patient for which of the following adverse effects?
A) Bradycardia and hypotension
B) Tachycardia and hypertension
C) Dizziness and headaches
D) Nausea and vomiting
A nurse is teaching a patient with coronary artery disease (CAD) about the use of nitroglycerin. Which of the following statements by the patient indicates the need for further teaching?
A) “I should use this medication at the first sign of chest pain.”
B) “If I still have pain after taking three doses, I should go to the emergency room.”
C) “I can take the medication with any drink.”
D) “I should lie down while taking the medication to prevent dizziness.”
A nurse is caring for a patient with hypertension who is prescribed an ACE inhibitor. Which of the following side effects should the nurse educate the patient about?
A) Hyperkalemia
B) Hypoglycemia
C) Weight gain
D) Constipation
A nurse is caring for a patient with uncontrolled hypertension. Which of the following laboratory values should the nurse monitor to assess for target organ damage?
A) Blood glucose levels
B) Kidney function tests (creatinine, BUN)
C) Lipid profile
D) Hemoglobin A1c
A nurse is providing dietary teaching to a patient with hypertension. Which of the following recommendations should the nurse include?
A) Limit potassium-rich foods
B) Increase intake of sodium-rich foods
C) Limit alcohol consumption
D) Avoid all dairy products
A nurse is assessing a patient who has been prescribed a beta-blocker for hypertension. The nurse should monitor the patient for which of the following adverse effects?
A) Bradycardia
B) Increased appetite
C) Hypertension
D) Hyperglycemia
A nurse is caring for a patient with hypertension. The patient asks about the purpose of taking medication. Which of the following should the nurse explain as the primary goal of antihypertensive therapy?
A) To increase blood pressure
B) To reduce the risk of stroke and heart attack
C) To increase urine output
D) To reduce the need for exercise
A nurse is teaching a patient with hypertension about the importance of medication adherence. Which of the following statements by the patient indicates understanding of the teaching?
A) “I will stop taking the medication when I feel better.”
B) “I will only take the medication if I have high blood pressure.”
C) “I will take my medication even if I feel fine.”
D) “I will increase my dose if my blood pressure is high.”
A nurse is assessing a patient with hypertension and a family history of cardiovascular disease. Which of the following lifestyle changes should the nurse prioritize in the teaching plan?
A) Increase physical activity
B) Reduce protein intake
C) Decrease calcium intake
D) Increase salt intake
A nurse is caring for a patient with coronary artery disease (CAD) who is experiencing acute chest pain. Which of the following actions should the nurse take first?
A) Administer nitroglycerin
B) Assess the pain using a pain scale
C) Administer oxygen
D) Call the healthcare provider
A nurse is teaching a patient with coronary artery disease (CAD) about the importance of smoking cessation. Which of the following is the most compelling reason to stop smoking?
A) Smoking increases cholesterol levels
B) Smoking contributes to the formation of blood clots
C) Smoking increases the risk for obesity
D) Smoking lowers blood pressure
A nurse is caring for a patient who has recently undergone a coronary artery bypass graft (CABG) surgery. The nurse should prioritize monitoring for which of the following complications?
A) Renal failure
B) Gastrointestinal bleeding
C) Wound infection
D) Stroke
A nurse is caring for a patient with coronary artery disease (CAD) who is prescribed aspirin. The nurse should instruct the patient to monitor for which of the following side effects?
A) Weight loss
B) Bruising or bleeding
C) Constipation
D) Increased heart rate
A nurse is assessing a patient with coronary artery disease (CAD) who has been prescribed a statin medication. The nurse should monitor the patient for which of the following side effects?
A) Jaundice
B) Muscle pain
C) Constipation
D) Hypertension
A nurse is caring for a patient with coronary artery disease (CAD) who is prescribed nitroglycerin for chest pain. Which of the following instructions should the nurse provide regarding the use of nitroglycerin?
A) Take the medication with food to prevent stomach upset
B) Take up to three doses, five minutes apart, and then call 911 if pain persists
C) Take the medication once a day at bedtime
D) Avoid taking the medication with grapefruit juice
A nurse is caring for a patient with coronary artery disease (CAD) who has been prescribed a beta-blocker. Which of the following interventions should the nurse include in the patient’s plan of care?
A) Monitor for signs of hypoglycemia
B) Assess for bradycardia
C) Encourage increased intake of caffeine
D) Increase fluid intake to prevent dehydration
A nurse is caring for a patient with coronary artery disease (CAD) who is prescribed a calcium channel blocker. Which of the following instructions should the nurse provide to the patient?
A) Avoid standing up quickly to prevent dizziness
B) Increase dietary intake of potassium-rich foods
C) Monitor blood glucose levels regularly
D) Take the medication with grapefruit juice
A nurse is caring for a patient with coronary artery disease (CAD) who is recovering from a myocardial infarction (MI). The nurse should assess for which of the following signs of worsening heart failure?
A) Decreased urinary output
B) Increased blood pressure
C) Productive cough with frothy sputum
D) Increased appetite
A nurse is educating a patient with coronary artery disease (CAD) about the importance of exercise. Which of the following should the nurse include in the teaching?
A) Engage in high-impact activities to increase cardiovascular fitness
B) Exercise can improve circulation and lower blood pressure
C) Exercise should be avoided if there is any chest pain
D) Only moderate physical activity should be done after meals
Questions and Answers for Study Guide
Describe the pathophysiology of hypertension and its impact on target organs.
Answer:
Hypertension is characterized by persistently elevated blood pressure that increases the workload on the cardiovascular system. The pathophysiology begins with increased systemic vascular resistance, often due to endothelial dysfunction, impaired vasodilation, or overactivation of the renin-angiotensin-aldosterone system (RAAS). These mechanisms lead to vasoconstriction, fluid retention, and an elevated cardiac output.
Over time, hypertension causes damage to target organs. For instance:
- Heart: Chronic pressure overload leads to left ventricular hypertrophy, increasing the risk of heart failure.
- Kidneys: Elevated pressure damages glomeruli, leading to chronic kidney disease.
- Brain: Hypertension can cause cerebrovascular events, such as stroke or vascular dementia.
- Eyes: Retinal blood vessel damage results in hypertensive retinopathy.
Effective management through lifestyle changes and medications, such as antihypertensives, is critical to reduce morbidity and mortality.
Explain the nursing interventions for a patient diagnosed with coronary artery disease (CAD).
Answer:
Nursing interventions for a patient with CAD focus on improving oxygen supply to the myocardium, reducing oxygen demand, and preventing complications. Key interventions include:
- Monitoring and Assessment:
- Assess for chest pain, dyspnea, or fatigue, which are indicative of myocardial ischemia.
- Monitor vital signs, including blood pressure, heart rate, and oxygen saturation.
- Medication Administration:
- Administer nitrates to relieve angina by dilating coronary arteries.
- Administer beta-blockers to reduce myocardial oxygen demand.
- Use antiplatelet agents, like aspirin, to prevent clot formation.
- Patient Education:
- Encourage a heart-healthy diet, such as the DASH or Mediterranean diet, to reduce cholesterol levels.
- Stress the importance of regular physical activity and smoking cessation to improve cardiovascular health.
- Educate about recognizing symptoms of angina or myocardial infarction.
- Psychosocial Support:
- Address emotional stressors that can exacerbate CAD.
- Provide support for lifestyle modifications and coping mechanisms.
- Collaborative Care:
- Collaborate with dietitians, physical therapists, and cardiologists to optimize patient outcomes.
Discuss the role of lifestyle modifications in managing hypertension and preventing coronary artery disease.
Answer:
Lifestyle modifications are foundational in managing hypertension and preventing coronary artery disease. They aim to reduce modifiable risk factors, improve cardiovascular health, and enhance overall quality of life. Key lifestyle changes include:
- Dietary Adjustments:
- Following a low-sodium diet reduces fluid retention and blood pressure.
- Increasing intake of fruits, vegetables, whole grains, and lean proteins improves lipid profiles and overall heart health.
- Physical Activity:
- Regular aerobic exercise (e.g., walking, cycling) improves cardiovascular fitness, lowers blood pressure, and reduces LDL cholesterol.
- Weight Management:
- Maintaining a healthy weight reduces the strain on the heart and lowers the risk of hypertension and diabetes.
- Smoking Cessation:
- Quitting smoking improves vascular health, reduces oxidative stress, and prevents plaque formation in coronary arteries.
- Stress Reduction:
- Techniques such as mindfulness, yoga, or therapy help manage stress, which can otherwise exacerbate hypertension and CAD.
By combining these changes with pharmacological interventions when necessary, patients can achieve better health outcomes and reduce the risk of complications such as heart attack or stroke.
What are the complications of untreated hypertension, and how can nurses play a role in preventing these complications?
Answer:
Untreated hypertension can lead to severe complications that affect multiple organ systems, including:
- Cardiovascular Complications:
- Left ventricular hypertrophy, heart failure, myocardial infarction, and aortic aneurysms are common outcomes due to chronic high pressure on the heart and vessels.
- Cerebrovascular Events:
- Stroke or transient ischemic attacks occur from damaged blood vessels or emboli due to long-standing hypertension.
- Renal Damage:
- Chronic kidney disease (CKD) can develop from damaged glomeruli, leading to decreased filtration and eventual renal failure.
- Retinopathy:
- Hypertensive damage to retinal vessels causes vision impairment and, in severe cases, blindness.
Nursing Role in Prevention:
Nurses play a vital role in preventing these complications by:
- Monitoring: Regularly assessing blood pressure and ensuring adherence to antihypertensive medications.
- Education: Teaching patients about the importance of lifestyle modifications, such as a low-sodium diet, exercise, and stress management.
- Follow-Up: Encouraging routine check-ups and providing guidance on managing comorbidities like diabetes or hyperlipidemia.
- Support: Addressing barriers to medication compliance, such as financial issues or lack of understanding about the disease.
Early intervention by nurses can significantly reduce the risk of long-term complications.
Compare and contrast the pharmacological management of hypertension and coronary artery disease.
Answer:
The pharmacological management of hypertension and coronary artery disease (CAD) shares some overlap but also has distinct approaches based on pathophysiology:
- Hypertension Management:
- Diuretics: Reduce blood volume and decrease blood pressure.
- ACE Inhibitors/ARBs: Block the renin-angiotensin-aldosterone system to reduce vasoconstriction and fluid retention.
- Calcium Channel Blockers: Relax blood vessels and reduce peripheral resistance.
- Beta-Blockers: Lower heart rate and myocardial oxygen demand, especially useful in hypertensive patients with concurrent CAD.
- CAD Management:
- Antiplatelets: Aspirin or clopidogrel reduces clot formation in coronary arteries.
- Statins: Lower LDL cholesterol and stabilize atherosclerotic plaques.
- Nitrates: Relieve angina by dilating coronary arteries.
- Beta-Blockers and Calcium Channel Blockers: Reduce myocardial oxygen demand and control anginal symptoms.
Differences:
- Hypertension management primarily focuses on controlling systemic blood pressure to prevent end-organ damage.
- CAD management aims to improve myocardial perfusion, reduce ischemia, and prevent acute events like myocardial infarction.
Both conditions benefit from comprehensive care involving lifestyle changes alongside medication.
Explain the significance of patient education in preventing the progression of coronary artery disease.
Answer:
Patient education is a cornerstone in preventing the progression of coronary artery disease (CAD). Effective education empowers patients to manage their health proactively and reduce modifiable risk factors.
Key Elements of Patient Education:
- Understanding CAD:
- Educating patients about the pathophysiology of CAD helps them comprehend the importance of interventions.
- Discussing risk factors such as smoking, obesity, and high cholesterol emphasizes areas for lifestyle modification.
- Dietary Counseling:
- Patients should be educated on adopting a heart-healthy diet, such as increasing fiber intake and avoiding trans fats.
- Physical Activity:
- Explaining the benefits of regular aerobic exercise for improving cardiac efficiency and lowering cholesterol.
- Medication Adherence:
- Ensuring patients understand the purpose and potential side effects of medications, such as antiplatelets or statins.
- Symptom Recognition:
- Teaching patients to recognize symptoms of angina or myocardial infarction for early medical intervention.
Outcome of Education:
Educated patients are more likely to adhere to treatment plans, make informed decisions, and adopt behaviors that slow CAD progression, reducing the risk of complications.
Discuss the role of the nurse in managing a hypertensive crisis.
Answer:
A hypertensive crisis is a severe elevation in blood pressure (≥180/120 mmHg) that requires immediate medical attention to prevent organ damage. Nurses play a critical role in its management:
- Assessment and Monitoring:
- Assess for symptoms such as severe headache, blurred vision, chest pain, or neurological deficits.
- Monitor vital signs and ensure continuous blood pressure monitoring.
- Interventions:
- Administer intravenous antihypertensives (e.g., nitroprusside, labetalol) as prescribed to rapidly lower blood pressure.
- Ensure gradual blood pressure reduction to prevent ischemic complications.
- Preventing Complications:
- Monitor for signs of end-organ damage, including renal dysfunction or pulmonary edema.
- Conduct frequent neurological checks to assess for stroke.
- Education and Discharge Planning:
- Educate the patient about the causes of the crisis, such as medication non-compliance or high-sodium intake.
- Reinforce the importance of regular blood pressure monitoring and adherence to prescribed treatments.
Timely nursing interventions can prevent morbidity and mortality in hypertensive crisis cases.
Explain the diagnostic criteria for hypertension and the steps involved in confirming a diagnosis.
Answer:
Hypertension is diagnosed when a patient exhibits persistently elevated blood pressure readings over time, often classified based on the American Heart Association (AHA) guidelines:
- Normal BP: <120/80 mmHg
- Elevated BP: 120-129/<80 mmHg
- Stage 1 Hypertension: 130-139/80-89 mmHg
- Stage 2 Hypertension: ≥140/90 mmHg
Steps in Diagnosis:
- Initial Screening:
- Blood pressure is measured using a validated sphygmomanometer. The patient should be seated, relaxed, and refrain from caffeine or tobacco 30 minutes before measurement.
- Repeat Measurements:
- BP should be measured on two or more separate occasions, at least one week apart, to confirm persistently high readings.
- Ambulatory blood pressure monitoring (ABPM) may be used to rule out white-coat or masked hypertension.
- Clinical Assessment:
- A thorough history is taken, including risk factors such as family history, obesity, and smoking.
- Physical examination may reveal signs of target organ damage, such as hypertensive retinopathy or left ventricular hypertrophy.
- Laboratory Tests and Imaging:
- Tests include serum electrolytes, renal function tests, lipid profiles, and urinalysis to identify secondary causes or complications.
- Imaging (e.g., echocardiogram) may be used to evaluate cardiac damage.
Nursing Role in Diagnosis:
Nurses ensure accurate BP measurement, educate patients on home monitoring, and collaborate with healthcare providers to schedule follow-ups and confirm the diagnosis.
Discuss the role of the DASH diet in managing hypertension. Provide examples of recommended foods and those to avoid.
Answer:
The Dietary Approaches to Stop Hypertension (DASH) diet is a clinically proven nutritional strategy designed to lower blood pressure by promoting heart-healthy eating habits.
Key Components of the DASH Diet:
- Focus on Nutrient-Rich Foods:
- Emphasizes fruits, vegetables, whole grains, lean protein, and low-fat dairy products.
- High potassium, calcium, and magnesium intake helps counteract the effects of sodium and reduces blood pressure.
- Limit Sodium Intake:
- Sodium should be restricted to 1,500-2,300 mg/day, as excess sodium contributes to fluid retention and elevated BP.
Recommended Foods:
- Vegetables: Spinach, broccoli, carrots.
- Fruits: Bananas, oranges, apples.
- Whole Grains: Brown rice, oatmeal, quinoa.
- Proteins: Skinless poultry, fish, legumes.
- Dairy: Low-fat yogurt, skim milk.
Foods to Avoid:
- Processed meats like bacon and sausages.
- Sugary beverages and sweets.
- High-sodium snacks like chips or canned soups.
Impact on Hypertension:
The DASH diet has been shown to reduce systolic BP by 8-14 mmHg when followed consistently. Combined with exercise and weight management, it significantly lowers cardiovascular risk.
Nursing Implications:
Nurses educate patients on meal planning, portion sizes, and reading nutrition labels to adhere to DASH principles.
Analyze the relationship between hypertension and coronary artery disease (CAD). How does one condition influence the other?
Answer:
Hypertension and coronary artery disease (CAD) are interrelated cardiovascular conditions, often coexisting and exacerbating each other’s progression.
Hypertension as a Risk Factor for CAD:
- Vascular Damage:
- Chronic high blood pressure damages the endothelial lining of arteries, promoting atherosclerosis.
- The narrowing of coronary arteries due to plaque formation reduces blood flow to the myocardium, leading to ischemia.
- Increased Cardiac Workload:
- Persistent hypertension increases the heart’s workload, leading to left ventricular hypertrophy.
- Over time, hypertrophy compromises coronary perfusion, contributing to angina or myocardial infarction.
CAD’s Effect on Hypertension:
- Ischemic Dysfunction:
- Reduced myocardial function from CAD can worsen hypertension by impairing cardiac output regulation.
- Secondary Effects:
- Medications used for CAD, such as beta-blockers, may help control BP, but untreated CAD complicates hypertension management.
Nursing Considerations:
Nurses play a crucial role in managing both conditions by:
- Educating patients on lifestyle changes that address both hypertension and CAD.
- Ensuring adherence to medication regimens, such as antihypertensives, statins, and antiplatelets.
- Monitoring for signs of complications, including chest pain or worsening blood pressure control.
Describe the nursing process for managing a patient with stable angina due to coronary artery disease.
Answer:
The nursing process involves comprehensive assessment, diagnosis, planning, implementation, and evaluation to manage stable angina in CAD patients effectively.
- Assessment:
- Gather a detailed history of chest pain (e.g., onset, location, duration, relieving/aggravating factors).
- Monitor vital signs, including blood pressure and heart rate.
- Assess for risk factors like smoking, diabetes, or hyperlipidemia.
- Nursing Diagnoses:
- Impaired cardiac output related to decreased coronary perfusion.
- Activity intolerance related to anginal pain.
- Knowledge deficit regarding CAD management.
- Planning:
- Set goals such as reducing the frequency of angina episodes and improving the patient’s activity tolerance.
- Implementation:
- Medications: Administer nitrates, beta-blockers, and calcium channel blockers as prescribed to relieve symptoms.
- Lifestyle Modification Education: Teach patients about dietary changes, exercise, and stress management.
- Symptom Management: Instruct patients to rest during angina episodes and use nitroglycerin as directed.
- Evaluation:
- Reassess the frequency and severity of angina episodes.
- Monitor adherence to lifestyle changes and medication regimens.
- Evaluate patient understanding of CAD management strategies.
Outcome:
Effective nursing interventions reduce angina episodes, improve quality of life, and prevent complications like myocardial infarction.
Discuss the psychosocial impact of chronic hypertension and coronary artery disease on patients and their families.
Answer:
Chronic hypertension and coronary artery disease (CAD) significantly impact the psychological and social well-being of patients and their families.
Psychological Impact:
- Stress and Anxiety:
- Patients may experience fear of life-threatening events such as stroke or myocardial infarction.
- Depression:
- The chronic nature of the conditions and lifestyle restrictions can lead to feelings of hopelessness or depression.
Social Impact:
- Lifestyle Changes:
- Dietary restrictions and the need for regular exercise may alter family dynamics and social activities.
- Financial Burden:
- The cost of long-term medications, frequent doctor visits, and potential hospitalizations can strain family resources.
Nursing Role:
- Emotional Support:
- Provide a supportive environment where patients can express their fears and concerns.
- Offer counseling referrals when necessary.
- Family Education:
- Educate family members on how to support the patient, such as preparing healthy meals or encouraging adherence to medications.
- Community Resources:
- Connect patients and families to support groups or financial assistance programs.
Conclusion:
Addressing the psychosocial impact holistically improves patient outcomes, compliance, and overall quality of life for both patients and their families.
What are the pathophysiological mechanisms underlying hypertension, and how do they contribute to the progression of coronary artery disease (CAD)?
Answer:
Hypertension is a chronic condition characterized by persistently elevated blood pressure, which can lead to structural and functional damage to the cardiovascular system. The pathophysiology involves several complex mechanisms:
Pathophysiological Mechanisms of Hypertension:
- Increased Peripheral Resistance:
- Chronic vasoconstriction caused by overactivation of the sympathetic nervous system (SNS) and the renin-angiotensin-aldosterone system (RAAS) results in elevated systemic vascular resistance.
- Angiotensin II, a potent vasoconstrictor, contributes to arterial stiffness and vascular remodeling.
- Altered Sodium and Water Balance:
- Dysregulation in the kidneys leads to sodium retention and water retention, increasing blood volume and cardiac output.
- High sodium intake exacerbates these effects, particularly in salt-sensitive individuals.
- Endothelial Dysfunction:
- Damage to the endothelium impairs the production of nitric oxide, a vasodilator, leading to reduced vascular compliance.
- Vascular Remodeling and Arteriosclerosis:
- Prolonged hypertension causes hypertrophy of the arterial walls, reducing lumen diameter and increasing resistance.
- This process is accelerated by oxidative stress and inflammation.
Link Between Hypertension and CAD:
- Accelerated Atherosclerosis:
- Hypertension causes endothelial injury, facilitating the deposition of low-density lipoproteins (LDL) and the formation of atherosclerotic plaques in coronary arteries.
- Over time, these plaques reduce blood flow to the myocardium, leading to ischemia.
- Left Ventricular Hypertrophy (LVH):
- Persistent high blood pressure forces the heart to work harder, leading to hypertrophy. LVH reduces coronary perfusion efficiency and increases oxygen demand, contributing to angina or myocardial infarction.
- Inflammatory Pathways:
- Hypertension activates inflammatory pathways that exacerbate plaque instability, increasing the risk of rupture and acute coronary syndrome.
- Microvascular Disease:
- Hypertension damages small coronary vessels, leading to microvascular angina and heart failure with preserved ejection fraction (HFpEF).
Nursing Considerations:
- Education:
- Teach patients about lifestyle modifications, such as reducing sodium intake, exercising, and managing stress, to control blood pressure.
- Medication Adherence:
- Emphasize the importance of adhering to antihypertensive medications like ACE inhibitors, beta-blockers, and calcium channel blockers.
- Monitoring:
- Regularly monitor blood pressure, lipid profiles, and signs of CAD progression, such as chest pain or dyspnea.
Addressing hypertension through early detection and management is critical to reducing the risk of CAD and improving long-term cardiovascular outcomes.
Discuss the nursing interventions and management strategies for a patient experiencing a hypertensive crisis. Include pharmacological and non-pharmacological approaches.
Answer:
A hypertensive crisis is a severe elevation in blood pressure, categorized as either hypertensive urgency or hypertensive emergency.
- Hypertensive Urgency: BP >180/120 mmHg without signs of target organ damage.
- Hypertensive Emergency: BP >180/120 mmHg with evidence of target organ damage (e.g., acute myocardial infarction, stroke, or kidney failure).
Nursing Interventions:
- Immediate Assessment:
- Obtain a thorough history, including medications, recent symptoms, and potential triggers (e.g., missed doses, stress, or drug use).
- Assess for symptoms such as severe headache, chest pain, shortness of breath, or altered mental status.
- Monitor vital signs and perform a focused physical examination to detect signs of organ damage.
- Pharmacological Management:
- Hypertensive Emergency:
- Administer intravenous antihypertensives to lower BP gradually (e.g., nitroprusside, labetalol, or nicardipine).
- Target reduction: Lower BP by no more than 25% within the first hour to prevent ischemia.
- Hypertensive Urgency:
- Use oral antihypertensives such as captopril or clonidine.
- Gradual BP reduction over 24-48 hours is recommended to avoid organ hypoperfusion.
- Hypertensive Emergency:
- Non-Pharmacological Management:
- Calm Environment:
- Place the patient in a quiet, low-stimulation room to reduce anxiety, which can exacerbate hypertension.
- Positioning:
- Keep the patient in a semi-Fowler’s position to promote oxygenation and reduce cardiac workload.
- Fluid Management:
- Administer intravenous fluids carefully to maintain perfusion without exacerbating hypertension.
- Calm Environment:
- Frequent Monitoring:
- Continuously monitor BP, heart rate, oxygen saturation, and urine output.
- Assess for signs of worsening organ dysfunction, such as changes in neurological status (stroke) or worsening chest pain (myocardial infarction).
- Patient Education:
- Teach the importance of medication adherence to prevent future crises.
- Educate on lifestyle changes, including a low-sodium diet, weight management, and stress reduction.
Nursing Goals:
- Achieve a controlled reduction in BP to safe levels.
- Prevent further target organ damage.
- Ensure the patient understands the seriousness of their condition and adheres to preventive measures.
Effective management of hypertensive crises requires prompt recognition, intervention, and ongoing care to prevent life-threatening complications.
Evaluate the importance of cardiac rehabilitation for a patient recovering from a myocardial infarction due to CAD. How can nurses support this process?
Answer:
Cardiac rehabilitation is a critical component of recovery for patients following a myocardial infarction (MI) caused by coronary artery disease (CAD). It aims to restore physical function, prevent recurrent cardiovascular events, and improve overall quality of life.
Components of Cardiac Rehabilitation:
- Medical Evaluation:
- Initial assessment to evaluate the patient’s physical capabilities, cardiac function, and risk factors.
- Supervised Exercise Program:
- Gradual physical activity designed to improve cardiovascular fitness.
- Includes aerobic exercises (e.g., walking, cycling) and resistance training tailored to the patient’s tolerance.
- Lifestyle Modification:
- Focus on smoking cessation, dietary changes (low saturated fat and sodium), and weight management.
- Psychosocial Support:
- Address emotional challenges such as anxiety or depression, which are common after an MI.
- Education:
- Teach patients about CAD, medication adherence, symptom recognition, and when to seek medical help.
Role of Nurses in Cardiac Rehabilitation:
- Assessment and Planning:
- Evaluate the patient’s baseline physical and emotional status.
- Develop individualized care plans that align with rehabilitation goals.
- Support During Exercise:
- Monitor vital signs and symptoms during supervised activities to ensure safety.
- Educate patients on recognizing signs of exercise intolerance, such as chest pain or dizziness.
- Lifestyle Coaching:
- Provide practical tips for integrating heart-healthy habits into daily life.
- Encourage the use of tools like food diaries or pedometers to track progress.
- Emotional Support:
- Offer counseling or referrals to support groups to address psychological stress.
- Monitoring Progress:
- Track improvements in physical endurance, weight, and lipid profiles.
- Adjust rehabilitation plans as needed based on progress and challenges.
Outcomes of Cardiac Rehabilitation:
- Reduced mortality and risk of recurrent MI.
- Improved exercise tolerance and quality of life.
- Enhanced patient knowledge and self-management skills.
Nurses play a pivotal role in encouraging adherence to cardiac rehabilitation, fostering long-term behavior changes, and ultimately improving patient outcomes after an MI.