A nurse is screening a community group for hypertension. Which person should be referred for immediate treatment?

A 20-year-old client who has a blood pressure of 125/60 mm Hg.

A 40-year-old client who has a blood pressure of 138/98 mm Hg.

A 55-year-old client who has a blood pressure of 142/68 mm Hg.

A 70-year-old client who has a blood pressure of 150/78 mm Hg.

Answer and Explanation

The Correct Answer is B

A 40-year-old client who has a blood pressure of 138/98 mm Hg should be referred for immediate treatment. This is because this client has grade 1 hypertension according to the International Society of Hypertension (ISH) guidelines, which define hypertension as a systolic blood pressure (SBP) of 140 mm Hg or higher and/or a diastolic blood pressure (DBP) of 90 mm Hg or higher in the office or clinic. This client also has a high risk of cardiovascular complications due to their age and elevated DBP.

Choice A is wrong because a 20-year-old client who has a blood pressure of 125/60 mm Hg does not have hypertension. This client has normal blood pressure according to the ISH guidelines, which define normal blood pressure as an SBP of less than 130 mm Hg and a DBP of less than 85 mm Hg in the office or clinic. This client also has a low risk of cardiovascular complications due to their age and low DBP.

Choice C is wrong because a 55-year-old client who has a blood pressure of 142/68 mm Hg does not need immediate treatment. This client has grade 1 hypertension according to the ISH guidelines, but their DBP is normal. The ISH guidelines recommend lifestyle interventions for three to six months before medication in patients with grade 1 hypertension and no comorbidities.

This client may have other risk factors that need to be assessed, such as obesity, diabetes, or smoking, but they do not require urgent referral.

Choice D is wrong because a 70-year-old client who has a blood pressure of 150/78 mm Hg does not need immediate treatment. This client has grade 1 hypertension according to the ISH guidelines, but their DBP is normal. The ISH guidelines recommend a target blood pressure of less than 140/90 mm Hg within three months for patients older than 65 years, and after three months reduce the target to less than 130/80 mm Hg.

This client may have other risk factors that need to be assessed, such as chronic kidney disease, heart failure, or atrial fibrillation, but they do not require urgent referral.

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Free Nursing Study Resources

Correct Answer is A

Explanation

“Have you had thoughts about killing yourself?” This is the best response because it directly assesses the client’s suicidal risk and shows empathy and concern.

The other choices are wrong because:

Choice B. “What can’t you go on anymore?” This is a vague and open-ended question that does not address the client’s immediate safety or emotional state.

Choice C. “Don’t think like that.

It’s not true!” This is a dismissive and invalidating response that does not acknowledge the client’s feelings or offer support.

Choice D. “Have you talked to your doctor about these feelings?” This is a deferring and avoiding response that does not explore the client’s situation or provide any intervention.

A. Straighten the auditory canal by pulling it down and toward the front. B. Gently pull the auricle up and back before instilling the drops. C. Ask the client to lower the head and take a deep breath during the instillation. D. Don sterile glove and gently insert one finger in the canal to promote the flow of the drops.

Correct Answer is B

Explanation

Gently pull the auricle up and back before instilling the drops. This technique straightens the auditory canal and allows the drops to reach the eardrum.

It also prevents contamination of the ear canal by the finger.

Choice A is wrong because pulling the auditory canal down and toward the front is the proper method for children, not adults.

This technique is used for children because their auditory canal is shorter and more curved than adults.

Choice C is wrong because lowering the head and taking a deep breath during the instillation has no effect on the administration of otic drops.

It may also cause discomfort or dizziness for the client.

Choice D is wrong because wearing sterile gloves and inserting one finger in the canal is unnecessary and potentially harmful.

It may introduce bacteria or damage the ear canal or eardrum.

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A nurse is screening a community group for hypertension. Which person should be referred for immediate treatment?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is B

Explanation

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