The client diagnosed with primary hypertension says, "I don't know why the doctor is worried about my blood pressure. I am feeling just fine." Which statement by the nurse would be the most appropriate?
You feel good because your medication is working properly.
Your blood pressure reflects how strong your heart muscle contracts.
Even if you are feeling good, damage can occur to your heart and kidneys.
Have you told your doctor that you are feeling good?
The Correct Answer is C
Choice A reason: You feel good because your medication is working properly is not the most appropriate statement by the nurse. This statement may imply that the client does not need to worry about their blood pressure or follow up with their doctor. The nurse should educate the client about the importance of regular monitoring and adherence to the prescribed treatment.
Choice B reason: Your blood pressure reflects how strong your heart muscle contracts is not the most appropriate statement by the nurse. This statement may confuse the client or give them a false sense of security. The nurse should explain that blood pressure is determined by the force and amount of blood pumped by the heart and the resistance of the blood vessels. The nurse should also inform the client about the normal and abnormal ranges of blood pressure and the risk factors for hypertension.
Choice C reason: Even if you are feeling good, damage can occur to your heart and kidneys is the most appropriate statement by the nurse. This statement conveys the seriousness of hypertension and its potential complications. The nurse should educate the client about the effects of high blood pressure on the vital organs and the need for preventive measures and lifestyle modifications.
Choice D reason: Have you told your doctor that you are feeling good is not the most appropriate statement by the nurse. This statement may suggest that the nurse is not interested in the client's condition or does not have the knowledge or authority to address their concerns. The nurse should communicate effectively with the client and the health care team and provide appropriate guidance and support.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: Respiratory alkalosis is not the correct answer. Respiratory alkalosis is a condition where the blood pH is high (above 7.45) due to low carbon dioxide levels (below 35 mmHg) caused by hyperventilation. The client's blood pH is low (7.2) and the carbon dioxide level is normal (40 mmHg), which does not indicate respiratory alkalosis.
Choice B reason: Metabolic alkalosis is not the correct answer. Metabolic alkalosis is a condition where the blood pH is high (above 7.45) due to high bicarbonate levels (above 26 mEq/L) caused by excessive loss of acids or intake of alkali. The client's blood pH is low (7.2) and the bicarbonate level is low (19 mEq/L), which does not indicate metabolic alkalosis.
Choice C reason: Respiratory acidosis is not the correct answer. Respiratory acidosis is a condition where the blood pH is low (below 7.35) due to high carbon dioxide levels (above 45 mmHg) caused by hypoventilation. The client's blood pH is low (7.2) but the carbon dioxide level is normal (40 mmHg), which does not indicate respiratory acidosis.
Choice D reason: This is the correct answer. Metabolic acidosis is a condition where the blood pH is low (below 7.35) due to low bicarbonate levels (below 22 mEq/L) caused by excessive production or intake of acids or loss of alkali. The client's blood pH is low (7.2) and the bicarbonate level is low (19 mEq/L), which indicates metabolic acidosis.
Correct Answer is D
Explanation
Choice A reason: Vitamin B12 does not contribute to the increased production of RBCs after significant blood loss. Vitamin B12 is a type of vitamin that is essential for the normal formation and maturation of red blood cells (RBCs), which carry oxygen throughout the body. ¹ However, vitamin B12 does not increase the production of RBCs in response to blood loss. That is the role of erythropoietin, a hormone that stimulates the bone marrow to produce more RBCs. ²
Choice B reason: Vitamin B12 is not needed to prevent excessive production of red blood cells. Vitamin B12 is needed for the normal production of red blood cells, not for the prevention of overproduction. Excessive production of red blood cells, also known as polycythemia, can cause the blood to become thick and viscous, increasing the risk of clotting and stroke. ³ Polycythemia can be caused by various factors, such as smoking, dehydration, or genetic mutations, but not by a lack of vitamin B12.
Choice C reason: Vitamin B12 is not needed to prevent RBCs from sticking together. Vitamin B12 is needed for the normal formation and maturation of RBCs, not for the prevention of aggregation. RBCs can stick together and form clumps, also known as rouleaux, which can impair blood flow and oxygen delivery. Rouleaux can be caused by various factors, such as inflammation, infection, or cancer, but not by a lack of vitamin B12.
Choice D reason: Vitamin B12 is needed for the normal formation and maturation of RBCs, but it cannot be absorbed by the body without a substance called intrinsic factor. Intrinsic factor is a protein that is produced by the stomach and binds to vitamin B12, allowing it to be absorbed by the small intestine. ¹ Pernicious anemia is a type of anemia that occurs when the stomach does not produce enough intrinsic factor, leading to vitamin B12 deficiency. The only way to treat pernicious anemia is by giving vitamin B12 injections, which bypass the need for intrinsic factor.
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