The nurse is evaluating a client at a one-month check-up who is being treated for hypertension through lifestyle modifications.
Which of the following findings would be a priority for the nurse to follow up?

The client is obese and has been exercising for 20 minutes per day twice each week.

The client has reduced sodium intake from 5 grams per day to 3.5 grams per day.

The client drinks 1 to 2 glasses of wine with dinner a few nights per week.

The client has reduced smoking cigarettes from 2 packs per day to 1.5 packs per day.

Answer and Explanation

The Correct Answer is A

Choice A rationale

Obesity and minimal exercise contribute significantly to hypertension due to increased vascular resistance and poor cardiac health. Recommendations for hypertension management include regular physical activity at least 30 minutes daily, five times per week. Current exercise efforts are insufficient, indicating a need for intervention to optimize blood pressure reduction.

Choice B rationale

Sodium intake reduction to 3.5 grams daily is an improvement but still exceeds the recommended limit of 2.3 grams. Excess sodium contributes to hypertension by increasing fluid retention and vascular resistance, though this change alone does not prioritize follow-up over sedentary behavior, which has a larger impact.

Choice C rationale

Alcohol consumption can elevate blood pressure by affecting vascular tone and increasing sympathetic nervous system activity. While 1-2 glasses per day may be within moderation, prioritizing increased physical activity would have a greater benefit on hypertension management than reducing alcohol intake alone.

Choice D rationale

Reducing cigarette smoking from 2 packs to 1.5 packs per day lowers nicotine exposure but still significantly contributes to hypertension through vasoconstriction and arterial damage. Exercise intervention is more impactful for cardiovascular health and blood pressure management in this context.

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Correct Answer is B

Explanation

Choice A rationale

Decreasing caffeine intake is a proven method for managing urinary incontinence. Caffeine stimulates bladder activity, potentially worsening symptoms. Reducing caffeine to one cup per day can decrease urgency and frequency. This recommendation aligns with the scientific understanding that caffeine is a bladder irritant and is supported by clinical guidelines on managing urinary incontinence.

Choice B rationale

Grapefruit juice is acidic and can irritate the bladder lining, worsening urinary incontinence symptoms. Substituting orange juice with grapefruit juice does not address the problem, as both are acidic and contain bladder irritants. Citrus juices, including grapefruit and orange, are often advised against for patients managing urinary incontinence due to their potential to exacerbate symptoms.

Choice C rationale

Kegel exercises strengthen the pelvic floor muscles, enhancing bladder control and reducing incontinence episodes. This evidence-based practice is recommended for individuals with urinary incontinence. Regular Kegel exercise improves urinary sphincter function and supports the overall health of pelvic muscles, which is key for managing incontinence.

Choice D rationale

Establishing a fixed schedule for bathroom visits can prevent overdistension of the bladder and manage symptoms of urinary incontinence effectively. Timed voiding helps train the bladder and reduce episodes of urgency or leakage. It is widely supported as part of behavioral therapy for urinary incontinence management.

A. Medications. B. Negative-pressure devices. C. Penile injections. D. Penis transplant.

Correct Answer is A

Explanation

Choice A rationale

Phosphodiesterase type 5 inhibitors, such as sildenafil, are the next step in treating erectile dysfunction after lifestyle changes fail. These medications enhance nitric oxide-mediated vasodilation in the penile tissues, improving erectile function. Their efficacy, safety, and widespread availability make them the first-line pharmacological option.

Choice B rationale

Negative-pressure devices, like vacuum erection devices, mechanically increase blood flow to the penis to maintain an erection. While effective for some, they are typically considered after the failure of oral pharmacological agents, as they require significant user compliance and may cause discomfort.

Choice C rationale

Penile injections of vasodilatory agents, such as alprostadil, are effective for managing erectile dysfunction. However, these are invasive and often reserved for cases unresponsive to oral medications or mechanical devices. They are not typically the first choice after lifestyle modification.

Choice D rationale

Penis transplantation is an experimental treatment and not a standard approach to managing erectile dysfunction. Its application is limited to cases of significant penile trauma or congenital abnormalities and is not relevant for individuals without such conditions.

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The nurse is evaluating a client at a one-month check-up who is being treated for hypertension through lifestyle modifications.Which of the following findings would be a priority for the nurse to follow up?

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Explanation

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Explanation

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The nurse is evaluating a client at a one-month check-up who is being treated for hypertension through lifestyle modifications.
Which of the following findings would be a priority for the nurse to follow up?