The nurse is teaching a client with hypertension about the prescribed hydrochlorothiazide 10 mg PO daily. Which statement, made by the client, would indicate that the teaching has been effective? "I will:

Limit my intake of citrus juices

Eat bananas daily to lower my potassium level

Take my pill each day in the morning

Take my pill each day after dinner

Answer and Explanation

The Correct Answer is C

Choice A reason: Limiting the intake of citrus juices is not related to the teaching about hydrochlorothiazide. Citrus juices are rich in vitamin C, which has no significant interaction with hydrochlorothiazide. The client does not need to avoid or limit citrus juices unless they have other medical conditions that require dietary restrictions.

Choice B reason: Eating bananas daily to lower the potassium level is a wrong statement. Bananas are high in potassium, which is a mineral that hydrochlorothiazide can deplete from the body. The client may need to increase their potassium intake or take a potassium supplement to prevent hypokalemia, a condition of low potassium level that can cause muscle weakness, cramps, and arrhythmias.

Choice C reason: Taking the pill each day in the morning is the correct statement. Hydrochlorothiazide is a diuretic that increases the urine output and reduces the blood volume and pressure. The client should take the pill in the morning to avoid nocturia, which is frequent urination at night that can disrupt the sleep quality and increase the risk of falls.

Choice D reason: Taking the pill each day after dinner is not the best statement. Hydrochlorothiazide can cause diuresis, which is increased urine production and excretion. Taking the pill after dinner can lead to nocturia, which is frequent urination at night that can interfere with the sleep cycle and cause fatigue and irritability. The client should take the pill in the morning to prevent nocturia and its complications.

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Correct Answer is D

Explanation

Choice A reason: I should continue to read the labels of foods I select at the grocery store is not a statement that indicates a need for further clarification by the nurse. This statement shows that the client understands the importance of choosing foods that are low in sodium, fat, and calories, which can help lower blood pressure and prevent complications.

Choice B reason: Keeping my blood pressure under control reduces my risk for a heart attack is not a statement that indicates a need for further clarification by the nurse. This statement shows that the client understands the benefits of pharmacologic therapy for hypertension, which can prevent or delay the development of cardiovascular disease.

Choice C reason: When I get out of bed in the morning, I should first sit for a few minutes and then stand is not a statement that indicates a need for further clarification by the nurse. This statement shows that the client understands how to prevent or minimize orthostatic hypotension, which is a possible side effect of some anti-hypertensive medications.

Choice D reason: I will be able to stop my anti-hypertensive medication when my blood pressure is normal is a statement that indicates a need for further clarification by the nurse. This statement shows that the client has a misconception about the nature and duration of pharmacologic therapy for hypertension. The nurse should explain that hypertension is a chronic condition that requires lifelong treatment and monitoring, and that stopping the medication abruptly can cause a rebound increase in blood pressure and increase the risk of complications.

A. Second intercostal space, right of sternum. B. Third intercostal space, left of sternum. C. Second intercostal space, left of sternum. D. Fourth intercostal space, left mid-clavicular line.

Correct Answer is C

Explanation

Choice A reason: The second intercostal space, right of sternum, is not the anatomic landmark where an aortic murmur will be heard the loudest. A heart murmur is an abnormal sound that is produced by turbulent blood flow through the heart valves or chambers. ¹ An aortic murmur is a type of heart murmur that occurs when the aortic valve, which separates the left ventricle and the aorta, is damaged or diseased. ² The second intercostal space, right of sternum, is the location where the aortic valve can be best heard, but not the location where the aortic murmur will be most audible. ³

Choice B reason: The third intercostal space, left of sternum, is not the anatomic landmark where an aortic murmur will be heard the loudest. A heart murmur is an abnormal sound that is produced by turbulent blood flow through the heart valves or chambers. ¹ An aortic murmur is a type of heart murmur that occurs when the aortic valve, which separates the left ventricle and the aorta, is damaged or diseased. ² The third intercostal space, left of sternum, is the location where the pulmonary valve, which separates the right ventricle and the pulmonary artery, can be best heard, but not the location where the aortic murmur will be most audible. ³

Choice C reason: The second intercostal space, left of sternum, is the anatomic landmark where an aortic murmur will be heard the loudest. A heart murmur is an abnormal sound that is produced by turbulent blood flow through the heart valves or chambers. ¹ An aortic murmur is a type of heart murmur that occurs when the aortic valve, which separates the left ventricle and the aorta, is damaged or diseased. ² The second intercostal space, left of sternum, is the location where the aortic murmur will be most audible, as it is the closest to the aorta, the largest artery in the body. ³

Choice D reason: The fourth intercostal space, left mid-clavicular line, is not the anatomic landmark where an aortic murmur will be heard the loudest. A heart murmur is an abnormal sound that is produced by turbulent blood flow through the heart valves or chambers. ¹ An aortic murmur is a type of heart murmur that occurs when the aortic valve, which separates the left ventricle and the aorta, is damaged or diseased. ² The fourth intercostal space, left mid-clavicular line, is the location where the tricuspid valve, which separates the right atrium and the right ventricle, can be best heard, but not the location where the aortic murmur will be most audible. ³

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The nurse is teaching a client with hypertension about the prescribed hydrochlorothiazide 10 mg PO daily. Which statement, made by the client, would indicate that the teaching has been effective? "I will:

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Which statement, made by a client receiving pharmacologic therapy for hypertension, indicates a need for further clarification by the nurse?

Correct Answer is D

Explanation

The nurse auscultates a heart murmur on a client with cardiovascular disease. At which anatomic landmark will an aortic murmur be heard the loudest?

Correct Answer is C

Explanation

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