The nurse notes that there is a difference in a patient's blood pressure (BP) and heart rate (HR) when the patient changes position from supine to standing. The differences are a decrease of 20 mm Hg in systolic BP, a decrease of 10 mm Hg in diastolic BP, and an increase in the HR of 20 beats/minute.
Which interpretation would the nurse make about the patient's condition?

Hypertensive crisis.

An auscultatory gap.

Resistant hypertension.

Enlarged lymph nodes.

Answer and Explanation

The Correct Answer is B

Choice A rationale:

Hypertensive crisis is characterized by severely elevated blood pressure, usually above 180/120 mm Hg. The given differences in blood pressure (a decrease of 20 mm Hg in systolic BP) do not indicate hypertensive crisis.

Choice B rationale:

An auscultatory gap refers to a temporary disappearance of sounds normally heard over the brachial artery during blood pressure measurement. This phenomenon can lead to inaccurate readings and might cause a delay in recognizing the true blood pressure values. In this case, the decrease in systolic BP when changing positions indicates the presence of an auscultatory gap, requiring the nurse to be vigilant during blood pressure measurements.

Choice C rationale:

Resistant hypertension is a term used when blood pressure remains above goal despite concurrent use of three antihypertensive agents of different classes. The given scenario does not indicate resistant hypertension but rather suggests a technical issue during blood pressure measurement due to the auscultatory gap.

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Correct Answer is D

Explanation

Choice A rationale:

Chronic stable angina typically occurs with activity and is relieved with rest or nitroglycerin. Therefore, this statement is incorrect for chronic stable angina.

Choice B rationale:

Chronic stable angina usually lasts for a short duration, usually around 5 minutes, and is relieved with rest or nitroglycerin. Prolonged pain lasting 10-15 minutes or more could indicate an unstable angina or myocardial infarction. This choice is incorrect for chronic stable angina.

Choice C rationale:

Pain due to chronic stable angina subsides when the precipitating factor, such as physical exertion, is resolved or with medication like nitroglycerin. Therefore, this statement is incorrect for chronic stable angina.

Choice D rationale:

Chronic stable angina follows a predictable pattern, occurring intermittently over a period of time, and is usually triggered by physical exertion or emotional stress. This option correctly describes the characteristic pattern of chronic stable angina.

A. The patient has neutropenia. B. The patient has polycythemia. C. The patient has pernicious anemia. D. The patient has elevated estrogen levels.

Correct Answer is C

Explanation

Choice A rationale:

Neutropenia is a condition characterized by a low number of neutrophils, a type of white blood cell. Neutropenic patients are at increased risk of infections, but neutropenia does not cause specific changes in the tongue surface. The smooth and shiny tongue surface described in the question is not indicative of neutropenia.

Choice B rationale:

Polycythemia is a condition characterized by an abnormally high concentration of hemoglobin in the blood. It can cause the skin to appear reddish or flushed, but it does not directly cause changes in the tongue surface such as smoothness and shininess.

Choice C rationale:

Pernicious anemia is a type of anemia caused by a deficiency of vitamin B12, which is essential for the formation of red blood cells and the maintenance of the nervous system. One of the characteristic signs of pernicious anemia is glossitis, which is inflammation of the tongue that can make the tongue appear smooth and shiny. This finding aligns with the description provided in the question.

Choice D rationale:

Elevated estrogen levels can cause changes in the skin, such as increased pigmentation or the development of spider veins, but they do not directly cause changes in the tongue surface as described in the question.

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Naxlex Comprehensive Predictor Exams

Which information would the nurse include when discussing pain due to chronic stable angina with the patient?

Correct Answer is D

Explanation

The nurse notes that a patient has a smooth and shiny tongue surface.The nurse would attribute these findings to which condition?

Correct Answer is C

Explanation

Which component forms an adhesive bridge between platelets and vascular subendothelial structures in the clotting process?

Which instruction would the nurse include in the teaching plan for a patient newly diagnosed with microcytic hypochromic anemia?

The nurse suspects that a patient has polycythemia vera based on which finding in the patient's laboratory reports? Select all that apply. One, some, or all responses may be correct.

Which fluid replacement therapy would the nurse prepare to administer for a patient who is exhibiting clinical manifestations of hypovolemic shock?

Which erythrocyte characteristic would the nurse expect to see in the laboratory findings for a patient who has experienced acute blood loss?

Which change occurs first, making patients susceptible to coronary artery disease?

Which finding will the nurse expect in a patient who is hospitalized with stage I Hodgkin lymphoma?