The nurse notes that which disorder places the patient at greatest risk for hypertensive crisis?

Pheochromocytoma

Adrenal insufficiency

Hypothyroidism

Diabetes insipidus

Answer and Explanation

The Correct Answer is A

A. Pheochromocytoma is a tumor of the adrenal glands that can cause excessive production of catecholamines (such as norepinephrine and epinephrine), leading to a hypertensive crisis. This condition can cause severe hypertension, headaches, palpitations, and sweating.
B. Adrenal insufficiency is typically associated with low blood pressure, not hypertension. It is characterized by symptoms like weakness, fatigue, and hypotension, which are not linked to hypertensive crises.
C. Hypothyroidism is associated with low blood pressure and bradycardia, not an increased risk of hypertensive crisis. It typically leads to symptoms like weight gain, fatigue, and cold intolerance.
D. Diabetes insipidus is a condition that leads to excessive urination and thirst due to a lack of antidiuretic hormone, but it does not directly lead to a hypertensive crisis. It is primarily concerned with electrolyte imbalance and dehydration.

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Correct Answer is C

Explanation

A. Dumping syndrome is not related to the increased secretion of bile and pancreatic enzymes; it occurs when food passes too quickly from the stomach into the small intestine.
B. Dumping syndrome is not caused by a decrease in insulin secretion, but rather by rapid gastric emptying that can result in fluctuating blood sugar levels.
C. Dumping syndrome occurs when food moves too quickly from the stomach into the small intestine, causing a sudden release of insulin and other gastrointestinal symptoms, such as nausea, diarrhea, and dizziness.
D. While high-fat foods can be problematic for some gastric bypass patients, dumping syndrome is specifically related to rapid gastric emptying and not the inability to digest fat.

A. Elevate the head of the client's bed to 45° during meals. B. Provide the client with oral hygiene. C. Instruct the client to tilt their head back while swallowing. D. Turn on the television for the client during meals.

Correct Answer is A

Explanation

A. Elevate the head of the client's bed to 45° during meals: This is the correct action. Elevating the head during meals helps promote proper swallowing and reduces the risk of aspiration by preventing food or liquid from entering the airway. A semi-upright position is essential for clients at risk of aspiration, particularly those with dementia, who may have impaired swallowing reflexes.
B. Provide the client with oral hygiene: While important for oral health and to reduce bacteria in the mouth, this action does not directly reduce the risk of aspiration during meals. Oral hygiene is beneficial for preventing infections, but it doesn't influence the act of swallowing during eating.
C. Instruct the client to tilt their head back while swallowing: This is incorrect. Tilting the head back can cause difficulty in swallowing and increase the risk of aspiration. The correct technique is to maintain a neutral or slightly forward position of the head to allow food to travel smoothly down the esophagus and prevent it from entering the airway.
D. Turn on the television for the client during meals: This is not recommended as it can distract the client from focusing on eating. Distractions like a television may reduce the client's ability to concentrate on the swallowing process, increasing the risk of aspiration and choking.

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The nurse notes that which disorder places the patient at greatest risk for hypertensive crisis?

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Correct Answer is A

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