Practice Question
The nurse encourages the client with essential hypertension that a first-line therapeutic approach to lower blood pressure is (select all that apply):
Answer Choices:
Correct Answer:
weight loss
Rationale:
Weight loss
💎 Even a modest weight reduction (≈5–10% of body weight) lowers sympathetic tone and systemic vascular resistance, producing meaningful blood pressure (BP) declines.
💎 On average, about 5–20 mm Hg SBP reduction per 10 kg lost is achievable, which rivals single-agent pharmacotherapy in many adults with essential hypertension.
💎 Weight loss improves insulin sensitivity, decreases inflammatory cytokines, and reduces renin–angiotensin–aldosterone system (RAAS) activation—each of which favorably impacts arterial stiffness and endothelial function.
💎 Sustained weight control also improves lipids, glycemic status, and sleep apnea severity, amplifying overall cardiovascular (CV) risk reduction beyond BP alone.
💎 Combining caloric deficit, high-quality protein and fiber, and behavioral supports (self-monitoring, coaching) enhances adherence and long-term BP maintenance.
Exercise programs
💎 Regular aerobic activity (≥150 min/week moderate or ≥75 min/week vigorous) typically reduces SBP/DBP by ~4–9 mm Hg, with additional gains when paired with resistance training.
💎 Exercise enhances endothelial nitric oxide bioavailability, lowers resting heart rate, and improves arterial compliance, directly reducing afterload and BP.
💎 Physical activity decreases visceral adiposity, improves insulin sensitivity, and down-regulates RAAS and sympathetic activity, all of which favor durable BP control.
💎 Structured programs (e.g., brisk walking, cycling, swimming) plus step-count goals and progressive resistance maximize adherence and cardiometabolic benefit.
💎 Exercise also improves HRV, sleep, and stress coping, indirectly supporting lower BP and long-term CV event reduction.
Decrease in sodium intake
💎 Sodium restriction to ≤1,500–2,300 mg/day reduces intravascular volume and arterial stiffness, producing clinically relevant BP reductions (often ~2–8 mm Hg in typical adults; greater in salt-sensitive populations).
💎 Lower sodium down-modulates RAAS and sympathetic outflow, lessening vascular resistance and improving pressure natriuresis.
💎 Pairing sodium reduction with DASH eating (high in potassium, magnesium, calcium, and fiber) yields additive, larger BP declines than either strategy alone.
💎 Practical methods—label reading, home cooking, choosing low-sodium staples, and replacing processed foods—sustain daily intake targets.
💎 Sodium reduction also decreases left ventricular mass and may slow progression of CKD in hypertensive patients, conferring organ-protection benefits beyond BP.
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This question is from ☑️ ADRN 210 Med-Surg 4 Test 2 which contains 71 questions.
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Question Details
- Category: RN Nursing Exam(s)
- Subcategory: General Exams
- Domain: Medical-surgical📚
- Answer Choices: 4