Difficulty: Medium
Average Score: 76%
Simulated
The client diagnosed with essential hypertension is taking a loop diuretic daily. Which assessment data would require immediate intervention by the nurse?
Correct answer
B
Rationale
Weight gain of 2 kg in 1ÔÇô2 days (B) indicates fluid retention, a serious issue in hypertension requiring intervention. Normal sinus rhythm (A), BP 148/92 (C), and K+ 4.5 (D) are not urgent.