TEST INSTRUCTIONS Read the article. The test for this CE activity is to be taken online at www.nursingcenter.com/CE/NP. Tests can no longer be mailed or faxed. You'll need to create (it's free!) and log in to your personal CE Planner account before taking online tests. Your planner will keep track of all your Lippincott Professional Development online CE activities for you. There's only one correct answer for each question. A passing score for this test is 7 correct answers. If you pass, you can print your certificate of earned contact hours and access the answer key. If you fail, you have the option of taking the test again at no additional cost. For questions, contact Lippincott Professional Development: 1-800-787-8985. Registration deadline is June 1, 2023. PROVIDER ACCREDITATION

Lippincott Professional Development will award 2.0 contact hours and 1.0 pharmacology consult hour for this continuing nursing education activity.

Lippincott Professional Development is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation.

This activity is also provider approved by the California Board of Registered Nursing, Provider Number CEP 11749 for 2.0 contact hours and 0.5 pharmacology consult hour. Lippincott Professional Development is also an approved provider of continuing nursing education by the District of Columbia, Georgia, West Virginia, New Mexico, South Carolina, and Florida, CE Broker #50-1223. Your certificate is valid in all states.

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Obesity-related hypertension: Implications for advanced nursing practice

Learning Outcomes: Seventy-five percent of participants will be able to demonstrate competency in clinical reasoning for care of patients with obesity-related hypertension by achieving a posttest score of 70% or greater.

Learning Objectives: After reading the article and completing the posttest, the participant will be able to:

Describe how to accurately diagnose obesity and hypertension (HTN). Summarize lifestyle modifications for obesity and HTN. Compare lifestyle modifications, weight-reducing medications, and metabolic surgery for weight loss and effective BP management.

Posttest:

You are an NP caring for a female patient in a primary care setting. To determine whether she has visceral obesity with a higher cardiovascular risk, you need to measure her weight only. assess her height and weight only. determine her body mass index (BMI) and measure her waist circumference. A male patient's BP in your clinic is 146/92 mm Hg. His BP measurements are similar during three return visits over a period of a month. Four at-home BP measurements are approximately 140/90 mm Hg. The patient meets the diagnostic criteria for stage I HTN. meets the diagnostic criteria for stage II HTN. needs additional testing before receiving a diagnosis. While advising a female patient to start home BP monitoring, you provide patient education on proper technique. You explain that prior to taking her BP she should sit with her feet elevated for 20 minutes. urinate to empty her bladder. ensure the BP cuff length covers 40% of her upper arm circumference. A patient diagnosed with HTN asks which diet would be best to follow. You explain that the diet with the strongest effect of BP reduction, especially when combined with exercise, is the DASH diet. Mediterranean diet. intermittent fasting diet. To achieve improvements in cardiometabolic health and BP reduction, you recommend participation in regular physical activity, which is most beneficial for weight loss. maintenance of weight loss. weight gain. A female patient has a diagnosis of HTN treated with an antihypertensive medication. After following lifestyle modifications for 6 months, her BP is 139/87 mm Hg and her BMI remains unchanged at 29 kg/m2. Her treatment plan includes weight loss, and the NP explains that the best choice at this time is for her to pursue bariatric surgery. continue with lifestyle modifications only. begin weight-reducing medication. A male patient with a BMI of 31 kg/m2 has unresolved HTN despite making lifestyle changes. You discuss treatment options, and he agrees to begin taking medication for weight loss. Which medication is least likely to raise his BP? orlistat phentermine naltrexone/bupropion A male patient with obesity and type 2 diabetes mellitus has mild BP elevation. He has agreed to set a goal to lose weight to help reduce his BP. To best assist him, you prescribe phentermine alone since it also helps with BP reduction. advise him to start with only lifestyle changes for 1 year before starting medication. prescribe tirzepatide and explain that it is also used off-label for weight loss. A female patient with obesity asks about the possibility of having metabolic (bariatric) surgery to achieve a substantial loss in weight. You explain that metabolic surgery is the most effective therapy for achieving substantial and sustained weight loss. not as effective as lifestyle changes for achieving significant weight loss. less effective than using weight-reducing medication for weight loss. A randomized controlled trial studying patients diagnosed with HTN undergoing both Roux-en-Y gastric bypass surgery and medical therapy found that patients receiving both surgery and medication did not have any significant reduction in BP. were not able to maintain BPs of less than 140/90 mm Hg. were more likely to achieve at least a 30% reduction in the total number of BP medications.