NCLEX · Lifestyle Choices and Self-Care

A client with hypertension asks which dietary change would have the GREATEST impact on blood pressure reduction. What is evidence-based?

  1. A Eliminating all fats from the diet
  2. B Reducing sodium intake to 2,300 mg/day or less (ideally 1,500 mg for higher-risk individuals); adopting the DASH diet pattern — high in fruits, vegetables, whole grains, lean protein, low-fat dairy, and low in saturated fat and sodium — can reduce systolic blood pressure by 8-14 mmHg
  3. C Increasing protein intake only
  4. D Eliminating all carbohydrates

Why this is the answer

HYPERTENSION DIETARY MANAGEMENT evidence supports sodium reduction and the DASH (Dietary Approaches to Stop Hypertension) pattern as primary dietary interventions. SODIUM: Sodium causes water retention, increasing blood volume and blood pressure; the current recommendation is <2,300 mg/day for most adults, and the JNC guideline and AHA recommend <1,500 mg/day for those with hypertension; most Americans consume 3,400 mg/day — primarily from processed foods, restaurant meals, and canned goods; DASH DIET COMPONENTS: High: fruits and vegetables (8-10 servings/day); whole grains; low-fat dairy; nuts, seeds, legumes; lean poultry and fish; Low: red meat; sweets and sugar-sweetened beverages; saturated fats; sodium; EVIDENCE: The DASH diet reduces systolic BP by 8-14 mmHg — comparable to starting a single antihypertensive medication; sodium reduction by 1,000 mg/day reduces systolic BP by approximately 5-6 mmHg; ADDITIONAL LIFESTYLE MEASURES: Weight loss (each kg lost reduces BP ~1 mmHg); aerobic exercise (150+ min/week reduces BP 5-8 mmHg); moderate alcohol (<1 drink/day women, <2/day men); smoking cessation; PN TEACHING: Use MyPlate; read nutrition labels for sodium (aim <600 mg per serving for pre-packaged foods); choose fresh over canned; rinse canned foods; minimize restaurant and fast food; cook at home with herbs and spices instead of salt.
Source: NCLEX-PN Test Plan: Health Promotion — Lifestyle, Hypertension Diet