Final answer:
The most direct indication of effective hypertension management is a blood pressure within the normal range. However, of the provided options, the absence of renal impairment is the most indicative of effective management, since kidney damage is a complication of uncontrolled hypertension.
Step-by-step explanation:
The question is asking which outcome is indicative of effective hypertension management in a client being assessed by a nurse. Effective management of hypertension typically involves reducing blood pressure to safe levels. Of the choices provided, the most direct indication of effective hypertension management would be a blood pressure reading within the normal or target range. According to the American College of Cardiology and American Heart Association guidelines, hypertension should be treated when blood pressure is at or above 130/80 mm Hg.
The answer is therefore not d. The blood pressure reading of 148/94 mm Hg, as this is still in the hypertensive range. Although absence of pedal edema, lack of sexual dysfunction, and no renal impairment are desirable, they do not directly measure blood pressure control. Hence, the most correct answer from the options provided would be c. No indication of renal impairment is present, as kidney damage can be a complication of longstanding, uncontrolled hypertension, and its absence could be an indicator that the hypertension is being managed well.