NUR01: Patho → Exam 4

A client with secondary hypertension has come into the clinic for a routine check-up. When comparing this client's diagnosis to primary hypertension, the nurse recognizes that secondary hypertension:

has a specific cause.

T/F: The electrocardiogram is a reflection of cardiac muscle contraction. You can directly diagnose specific defects in muscle activity.

false

Chronic stable angina, associated with inadequate blood flow to meet the metabolic demands of the myocardium, is caused by:

fixed coronary obstruction

A nurse is performing client health education with a 68 year old man who has recently been diagnosed with heart failure. Which of the following statements demonstrates an accurate understanding of his new diagnosis?

"I'm trying to think of ways that I can cut down the amount of salt that I usually eat."

The nurse is providing health education to an older adult client. What should the nurse teach the client about the relationship between hypertension and age?

"Structural and functional changes in the cardiovascular system that occur with age contribute to increase in blood pressure"

Damage to the heart muscle. The location and extent of the ischemic damage is the major predictor of complication, Ranging from cardiac insufficiency to death, following an MI. What is the window of opportunity in restoring blood flow to the affected Area so as to diminish the ischemic damage to the heart and maintain the viability of the cells?

20-40min

A nurse is performing blood pressure screenings at a local health fair. While obtaining subjective assessment data from a client with hypertension, the nurse learns that the client has a family history of hypertension and she herself has high cholesterol and lipid levels. The client says she smokes one pack of cigarettes daily and drinks about a pack of beer everyday. The nurse knows what non-modifiable risk factor for hypertension?

A family history of hypertension

Electrical burns over a large surface area of a client's body have resulted in hypovolemic shock after the loss of a large amounts of blood and plasma. Following physical assessment, which findings lead the nurse to believe the client's body is compensating for this fluid loss? SATA

A)Increased heart rate D)The client complaining of extreme thirst E)Deep, rapid respirations

A client is admitted with dilated cardiomyopathy with left ventricular dysfunction. The nurse should assess for which of the following clinical manifestations? SATA

A. Extreme fatigue with activity B. Orthopnea C. Dyspnea

A family member comes rushing out of a client's room telling the nurse that the loved one can't breathe. The nurse has just left the room after hanging IV penicillin. Which of the following clinical manifestations lead the nurse to suspect the client is experiencing anaphylactic shock? SATA

A. Severe bronchospasm B. Hives over entire body D. Wheezing sound on inspiration E. Swelling around the lips and eyes

A client with a diagnosis of chronic renal failure secondary to diabetes has seen a gradual increase in her blood pressure over the past several months, culminating in a diagnosis of secondary hypertension. Which of the following has most likely resulted in the client's increased blood pressure?

Activation of the renin-angiotensin-aldosterone mechanism

The most common causes of left-sided heart failure include:

Acute myocardial infarction

A father experiences the onset of chest pain and died suddenly. The family asks, what caused him to die so suddenly? The healthcare provider to reply that is most appropriate would be, there's a high probability that your loved ones developed an acute heart attacked and experienced:

Acute ventricular arrhythmia

which of the following may result in the development of a cardiomyopathy?

All the above: Valvular stenosis Valvular regurgitation MI Ischemia

Which of the following clients should most likely be assessed for orthostatic hypotension?

An elderly patient who has experienced two falls since admission while attempting to ambulate to the bathroom

Football fans at a college have been shocked to learn of the sudden death of a star player, an event that was attributed in the media to "an enlarged heart". Which of the following disorders was the player's most likely cause of death?

B. Hypertrophic cardiomyopathy (HCM

an older adult client has been diagnosed with aortic regurgitation. What change in blood flow should the nurse expect to see on this clients echocardiogram?

Blood to flow back from the aorta to the left ventricle

Which of the following conditions will result in pathological changes arising from pulseless electrical activity?

Cardiac tamponade

A nurse in the ICU is planning the care of a client who is being treated for shock. What statement best describes the pathophysiology of this client's health problem?

Cells lack an adequate blood supply and are deprived of oxygen and nutrient

A nurse is admitting a 45-year-old man to the medical unit who has a history of Peripheral Artery Disease (PAD). While providing his health history, the client reveals that he smokes about two packs of cigarettes a day, has a history of alcohol abuse, and does not exercise. What would be the priority health education for this client?

Cigarettes contain nicotine, which is a powerful vasoconstrictor and may cause or aggravate PAD

A client presents to the clinic complaining of intermitent chest pain on exertion, which is eventually attributed to angina. The nurse should inform the client that angina is most often attributable to what cause?

Coronary arteriosclerosis

The cardiac nurse is caring for a client who has been diagnosed with dilated cardiomyopathy (DCM). Echocardiography is likely to reveal what pathophysiological finding?

Dilated ventricles without hypertrophy of the ventricles

Clients with ischemic coronary vessel disease and acute coronary syndrome (ACS) are classified as low or high risk for acute myocardial infarction based on characteristics that include significant:

ECG changes

Angina pectoris is a chronic ischemic CAD that is characterized by a symptomatic paroxysmal chest pain or pressure sensation associated with transient myocardial ischemia. What precipitates in attacks of angina pectoris?

Exposure to heat.

In an acute care setting, the nurse is assessing an unstable client. When prioritizing the clients care, the nurse should recognize that the client is at risk for hypovolemic shock in which of the following circumstances?

Fluid volume circulating in the blood vessels decreases

Which of the following lab results strongly suggest an immunologic response and the clients with possible rheumatic heart disease?

Group A (β-hemolytic) streptococcal antibodies

The renin-angiotensin-aldosterone system is a negative feedback system that plays a central role in blood pressure regulation. How does the end result of this feedback loop regulate blood pressure in the body?

Increases salt and water retention by the kidney.

The triage nurse in the EDD assesses an adult client who presents to the EDD with reports of midsternal chest pain that has lasted for the last 5 hours. If the clients symptoms are due to an MI, what will have happened to The myocardium?

It may have developed an increased area of infarction during the time without treatment.

the staff educator is presenting a workshop on valvular disorders. When discussing the pathophysiology of aortic regurgitation, the educated describes what consequences of this Disorder?

Left ventricular hypertrophy

the nurse is screening a number of adults for hypertension. What range of blood pressure is considered normal?

Less than 120/80 mm Hg

The nurse is providing care for a client who has just been diagnosed with Peripheral Arterial Occlusive Disease (PAD). What assessment finding is most consistent with this diagnosis?

Unequal peripheral pulses between extremities.

A nurse in the ICU receives report from the nurse in the ED about a new client being admitted with a neck injury he received while diving into a lake. The ED nurse reports that his blood pressure is 85/54, heart rate is 53 bpm, and his skin is warm and dry. What does the ICU nurse recognize that the client is probably experiencing?

Neurogenic shock

A client was in a car accident while not wearing a seatbelt and has sustained multiple rib fractures. During assessment, the nurse is having a hard time hearing heart sounds, and the client reports chest pain/pressure repeatedly. This client may be experiencing:

Pericardial effusion

A cardiac surgery client's new onset of signs and symptoms is suggestive of cardiac tamponade. As a member of the interdisciplinary team, what is the nurse's most appropriate action?

Prepare to assist with pericardiocentesis.

A community health nurse is presenting an educational event and is adjusting several health problems, including rheumatic heart disease. What should the nurse describe as the most effective way to prevent rheumatic heart disease?

Recognizing and promptly treating streptococcal infections

A client newly diagnosed with hypertension asks the nurse what happens when uncontrolled hypertension is prolonged. The nurse explains that a client with prolonged, uncontrolled hypertension is at risk for developing what health problem?

Renal failure

Assessment of an elderly female client reveals the presence of bilateral pitting edema of the client's feet and ankles and pedal pulses that are difficult to palpate. Auscultation of the client's lungs reveals clear air entry to bases, and the client's oxygen saturation level is 93%, and vital signs are within reference ranges. What is the client's most likely health problem?

Right-sided heart failure

the staff educator is teaching Ed nurses about hypertensive crisis. The nurse educator should explain that hypertensive urgency differs from hypertensive emergency in what way?

The BP is always higher in a hypertensive emergency.

A patient with a suspected MI is brought to the ED by ambulance. As the nurse is caring for this patient, what laboratory work would you expect to receive an order for to confirm a diagnosis of MI?

Troponin level

T/F: Aspirin is not the preferred antiplatelet agent for preventing platelet aggregation and persons with CAD

false

When lecturing to a group of students about the pathophysiological principles behind heart failure, the instructor explains that cardiac output represents:

amount of blood the heart pumps each minute

A child's history of a recurrent sore throat followed by severe knee and ankle pain has resulted in a diagnostic workup and a diagnosis of rheumatic fever. What are the treatment priorities for this child?

antibiotics and anti-inflammatory drugs

Aortic ? is the result of an incompetent aortic valve that allows blood to flow back to the left ventricle during diaostle.

aortic valve regurgitation

The ED nurse is caring for a client with a suspected MI. What drug should the nurse anticipate administering to this client?

morphine

While lecturing on blood pressure, the nurse will emphasize that the body maintains its blood pressure by adjusting the cardiac output to compensate for changes in which of the following physiologic processes?

peripheral vascular resistance

Pregnancy-induced hypertension is a serious condition affecting between 5% and 10% of pregnant women. The most serious classification of hypertension in pregnancy is preeclampsia-eclampsia. It is a pregnancy-specific syndrome that can have both maternal and fetal manifestations. What is a life-threatening manifestation of the preeclampsia-eclampsia classification of pregnancy-induced hypertension?

preeclampsia

which type of angina is brought about by exercise or stress?

stable angina

T/F: Myocardial ischemia is when blood flow through coronary arteries does not meet the metabolic demands of the heart.

true

T/F: The classic ECG pattern of ventricular fibrillation is that of gross disorganization without identifiable waveforms or intervals. When the ventricles do not contract, there is no CO and no palpable or audible pulses. Immediate defibrillation using non-synchronized, direct-current electrical shock is mandatory for ventricular fibrillation and for ventricular flutter that has caused loss of consciousness

true