porth patho final

During a prenatal education class, an expectant mother tells the group about a friend whose blood pressure became so high during pregnancy that she had to be admitted to hospital. Which of the following statements should the nurse include in response to this?

"Essentially, experts don't really know why so many pregnant women develop high blood pressure."

A client has been diagnosed with chronic obstructive arterial disease. Which client statement indicates she understands how to manage this disease?

"I should have my LDL monitored."

A young woman has been diagnosed by her family physician with primary Raynaud disease. The woman is distraught, stating, "I've always been healthy and I can't believe I have a disease now." What would be her physician's most appropriate response?

"If you make sure to keep yourself warm, it will have a fairly minimal effect; I'll also give you pills to enhance your circulation."

A number of older adults have come to attend a wellness clinic that includes both blood pressure monitoring and education about how to best control blood pressure. Which of the leader's following teaching points is most accurate?

"Too much alcohol, too little exercise and too much body fat all contribute to high blood pressure."

A patient with persistent primary hypertension remains apathetic about his high blood pressure, stating, "I don't feel sick, and it doesn't seem to be causing me any problems that I can tell." How would the nurse best respond to this patient's statement?

"You may not sense any problems, but it really increases your risk of heart disease and stroke."

A health care provider was asked by a client, "Why do my hands turn blue when I drive my car in the winter without gloves?" Which of the following is the best response?

"Your arteries in your hands/fingers are going into spasm, which decreases blood flow and circulating oxygen."

The nurse knows that the main objective of the management of hypertension is to achieve a sustainable level of blood pressure below which of the following?

140/90

The physician's order states, "Calculate the pulse pressure of the client's B/P." The blood pressure reading is as follows: systolic pressure of 146 mm Hg and a diastolic pressure of 82 mm Hg. The pulse pressure would be:

64 mm Hg

Which of the following patients is at greatest risk for orthostatic hypotension?

A 66-year-old post-surgery patient on bed rest

The client tells the provider he has lower back pain. Although most abdominal aneurysms are asymptomatic, the provider examines the client for which of the following initial signs of this condition?

A pulsating mass in the abdomen

Which of the following types of aortic aneurysms is the most common?

Abdominal aortic

When trying to educate a patient about the release of free radicals and the role they play in formation of atherosclerosis, which of the following statements is most accurate?

Activated cells that release free radical oxidize LDL which is harmful to the lining of your blood vessels.

A patient 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 patient's increased blood pressure?

Activation of the renin-angiotensin-aldosterone mechanism

Select the priority of care for the medical management of a client with a dissecting aortic aneurysm.

Administration of sodium nitroprusside and β-adrenergic blocking medications

Which of the following patients 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.

The nurse is developing a plan of care for a postsurgical client. A major goal is to prevent the formation of prevent deep vein thrombosis (DVT). The most important intervention for the nurse to implement would be:

Apply sequential pneumatic compression devices to lower extremities

A 70-year-old male client presents to the emergency department complaining of pain in his calf that is exacerbated when he walks. His pedal and popliteal pulses are faintly palpable and his leg distal to the pain is noticeably reddened. The nurse knows that the client is likely experiencing which of the following medical diagnosis/possible treatment plan listed below?

Atherosclerotic occlusive disease necessitating thrombolytic therapy

A pregnant female client is at risk for the development of preeclampsia-eclampsia. Select the most important data to assess.

Blood pressure 160/100 mm Hg and proteinuria during the 30th week of pregnancy

The role of inflammation in the etiology of atherosclerosis has emerged over the last few years. Which lab test is a marker for systemic inflammation?

C-reactive protein

An elderly patient arrives to the healthcare provider's office complaining of a "sore" that won't heal on their lower leg. Upon assessment, the nurse finds thin, shiny, bluish brown pigmented desquamative skin. It is located medially over the lower leg. The nurse will educate the patient that the usual treatment is:

Compression therapy to help facilitate blood flow back to the vena cava.

The nurse obtains a blood pressure reading of 150/96 mm Hg from a patient at the clinic. What instructions for follow-up does the nurse anticipate giving to this patient?

Confirm within 2 months

A client has been prescribed a thiazide diuretic, hydrochlorothiazide (HCTZ), for the initial treatment of hypertension. What effect does the nurse know this drug will have to decrease blood pressure?

Decrease vascular volume

From which one of the following sites is a fatal pulmonary thromboembolism most likely to originate?

Deep vein thrombophlebitis of the leg

Select the statement that best describes Buerger disease.

Disease of young, heavy cigarette smokers occurring before the age of 35.

A nurse is teaching a patient with newly diagnosed hypertension about antihypertensive drug therapy. The nurse determines that the patient understands when the patient correctly matches which of the following drug categories to the action of decreasing vascular volume by suppressing renal reabsorption of sodium and increasing salt and water excretion?

Diuretics

An elderly patient is diagnosed with orthostatic hypotension. For which of the following clinical manifestations should the nurse assess?

Dizziness and fainting

The nurse practitioner working in an overnight sleep lab assessing and diagnosing patients with sleep apnea. During this diagnostic procedure, the nurse notes that a patient's blood pressure is 162/97. The nurse explains this connection to the patient based on which of the following pathophysiological principles?

During apneic periods the patient experiences hypoxemia which stimulates chemoreceptors to induce vasoconstriction.

A client has been diagnosed with diabetes mellitus. Which of the following lab results would the practitioner expect?

Elevation of triglycerides

Hypertension is a risk factor for atherosclerosis. The nurse knows that which of the following is the initial lesion in the pathogenesis of atherosclerosis?

Endothelial damage

A 35-year-old man presents to the emergency department complaining of chest pain for the last 2 hours. He describes the pain as crushing, like a huge weight is on his chest. He also states that the pain goes up into his neck and down his left arm. An acute myocardial infarction (MI) is diagnosed. When taking his history, the following things are noted: ● Hyperlipoproteinemia for past 7 years ● Family history of early MI ● Cholesterol deposits along the tendons (diagnosed 1 year ago) ● Atherosclerosis (diagnosed 6 months ago) ● Diabetes mellitus (type 1) diagnosed at age 16 The nurse suspects which of the following diagnoses will be made?

Familial hypercholesterolemia (type 2A)

The client undergoes a cardiac catheterization to evaluate symptoms of chest pain and shortness of breath. The test shows lesions in the coronary arteries that have begun to reduce the size of the vessel lumen. This type of lesion is known as which of the following?

Fibrous atheromatous plaque

Raynaud disease or phenonemon is a functional disorder caused by intense vasospasm of the arteries and arterioles in which of the following?

Fingers

The client's ultrasound shows a true aneurysm that involves the entire circumference of the vessel and has a gradual and progressive dilation of the vessel. The provider tells the client the aneurysm is which of the following forms?

Fusiform

The nurse is teaching a class on reduction of cardiovascular disease. Which of the following demonstrates an intervention that is cognizant of the modifiable risk factors for hyperlipidemia?

Going for a brisk walk with a friend and talking to him about continuing to exercise regularly

A client with malignant hypertension is at risk for a hypertensive crisis, including the cerebral vascular system often causing cerebral edema. The nurse would assess this client for which signs and symptoms?

Headache and confusion

A patient comes to the clinic complaining of anorexia, weight loss, fever, fatigue along with paresthesias, pain, and weakness of the lower extremities. Assessment findings include reddish blue, mottled areas of discoloration to the skin of the lower extremities. Laboratory findings include an elevated erythrocyte sedimentation rate, leukocytosis, anemia, and abnormal liver function tests. A diagnosis of necrotizing vasculitis is confirmed through biopsy. The nurse anticipates treatment with which of the following medications?

High-dose corticosteroid therapy and cytotoxic immunosuppressant agents

Atherosclerosis begins in an insidious manner with symptoms becoming apparent as long as 20 to 40 years after the onset of the disease. Although an exact etiology of the disease has not been identified, epidemiologic studies have shown that there are predisposing risk factors to this disease. What is the major risk factor for developing atherosclerosis?

Hypercholesterolemia

A patient has developed atherosclerosis. The nurse knows that a major cause for this disorder is which of the following?

Hypertension

The health care provider is teaching a client about modifiable risk factors for atherosclerosis. The most appropriate information to provide would be:

Hypertension

In addition to direct invasion of the vascular wall by an infectious agent, this pathogenic mechanism is a common cause of vasculitis?

Immune-mediated inflammation

A 60-year-old woman is hospitalized after losing an extensive amount of blood in a work-related accident. She tells the nurse that she heard the doctor say that she would keep feeling faint until her brain made more blood. The nurse recognizes that when the woman's blood pressure dropped, the pressure in her carotid arteries decreased. This was detected by baroreceptors in the carotid arteries, with which subsequent effect?

Increased sympathetic stimulation of the heart and blood vessels

A nurse is teaching a patient with newly diagnosed hypertension about antihypertensive drug therapy. The nurse determines that the patient understands when the patient correctly describes which of the following as the mechanism of action of an angiotensin-converting enzyme (ACE) inhibitor?

Inhibition of the conversion of angiotensin I to angiotensin II, decreasing angiotensin II levels and reducing its effect on vasoconstriction

Which one of the following is characteristic of a thrombus?

It forms on the wall of a vessel.

The student attends a health fair and has his serum cholestrol checked. He has a high lipoprotein level (LDL). He understands which of the following about LDL cholesterol?

It is believed to play an active role in the pathogenesis of the atherosclerotic lesion.

The nurse is counseling a client regarding a high cholesterol level. The nurse teaches the client that which of the following lipoproteins is the main carrier of cholesterol?

LDL

The nurse practitioner's examination of a client reveals xanthomas along the client's tendons. Which of the following tests will the practitioner order?

LDL level

The nurse is reviewing the lipid results of four clients. Select the client at greatest risk for cardiovascular disease.

Patient with LDL cholesterol 205 mg/dL, HDL 40 mg/dL, and triglyceride level 150 mg/dL

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

A formerly normotensive woman, pregnant for the first time, develops hypertension and headaches at 26 weeks' gestation. Her blood pressure is 154/110 mm Hg and she has proteinuria. What other labs should be ordered for her?

Platelet count; serum creatinine; liver enzymes

A patient's blood pressure is persistently in the range of 130-135 mm Hg systolic and 85-88 mm Hg diastolic. The nurse knows that which of the following conditions correctly describes this patient's blood pressure?

Prehypertension

A client has been diagnosed with deep vein thrombosis (DVT). The nurse is planning care and recognizes that the client is most at risk for:

Pulmonary embolism

The client's ultrasound shows a thrombus in the venous sinus in the soleus muscle. The nurse explains that early treatment is important to prevent which of the following?

Pulmonary embolism

A patient presents to the emergency department with complaints of bilateral cyanosis and pallor of the fingers after being out in the cold weather for 5 minutes. The toes are of normal color. Which of the following is a potential diagnosis for this patient?

Raynaud's disease

A patient is admitted to the outpatient diagnostic unit for further testing to identity the cause of the uncontrolled secondary hypertension. In preparation, the nurse should anticipate that which of the following diagnostic procedures will provide the most definitive diagnosis?

Renal arteriography.

A patient is prescribed an angiotensin converting enzyme inhibitor (ACEI) for hypertension. The nurse knows that ACEIs are contraindicated by which clinical condition?

Renal artery stenosis

In infants and children, secondary hypertension is the most common form of hypertension. What is the most common cause of hypertension in an infant?

Renal artery thrombosis

A 16 year old adolescent who received a kidney transplant at the age of 10, has recently developed a trend of increasing BP readings. Of the following list of medications, which may be the primary cause for the development of hypertension?

Sandimmune (Cyclosporine).

Which one of the following organs are the two primary sites of lipoprotein synthesis?

Small intestine and liver

Venous thrombosis most commonly occurs in the lower extremities. Risk factors for venous thrombosis include which of the following?

Stasis of blood, hypercoagulability, vessel wall injury

A nurse is administering medication to treat hypercholesterolemia. Which of the following medications reduces or blocks the hepatic synthesis of cholesterol?

Statins

A patient is diagnosed with stage 2 hypertension. The nurse knows that which of the following is characteristic of stage 2 hypertension?

Sustained systolic pressure equal to or greater that 160 mm Hg

The smooth muscle cells produce vasoconstriction of blood vessels due to innervation by which part of the nervous system?

Sympathetic

A 60-year-old woman who has lost an extensive amount of blood in a work-related accident says that when her blood pressure was checked in the hospital, the top number (systolic pressure) was lower than usual but the bottom number (diastolic pressure) was about the same. The nurse recognizes that which of the following accounts for this lack of change in the diastolic pressure?

Systemic vasoconstriction maintained the diastolic pressure.

A client has been diagnosed with a dissecting aortic aneurysm. It is most important for the nurse to assess the client for:

Tearing or ripping-type pain in the chest or back

A client reporting a headache is diagnosed with giant cell arteritis. The nurse is aware that the vessels most commonly affected are the:

Temporal

A physiotherapist is measuring the lying, sitting, and standing blood pressure of a patient who has been admitted to hospital following a syncopal episode and recent falls. Which of the following facts about the patient best relate to these health problems?

The client is 89 years old and takes a diuretic medication for his congestive heart failure.

The nurse is preparing to auscultate a client's blood pressure. Which information obtained from the client would indicate that the nurse should wait 30 minutes prior to obtaining a reading?

The client just smoked a cigarette.

The client has been diagnosed with Raynaud disease. Which treatment measure will the nurse teach the client?

The client must protect the entire body from cold, not just the extremities.

The nurse knows that which of the following drugs can cause secondary hypertension? Select all that apply.

• Amphetamines • Decongestants • Oral contraceptives • Cocaine

Which of the following blood vessel layers is composed primarily of smooth muscle cells?

Tunica media

The nurse is providing education for a patient diagnosed with essential hypertension. The nurse will state that the cause of this disorder is which of the following?

Unknown

Which of the following blood vessel cells form the predominant cellular layer in the tunica media and produce vasoconstriction and/or dilation of blood vessels?

Vascular smooth muscle cells (SMCs)

Which of the following is associated with stasis of blood, increased blood coagulability and vessel wall injury?

Venous thrombosis

A client is prescribed an angiotensin-converting enzyme (ACE) inhibitor for treatment of hypertension. What expected outcome does the nurse expect this medication will have?

Will prevent the conversion of angiotensin I to angiotensin II

The nurse is educating a patient diagnosed with pre-hypertension about reducing modifiable risk factors. Which risk factors will the nurse address? Select all that apply.

• Decreasing salt intake • Decreasing alcohol consumption. • Increasing dietary potassium

The nurse is discussing hypertension with a group of patients. The nurse knows that which of the following statements regarding hypertension are true? Select all that apply.

• Family history of hypertension is a risk factor for hypertension. • Diabetes can lead to secondary hypertension.

Which of the following statements regarding hypertension are correct? Select all that apply.

• Hypertension is a major risk factor for cardiovascular disease. • Hypertension is one of the most common health problems for adults. • Hypertension is more frequent among younger men than in younger women.

The nurse knows that which of the following would put a patient at risk of developing hypertension, if everything else in the body remained unchanged? Select all that apply.

• Intravascular fluid retention • Elevated renin levels • Systemic vasoconstriction

A nurse is evaluating hypertension risk factors with an African American male who is a lawyer in a busy legal firm. He reports that he eats fairly well, usually having red meat and potatoes daily. His father and older brother have hypertension. His paternal grandfather had a stroke. The lawyer drinks about four beers and eats salted popcorn while watching television in the evening and has gained 15 pounds in the past year. Which of the following are nonmodifiable risk factors associated with this diagnosis? Select all that apply.

• Race • Family history

The client has been diagnosed with venous insufficiency after having a deep vein thrombosis (DVT). Which signs and symptoms would the nurse expect to see? Select all that apply.

• Status dermatitis • Brown pigmentation of the skin • Edema

The nurse is teaching a group of clients about hypertension. The nurse determines that teaching was effective when the clients state: Select all that apply.

• The incidence increases with age. • It is the most common cardiovascular disorder. • The systolic pressure is greater than or equal to 140 mm Hg.