Ch. 26 Disorders of Blood Flow and Blood Pressure

Which blood pressure reading would be classified as stage 1 hypertension 137/85 120/89 147/98 129/78

137/85

The nurse knows that the main objective of the management of hypertension is to achieve a sustainable level of blood pressure below 140/90 100/60 140/60 100/90

140/90

A client taking an antihypertensive drug for several months comes to the physicians office with a dry, persistent cough. The nurse knows that this cough is an adverse effect of which class of antihypertensive drugs? Angiotensin II receptor blockers Beta-blockers Calcium channel blockers ACE inhibitors

ACE inhibitors

When trying to educate a client about the release of free radicals and the role they play in formation of atherosclerosis, which statement is most accurate? Activated cells roam the vascular system looking for inflammatory cells to engulf Activated cells that release free radicals oxidize LDL, which is harmful to the lining of your blood vessels Oxidized free radicals produce toxic metabolic waste that can kill liver cells The end result of oxidation is rupture of the plaque, resulting in hemorrhage.

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

A client has been diagnosed with chronic obstructive arterial disease. which client statement indicated that she understands how to manage this disease? I should stay in bed with my legs elevated Diabetes mellitus has no effect on my condition I should have my LDL monitored I dont need to monitor my BP

I shouldhave my LDL monitored

The nurse knows that systolic hypertension carries risk for which cardiovascular events? Select all that apply Damage to elastic elements of blood vessel walls Risk for aneurysm Atherosclerosis Thrombosis Right ventricular hypertrophy

Damage to elastic elements of blood vessel walls Risk for aneurysm Atheroslcerosis Thrombosis

Which of the following is the site of chylomicron synthesis? Large intestine Pancreas Small intestine Stomach

Small intestine

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? Restlessness and nervousness Headache and confusion Papilledema and lethargy Stupor and hyperreflexia

headache and confusion

A client with chronic renal failure secondary to diabetes has just been diagnosed with secondary hypertension. This increase in blood pressure is likely caused by which physiologic factor? Activation of the renin-angiotensin-aldosterone mechanism Increased levels of adrenocortical hormones Increased sympathetic stimulation by the ANS Coarctation of the clients aorta

Activation of the renin-angiotensin-aldosterone mechanism

Which client is at greatest risk for orthostatic hypotension A 66 year old postoperative client on bed rest A 42 year old male client with history of pulmonary embolism A 20 year old pregnant client at 36 weeks gestation A 70 year old female client who has taken the same antihypertensive medication for 10 years

A 66 year old postoperative client on bed rest

The physician understands that which client is at risk for developing primary hyperlipoproteinemia? A client receiving beta-blockers A client with hypothyroidism A client with familial hypercholesterolemia a client with obstructive liver disease

A client with familial hypercholesterolemia

The client tells the provider he has lower back pain. Although most abdominal aneurysms are asymptomatic, the provider examines the client for which initial sign of this condition The pulse is unobtainable in one or both arms Syncope A pulsating mass in the abdomen Hemiplegia

A pulsating mass in the abdomen

Which client would the nurse recognize as needing to be assessed for orthostatic hypotension? A 42 year old client who has a history of poorly controlled type 1 diabetes An 80 year old client who has experienced two falls while attempting to ambulate to the bathroom A 78 year old who has begun reporting frequent headaches unrelieved by over-the-counter analgesics A 65 year old client whose vision has become less acute in recent months and who has noticed swelling in the ankles

An 80 year old client who has experienced two falls

The nurse is developing a plan of care for a post surgical client. A major goal is to prevent the formation of DVT. Which nursing intervention should the nurse implement. Apply ice compresses to the site of the DVT hourly Massage legs to maintain blood flow Apply sequential pneumatic compression devices to lower extremities Ensure that the client remains on bed rest

Apply sequential pneumatic compression devices to lower extremities

The nurse recognizes that there are many factors that influence blood flow within the systemic circulation. In the circulatory system, which of the following are called resistance vessels? Capillaries Arterioles Venules Aorta

Arterioles

Which goal is a priority for a nurse caring for a patient diagnosed with orthostatic hypotension? Monitoring for signs of diabetes mellitus Encouraging a low-fat diet Supporting an exercise program Preventing falls

Preventing falls

A pregnant female client is at risk for the development of preeclampsia-eclampsia. Select the most important data to assess. BP 160/100 and proteinuria during the 30th week of pregnancy BP 140/90 and glucose in the urine during the 36th week BP 90/60 and proteinuria in the second trimester BP 130/88 and hyperglycemia occurring during the 22nd week of pregnancy

Blood pressure 160/100 and preteinuria during the 30th week

The nurse knows that coarctation of the aorta can be a secondary cause of hypertension. Which blood pressure finding can be characteristic of this condition? BP in legs 20 mm Hg higher than in the arms BP in arms 20 mm Hg higher than in the legs Prominent femoral pulses Widened pulse pressure in the legs

Blood pressure in arms 20 mm Hg higher than in the legs

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. Lipoprotein(a) C-reactive protein Homocysteine Triglycerides

C-reactive protein

An older adult client is newly diagnosed with hypertension. Which vascular changes in the aging adult can lead to hypertension Increased elasticity of the arterial connective tissue Decreased elasticity of the venous connective tissue Decreased elasticity of the aorta and large arteries Increased elasticity of the venous connective tissue

Decreased elasticity of the aorta and large arteries

A client present to the ED with a sudden onset of acute pain in his left lower leg. The practitioner is unable to palpate pedal pulses and finds the client to e in atrial fibrillation. Which test will the practitioner order to find the source of the emboli? Chest x-ray CT of the head Ultrasound of the kidney Echocardiogram

Echocardiogram

The nurse is reviewing laboratory results for a client who is experiencing angina. Which finding might be expected in a client with dyslipidemia? Normal cholesterol and triglycerides Decreased triglycerides Elevated total cholesterol Decreased low-density lipoproteins

Elevated total cholesterol

A client has been diagnosed with diabetes mellitus. which lab would the practitioner expect? Decreased VLDL Decreased LDL Elevation of triglycerides Elevation of LDL

Elevation of triglycerides

An older adult clients BP is 120/80 when in a lying position. When the nurse retakes the clients BP in a sitting position, the BP is 92/60. Which intervention is appropriate for the nurse to implement Administering oxygen as prescribed Keeping the client in a supine position throughout the day Encouraging the client to maintain hydration throughout the day Contacting the health care provider immediately

Encouraging the client to maintain hydration

A 50 year old man is having routine blood work done as part of his yearly physical. The doctor informs him that his good cholesterol is low. To which form of cholesterol is the doctor referring VLDL IDL LDL HDL

HDL

The nurse is providing education to a client diagnosed with varicose veins. The nurse determines that teaching has been effective when the client states that which activity Is most likely the cause of the variscosities Prolonged sitting Heavy lifting Weight loss

Heavy lifting and prolonged standing

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, epidemiological studies have shown that there are predisposing risk factors. What is the major risk factor? Increasing age Hypercholesterolemia Familial history of premature coronary heart disease Male sex

Hypercholesterolemia

A client has developed atherosclerosis. The nurse knows that a major cause for this disorder is Heart failure History of myocardial infarction Hypertension Elevated HDL cholesterol

Hypertension

An older adult is prescribed a vasodilator for hypertension. Which adverse effect is of greatest concern for an older adult taking this class of drug? Constipation Restlessness Hypotension Dry mouth

Hypotension

A 52 year old man who is moderately obese has recently been diagnosed with hypertension by the health care provider. Which client statement indicates a need for further health promotion teaching? I'm planning to lose 15 lbs before the end of this year Im going to eat organic foods from now on but I'm glad I dont have to watch my fat intake Ive started going to the gym before work I'm trying to cut back on the amount of salt that I cook with

I'm going to eat organic foods from now on but im glad i dont have to watch my fat intake

In addition to a direct invasion of the vascular wall by an infectious agent, what pathogenic mechanism is a common cause of vasculitis? Tissue necrosis Immune mediated inflammation Mononuclear cells Necrotizing granulomas

Immune mediated inflammation

A client with hypercholesterolemia is being treated with diet and exercise. Which assessment finding is a positive outcome of this treatment regimen. Increased blood glucose levels Lowered high-density lipoproteins Increased low-density lipoproteins Increased high-density lipoprotein

Increased HDLs

The client reports a sudden onset of excruciating pain in the anterior chest and describes it as tearing or ripping. The physician is unable to palpate a pulse in the clients right arm. Based on the clients history and physical exam, which treatment would be implemented. Intravenous sodium nitroprusside Intravenous heparin Intravenous epinephrine Intravenous atropine

Intravenous sodium nitroprusside

The student attends a health fair and has his serum cholesterol checked. He has a high lipoprotein level (LDL). He understands which of the following about LDL cholesterol? It is associated with a low intake of saturated fats It has a low cholesterol content It transports cholesterol away from cells to the liver for excretion It is believed to play an active role in the pathogenesis of the atherosclerotic lesion.

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 lipoprotein is the main carrier of cholesterol? HDL LDL VLDL IDL

LDL

Which of the following could help convince the brother to stop smoking? Measure his BP and show him how much higher it is when he is smoking Measure his pulse and show him how much lower it is when he is smoking Measure his temperature and show him how much higher it is when he is smoking Have him listen to his heart for the obvious murmur that presents when smoking

Measure his BP and show him how much higher it is when he is smoking

At 4 am. The hemodynamics monitor for a critically ill client in the ICU indicates that the clients mean arterial pressure is at the low end of the normal range; at 6 am, the clients MAP has fallen definitively below normal. The client is at risk for Orthostatic hypotension Left ventricular hypertrophy Pulmonary hypertension Organ damage and hypovelemic shock

Organ damage and hypovelemic shock

Which of the following are characteristic signs of acute arterial embolism Pallor, pulselessness, and pain Purpura, muscle weakness, and shortness of breath Paralysis, warmth, and paranoia Pain, increased blood pressure, and warmth

Pallor, pulselessness, and pain

Malignant hypertension causes injuries to the walls of the arterioles. Because hypertension is a chronic disease and is associated with auto regulatory changes in the blood flow to major organs, what would be the initial treatment goal for malignant hypertension? Partial reduction in blood pressure to less critical values Slow, gradual decrease in blood pressure to normotensive blood pressures Reduction to normotensive levels of blood pressure Rapid decrease in blood pressure to less critical levels

Partial reduction in blood pressure to less critical values

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 physiologic process Peripheral vascular resistance Release of stress hormones Electrical impulses in the heart Rigidity of the ventricular walls

Peripheral vascular resistance

A client presents to the emergency department reporting bilateral cyanosis and pallor of the fingers after being in the cold weather for 5 minutes. The toes are of normal color. What is a potential diagnosis for this client? - atherosclerotic occlusive disease - deep vein thrombosis - frostbite related to hypothermia - raynaud disease

Raynaud disease

A client is prescribed an angiotensin-converting enzyme inhibitor for hypertension. The nurse questions the prescription for a client with which condition? Heart failure Renal artery stenosis Coronary artery disease Diabetes

Renal artery stenosis

The treatment for varicose veins includes which interventions? Sclerotherapy or surgery Surgery or Trendelenburg therapy Trendelenburg therapy or sclerotherapy Surgical or fibrotherapy

Sclerotherapy or surgery

A client has been diagnosed with hypercholesterolemia and is asking what treatment will be needed. about which topics should the nurse educate the client? Select all that apply Weight reduction Smoking cessation Decreased physical activity Increased intake of fats and sodium Dietary measures to reduce LDL levels

Smoking cessation Weight reduction Dietary measures to reduce LDL levels

The nurse knows that which food is excluded from the dietary approaches to stop hypertension diet? Nuts Whole grains Poultry Steak

Steak

The smooth muscle cells produce vasoconstriction of blood vessels due to inner action by which part of the NS? Sympathetic Parasympathetic Peripheral Central

Sympathetic

A client has been diagnosed with a dissecting aortic aneurysm. It is most important for the nurse to assess the client for: Late hypertensive crisis Tearing or ripping-type pain in the chest or back Chest pain radiating to the right arm Tonic-clinic seizures

Tearing or ripping-type pain in the chest or back

The nurse knows that the primary long-term regulation of blood pressure is exerted by which body system? Neural mechanisms Humoral influence Hormonal activity The kidneys

The kidneys

Which most important complication of atherosclerosis can result in occlusion of small heart vessels Ulceration Thrombosis Fibrous plaque Fatty streaks

Thrombosis

Small vessel vasculitides, which are involved in a number of different diseases, are mainly mediated by which physiologic function Mononuclear cells Type III immune complex hypersensitivity reactions Necrotizing damage to muscular vessel structure Infectious agents

Type III immune complex hypersensitivity reactions

The nurse is providing education for a client diagnosed with essential hypertension. The nurse will state that the cause of the disorder is Hyperaldosteronism Pheochromocytoma Unknown Decreased renal blood flow

Unknown

Which type of blood vessel cells in the tunica media layer produce vasoconstriction and/or dilation of blood vessels? -vascular smooth muscle cells? -endothelial cells -extracellular matrix cells -collagen tissue

Vascular smooth muscle cells

Which pathogenesis is primarily responsible for Raynaud phenomenon Vasospasm causing excessive vasoconstriction Vasculitides resulting from damaged vessels due to hypertension Thrombi formation blocking blood flow Occlusion by atherosclerosis

Vasospasm causing excessive vasoconstriction

Which of the following is associated with stasis of blood, increased blood coagulability, and vessel wall injury? Chronic venous insufficiency Peripheral artery disease (PAD) Varicose veins Venous thrombosis

Venous thrombosis

A client is pregnant for the first time and is considered to be at high risk for preeclampsia. The care team should prioritize which intervention Vigilant blood pressure monitoring Oral administration of beta-adrenergic blockers Cautious use of over-the-counter diuretics Restriction of dietary sodium

Vigilant blood pressure monitoring

An older adult client newly diagnosed with systolic hypertension asks her health care provider why this happens. Which response is most accurate With age, your arteries lose their elasticity and are replaced with collagen, which makes your arteries stiffer You heart has to work harder to pump blood through your vessels as you get older If you slow down and rest more, your blood pressure will more than likely return to its normal level Everyone over the age of 50 tends to have their blood pressure creep up over the years

With age, your arteries lose their elasticity and are replaced with collagen, which makes your arteries stiffer