Chapter 18: Disorders of Blood Flow and Blood Pressure

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

Fingers

A patient is reading a brochure on atherosclerosis while in the waiting room of medical clinic. Which of the following excerpts from the educational brochure warrants correction? "Because smoking causes a permanent increase in your risk of heart disease, it's best not to start." "All things being equal, men have a higher risk of coronary heart disease than peri-menopausal women." "High blood pressure often accompanies, or even causes, clogging of the arteries." "Every bit that you can lower your cholesterol means that you'll have a lower risk of developing heart disease."

"Because smoking causes a permanent increase in your risk of heart disease, it's best not to start."

The family of an elderly patient are wondering why his 'blood counts' are not rising after his last GI bleed. They state, "He has always bounced back after one of these episodes, but this time it isn't happening. Do you know why?" The nurse will respond based on which of the following pathophysiological principles? "Everything slows down when you get older. You just have to wait and see what happens." "Due stress, the red blood cells of older adults are not replaced as promptly as younger people." "The doctor may start looking for another cause of his anemia, maybe cancer of the bone." "Don't worry about it. We can always give him more blood."

"Due stress, the red blood cells of older adults are not replaced as promptly as younger people."

A client has been diagnosed with chronic obstructive arterial disease. Which client statement indicates she understands how to manage this disease? "I should stay in bed with my legs elevated." "I don't need to monitor my blood pressure." "Diabetes mellitus has no effect on my condition." "I should have my LDL monitored."

"I should have my LDL monitored."

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? "It's important to minimize the amount of potassium and, especially, sodium in your diet." "High blood pressure is largely controllable, except for those with a significant family history or African Americans." "Too much alcohol, too little exercise and too much body fat all contribute to high blood pressure." "Hypertension puts you at a significant risk of developing type 2 diabetes later in life."

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

An elderly patient is brought to the emergency department with garbled speech, unilateral facial drooping, and weakness. One hour after admission, the patient dies. An autopsy reveals the presence of polycythemia. Which of the following was the most likely cause of the patient's death? Anaphylactic reaction Cerebral thrombosis Infection and sepsis Acute leukemia

Cerebral thrombosis

A 56-year-old male patient has been diagnosed with hypercholesterolemia. Which of the following are the lab results that support this diagnosis? Cholesterol 250 mg/dL and HDL 32 mg/dL Cholesterol 180 mg/dL and HDL 40 mg/dL Cholesterol 160 mg/dL and HDL 30 mg/dL C holesterol 184 mg/dL and HDL 20 mg/dL

Cholesterol 250 mg/dL and HDL 32 mg/dL

A physical assessment of a 28-year-old female patient indicates that her blood pressure in her legs is lower than that in her arms and that her brachial pulse is weaker in her left arm than in her right. In addition, her femoral pulses are weak bilaterally. Which of the following possibilities would her care provider be most likely to suspect? Pheochromocytoma Essential hypertension Coarctation of the aorta An adrenocortical disorder

Coarctation of the aorta

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. When the patient starts to snore, their epiglottis is closed over the trachea. Specialized cells are located in the back of the throat what signals when the airway is obstructed which sends signals to the kidney to increase pulse rate. When airways are obstructed, the body will retain extracellular fluid so that this fluid can be shifted to intravascular space to increase volume.

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

The nurse is assessing a client diagnosed with anemia and notes that the client's skin and mucous membranes are pale. The nurse interprets this as: Insufficient hemoglobin Tissue hypoxia to the brain Changes in blood viscosity Presence of systolic murmur

Insufficient hemoglobin

A female patient comes to the clinic with symptoms of fatigue and heavy menses over the last 6 months. Laboratory tests reveal a microcytic hemochromic anemia. Based on these results, the nurse anticipates teaching the patient about which type of anemia? Iron deficiency anemia Aplastic anemia Sickle cell anemia Anemia related to kidney disease

Iron deficiency anemia

A 13-year-old African-American boy comes to the ER complaining of fatigue and a rapid heartbeat. In conversation with the father, it becomes apparent to you that the boy has grown 2 inches in the previous 5 months. What is the first problem the health care team would attempt to rule out? Sickle-cell anemia Iron-deficiency anemia Thalassemia Aplastic anemia

Iron-deficiency anemia

The nurse knows that the hypoxic patient will produce erythropoietin to stimulate red blood cell production. The nurse knows this hormone is produced in which of the following? Kidneys Lungs Bone marrow Pancreas

Kidneys

The nurse's brother is not convinced that he should quit smoking. He asks his sister (the nurse) to demonstrate for him the more immediate effects of smoking on his health. Which of the following could be used to help convince the brother to stop smoking? Measure his temperature and show him how much higher it is when he is smoking. Measure his blood pressure 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. Have him listen to his heart for the obvious murmur that presents when smoking.

Measure his blood pressure and show him how much higher it is when he is smoking.

A patient presents to the clinic with symptoms of elevated blood pressure, dizziness, red face, pain in fingers and toes, headache, and difficulty concentrating. A blood smear reveals an increased number of erythrocytes. Based on these findings, the nurse anticipates which of the following diagnoses? Polycythemia vera Leukemia Hemolytic anemia Hyperbilirubinemia

Polycythemia vera

The nurse is preparing a client with suspected leukemia for a bone marrow and biopsy. What preferred site will the nurse be sure is accessible for the physician? Clavicle Cervical spinous process Anterior femur Posterior iliac crest

Posterior iliac crest

Which of the following would be tested by a complete blood count (CBC)? Lymphocytes and neutrophils Red blood cells and platelets Size and shape of blood cells Sodium and potassium

Red blood cells and platelets

A male client with chronic obstructive pulmonary disease has a hematocrit of 55 percent. The practitioner tells the client that he has which of the following? Primary polycythemia Secondary polycythemia Polycythemia vera Relative polycythemia

Secondary polycythemia

The practitioner carefully monitors his client who exhibits hemoglobin S (HbS) genes. The practitioner know that the client is predisposed to life-threatening infection due to damage by HbS to which of the following organs? Spleen Lungs Heart Pancreas

Spleen

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

The kidneys

A nurse assessing a client with an acute exacerbation of polycythemia vera notes coolness to the right leg and foot, pale color and an absent right pedal pulse. Based on these findings the nurse suspects that the client has developed which of the following complications? Thrombosis in the right leg Infection in the right leg Compartment syndrome in the right leg Edema in the right leg

Thrombosis in the right leg