Chapter 26: Disorders of Blood Flow

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

"I should have my LDL monitored."

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 going to eat organic foods from now on but I'm glad I don't have to watch my fat intake." "I'm planning to lose 15 lb (7 kg) before the end of this year." "I'm trying to cut back on the amount of salt that I cook with and add to my food." "I've starting going to the gym before work three times a week."

"I'm going to eat organic foods from now on but I'm glad I don't have to watch my fat intake."

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

140/90

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 Blood pressure 130/88 and hyperglycemia occurring during the 22nd week of pregnancy Blood pressure 140/90 and glucose in the urine during the 36th week of pregnancy Blood pressure 90/60 and proteinuria in the second trimester

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

A nurse is planning a community education program on hypertension. Which parameter should be included to explain the regulation of arterial blood pressure? Heart rate and peripheral resistance Cardiac output and systemic vascular resistance Blood volume and renal blood flow Myocardial contractility and arteriolar constriction

Cardiac output and systemic vascular resistance

A nurse working on a gerontology unit notes that the majority of the clients on the unit are prescribed antihypertensive medications. When it comes to the aging process, which phenomenon is primarily a contributing factor to hypertension in the older adult population? Select all that apply. Decreased baroreceptor sensitivity and renal blood flow Stiffening of large arteries like the aorta Increased peripheral vascular resistance Increased sensitivity of the renin-angiotensin-aldosterone system Increase in renal perfusion

Decreased baroreceptor sensitivity and renal blood flow Stiffening of large arteries like the aorta Increased peripheral vascular resistance

Which vascular changes can occur in older adults because of the increase in blood pressure during the aging process? Increased elasticity in venous connective tissue Decreased elasticity in venous connective tissue Decreased elasticity in arterial connective tissue Increased elasticity in arterial connective tissue

Decreased elasticity in arterial connective tissue

The nurse is discussing hypertension with a group of clients. The nurse knows that which statements regarding hypertension are true? Select all that apply. Primary hypertension refers to the first diagnosis of hypertension. Family history of hypertension is a risk factor for hypertension. Diabetes can lead to secondary hypertension. Frequent headaches can be a symptom of primary hypertension. Hypertension can lead to right ventricular hypertrophy.

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

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

Encouraging the client to maintain hydration throughout the day

What should the nurse teach the client with peripheral vascular disease and intermittent claudication about exercise? Exercise can increase blood vessel growth and help to decrease symptoms. Clients with intermittent claudication should exercise only their arms. Aerobic exercise is not recommended but isometric exercise is. Exercise is not recommended in this population.

Exercise can increase blood vessel growth and help to decrease symptoms.

The nurse is teaching a class on reduction of cardiovascular disease. Which action/activity demonstrates an intervention that is cognizant of the modifiable risk factors for hyperlipidemia? Encouraging a friend to be tested for familial hypercholesterolemia Talking to a friend about using more saturated and less unsaturated fats when cooking Encouraging a friend to cook with trans fats, as they extend the shelf life of foods Going for a brisk walk with a friend and talking to him about continuing to exercise regularly

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

Headache and confusion

When will the nurse plan to assess a client's blood pressure to confirm the possible diagnosis of orthostatic hypotension? In the morning before arising from bed Within a half-hour after the heaviest meal of the day In the evening just before sleep Midmorning right after taking a short walk

In the morning before arising from bed

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 lipoprotein is the main carrier of cholesterol? Very-low-density lipoprotein (VLDL) Intermediate-density lipoprotein (IDL) Low-density lipoprotein (LDL) High-density lipoprotein (HDL)

Low-density lipoprotein (LDL)

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

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

Peripheral vascular resistance

The nurse knows that which food is excluded from the Dietary Approaches to Stop Hypertension (DASH) diet? Whole grains Nuts Poultry Steak

Steak

Which blood vessel layer is composed primarily of smooth muscle cells? Tunica externa Endothelium Tunica media Tunica intima

Tunica media

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 left work 1 hour ago. The client ate a hamburger 45 minutes prior to the reading. The client took her antihypertensive medication 2 hours ago. The client just smoked a cigarette.

The client just smoked a cigarette.

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

The kidneys

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

Unknown

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 aorta and large arteries increased elasticity of the venous connective tissue decreased elasticity of the venous connective tissue

decreased elasticity of the aorta and large arteries

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

increased high-density lipoproteins

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

A 66-year-old postoperative client on bed rest

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? The end result of oxidation is rupture of the plaque, resulting in hemorrhage. 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.

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

The nurse knows that which statements regarding the physiology of blood pressure are accurate? Select all that apply. Blood pressure is very variable. Blood pressure is poorly regulated. Constant elevation of blood pressure can be lethal. Blood flow is equally vital to all body organs. A decrease in blood flow can be an immediate threat to life.

Blood pressure is very variable. Constant elevation of blood pressure can be lethal. A decrease in blood flow can be an immediate threat to life.

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? Homocysteine Triglycerides C-reactive protein Lipoprotein(a)

C-reactive protein

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

Elevation of triglycerides

Raynaud disease or phenomenon is a functional disorder caused by intense vasospasm of the arteries and arterioles in the: Brain Lungs Heart Fingers

Fingers

Which statement is characteristic of a thrombus? It is a normal phenomenon associated with clotting. Formation depends initially on the clotting process. It forms on the wall of a vessel. It has no internal architecture.

It forms on the wall of a vessel.

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: Cerebrovascular accident Pulmonary embolism Acute myocardial infarction Loss of pulses in the limb

Pulmonary embolism

Which one of the following organs are the two primary sites of lipoprotein synthesis? Small intestine and liver Spleen and liver Small intestines and bone marrow Bone marrow and endothelium

Small intestine and liver

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

Tearing or ripping-type pain in the chest or back

In which situation is blood most likely to be rapidly relocated from central circulation to the lower extremities? A client does isotonic exercises in a wheelchair. A client reclines from a sitting to supine position. A client is helped out of bed and stands up. A client undergoes a stress test on a treadmill.

A client is helped out of bed and stands up.

A client is immobilized following a hip injury. The client has developed lower leg discoloration with edema, pain, and tenderness in the midcalf area. How should the nurse document these clinical findings? Primary varicose veins Deep vein thrombosis Arterial insufficiency Stasis ulcerations

Deep vein thrombosis

A nurse is teaching a client with newly diagnosed hypertension about antihypertensive drug therapy. The nurse determines that the knowledge is understood when the client correctly describes which of the following as the mechanism of action of an angiotensin-converting enzyme (ACE) inhibitor? Decreases vascular volume by suppressing renal reabsorption of sodium Inhibits the conversion of angiotensin I to angiotensin II, decreasing angiotensin II levels and reducing its effect on vasoconstriction Decreases the heart rate, which will cause a decrease in cardiac output Inhibits the movement of calcium into cardiac and vascular smooth muscle

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

Which assessment finding of a newly admitted 30-year-old male client would be most likely to cause his physician to suspect polyarteritis nodosa? The man's blood work indicates polycythemia (elevated red cells levels) and leukocytosis (elevated white cells). The man's blood pressure is 178/102 and he has abnormal liver function tests. The man is acutely short of breath and his oxygen saturation is 87%. The man's temperature is 101.9°F (38.8°C) and he is diaphoretic (heavily sweating).

The man's blood pressure is 178/102 and he has abnormal liver function tests.