PATHO Ch-26

A client diagnosed with giant cell arteritis will likely experience pain located in which region of the head?

Temporal

A client who is exercising has a blood pressure of 130/90 mm Hg at the start of exercise and 90/50 mm Hg midway into the exercise. What statement is true concerning this assessment?

The arterial pressure has fallen due to decreased cerebral blood flow.

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.

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

Venous Thrombosis

The professor knows that the pathophysiology student understands the structure and function of blood vessels when the student states:

"Capillaries permit the exchange of material between the blood and interstitial fluid."

The health care team proposes a treatment plan for a client with peripheral artery disease. Which treatment measures are likely included?

Exercise training like walking to increase collateral circulation

Which client will likely experience difficulty maintaining lipoprotein synthesis, resulting in elevated LDL levels?

35-year-old client with history of hepatitis C and B with end-stage liver disease. Rationale: There are two sites of lipoprotein synthesis—the small intestine and the liver. The liver synthesizes and releases VLDL and HDL. They are taken to the liver and recycled to form VLDL, or converted to LDL in the vascular compartment. Liver disease will result in this mechanism not working as expected. COPD, cervical cancer, and pancreatitis are not involved in elevated LDL levels. Reference:

The physician understands that which client is at risk for developing primary hyperlipoproteinemia?

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?

A pulsating mass in the abdomen

The nurse knows that there are many different groups of antihypertensive drugs having varied mechanisms of action. Which medication decreases the exit of adrenergic (sympathetic) stimulation from the central nervous system, thereby decreasing sympathetic outflow?

An Alpha-2 adrenergic agonist

A client taking an antihypertensive drug for several months comes to the physician's office with a dry, persistent cough. The nurse knows that this cough is an adverse effect of which class of antihypertensive drugs?

Angiotensin-converting enzyme (ACE) inhibitors

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?

Arterioles

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 & Confusion

The health care provider is reviewing the results of a client's magnetic resonance imaging (MRI). The results indicate a small spherical dilation at the circle of Willis. The provider would interpret this as:

Berry Aneurysm

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?

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

Which elevated serum marker for systemic inflammation is now considered a major risk factor for atherosclerosis and vascular disease?

C-reactive Protein

Which statements most accurately describe secondary hypertension?

Can be corrected or cured by surgery or specific medical treatment Accounts for 5% to 10% of hypertension cases May be caused by oral contraceptives Has an independent risk factor for obstructive sleep apnea Is most commonly caused by kidney disease

Which individual is at greatest risk for developing a venous thrombosis resulting from venous stasis?

Client on Bed Rest

Which vascular changes can occur in older adults because of the increase in blood pressure during the aging process?

Decreased elasticity in arterial connective tissue

A client has a narrowed pulse pressure with a BP of 89/68. The nurse knows that which major factors influence pulse pressure?

Distensibility of the arteries Stroke volume

A client presents to the emergency department 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 be in atrial fibrillation. Which test will the practitioner order to find the source of the emboli?

Echocardiogram

The nurse is reviewing laboratory results for a client who is experiencing angina. Which finding might be expected in a client with dyslipidemia?

Elevated Total Cholesterol

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

Elevation of triglycerides Rationale: In diabetes mellitus and the metabolic syndrome, typical dyslipidemia is seen with elevation of triglycerides, low HDL, and minimal or modest elevation of LDL. High calorie intake and diabetes mellitus increase the production of VLDL.

A client has systolic hypertension. The nurse knows that systolic pressure is influenced by which factors? Select all that apply.

Heart rate Compliance of arteries Stroke volume Contractile force

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

An older adult client is prescribed a vasodilator for hypertension. Which adverse effect is of greatest concern for an older adult taking this class of drug?

Hypotension

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

The pediatrician is examining a young client and notes necrotizing damage to the coronary arteries in the child's echocardiogram. The pediatrician suspects the child has which of the following?

Kawasaki Disease

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?

LDL

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

LDL level

Which lipoprotein is the main carrier of cholesterol?

Low-density lipoprotein (LDL)

At 4 AM, the hemodynamic monitor for a critically ill client in the intensive care unit indicates that the client's mean arterial pressure is at the low end of the normal range; at 6 AM, the client's MAP has fallen definitively below normal. The client is at risk for:

Organ damage and hypovolemic shock

Which of the following are characteristic signs of acute arterial embolism?

Pallor, Pulselessness, and Pain

A 37-year-old woman is admitted to the unit with a differential diagnosis of rule out pheochromocytoma. What are the most common symptoms the nurse would expect this client to exhibit?

Periodic severe headache and marked variability in blood pressure

A 75-year-old man presents at the clinic for a routine physical checkup. He is found to be hypertensive. While taking his blood pressure in the sitting, standing, lying positions, the nurse notes that the brachial artery is pulseless at a high cuff pressure, but she can still feel it. What condition would the nurse suspect?

Pseudo hypertension

A 56-year-old woman presents at the clinic complaining of the unsightliness of her varicose veins and wants to know what can be done about them. The nurse explains that the treatment for varicose veins includes which intervention?

Sclerotherapy or surgery

Which of the following is the site of chylomicron synthesis?

Small Intestine

Which blood vessel layer is composed primarily of smooth muscle cells?

Tunica media

The nurse is providing education for a client diagnosed with essential hypertension. The nurse will state that the cause of this disorder is:

Unknown

Which type of blood vessel cells in the tunica media layer produce vasoconstriction and/or dilation of blood vessels?

Vascular smooth muscle cells (SMCs)

Which is the most common site for an aortic aneurysm?

abdominal aorta

Which intervention will the nurse prioritize for the medical management of a client with a dissecting aortic aneurysm?

administration of vasodilators and beta-adrenergic blocking medications (beta-blockers)

An older adult client is newly diagnosed with hypertension. Which vascular changes in the aging adult can lead to hypertension?

decreased elasticity of the aorta and large arteries

A client is suspected of having secondary hypertension. Which condition(s) will the nurse anticipate being investigated as potential causes of secondary hypertension?

pheochromocytoma Cushing syndrome renal artery hypertension

Which of the following facilitates the clearance of cholesterol from the periphery (including atheromatous plaques) and transports it to the liver where it may be excreted?

HDL

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

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