Pathophys Chapter 26
Which type of aortic aneurysm is the most common?
Abdominal aortic
Hypertension in older adults is a common finding. This is because of the age-related rise in systolic blood pressure. Among the aging processes, what is a contributor to hypertension?
Decreased baroreceptor sensitivity
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 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?
Deep vein thrombosis
The physician understands that which client is at risk for developing primary hyperlipoproteinemia?
A client with familial hypercholesterolemia
A client with persistent primary hypertension is noncompliant with the currently prescribed antihypertensive due to adverse effects. Which antihypertensive medications might the health care provider select to use as alternatives to treat the client's hypertension? Select all that apply.
-Direct-acting vasodilators -Alpha-adrenergic blockers -Centrally acting adrenergic agonists
The nurse knows that which of the following would put a client 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
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 dietitian is teaching a client about cholesterol reduction strategies. Which comment by the client indicates that he understands the teaching?
"I should avoid fats that are manufactured from vegetable oils and used to extend the shelf life of fast foods."
Which health-focused educational programs will target the most common cause of renovascular disease among older adults?
"Preventive Measures to Decrease Atherosclerosis"
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."
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?" What is the best response?
"Your arteries in your hands/fingers are going into spasm, which decreases blood flow and circulating oxygen."
According to the latest guidelines by the American Heart Association, which blood pressure reading would be classified as stage 1 hypertension?
137/85 mm Hg
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 that release free radicals oxidize LDL, which is harmful to the lining of your blood vessels.
A client 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 factor has most likely resulted in the client's increased blood pressure?
Activation of the renin-angiotensin-aldosterone mechanism
Which intervention is the priority for the medical management of a client with a dissecting aortic aneurysm?
Administration of sodium nitroprusside and beta-adrenergic blocking medications (beta-blockers)
Which client would the nurse recognize as needing to be assessed for orthostatic hypotension
An 80-year-old client who has experienced two falls while attempting to ambulate to the bathroom
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
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
Select the response that best describes the pressure-sensitive receptors that respond to changes in the stretch of the vessel wall.
Baroreceptors
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
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
Select the statement that best describes Buerger disease.
Disease of young, heavy cigarette smokers occurring before the age of 35.
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
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?
Encouraging the client to maintain hydration throughout the day
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:
Fibrous atheromatous plaque
The nurse knows that hypertension can lead to nephrosclerotic damage. Which of the following occurs first in nephrosclerosis?
Glomerular hypoperfusion
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?
Going for a brisk walk with a friend and talking to him about continuing to exercise regularly
Which intervention by the client will decrease overall cardiovascular risk?
Higher levels of fitness and exercise
The health care provider is teaching a client about modifiable risk factors for atherosclerosis. The most appropriate information to provide would be:
Hypertension
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 practitioner's examination of a client reveals xanthomas along the client's tendons. Which test will the practitioner order?
LDL level
The nurse is assessing a client with arteriosclerosis obliterans. Which assessment sign would the nurse expect to see?
Limb color blanches with elevation of the leg
Several steps characterize the development of atherosclerosis. Which is the correct order in which atheromas develop?
Lipoprotein oxidation, foam cells produced, fibrous plaques develop, a thrombus forms
Which lipoprotein is the main carrier of cholesterol?
Low-density lipoprotein (LDL)
Which of the following are characteristic signs of acute arterial embolism?
Pallor, pulselessness, and pain
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 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:
Pulmonary embolism
A nurse is evaluating hypertension risk factors with a black 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 lb (6.8 kg) in the past year. The nurse teaches the client that which risk factors for hypertension are nonmodifiable? Select all that apply.
Race Family history
A client presents to the emergency department reporting bilateral cyanosis and pallor of the fingers after being out in the cold weather for 5 minutes. The toes are of normal color. What is a potential diagnosis for this client?
Raynaud disease
A female client tells the health care provider that she has recently been experiencing episodes of changes occurring in the color of her fingertips, especially when she experiences cold temperatures. She further states that the tips become pale, turn a bluish color, and then become reddened. The client is most likely experiencing:
Raynaud phenomenon
A client is prescribed an angiotensin-converting enzyme (ACE) inhibitor for hypertension. The nurse knows that ACE inhibitors are contraindicated by which clinical condition?
Renal artery stenosis
Which of the following is the site of chylomicron synthesis?
Small intestine
A client diagnosed with giant cell arteritis will likely experience pain located in which region of the head?
Temporal
A group of vascular disorders called vasculitides cause inflammatory injury and necrosis of the blood vessel wall (vasculitis). Which condition is the most common of the vasculitides?
Temporal arteritis
The nurse knows that the primary long-term regulation of blood pressure is exerted by which body system?
The kidneys
Small-vessel vasculitides, which are involved in a number of different diseases, are mainly mediated by which physiologic function?
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 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 pathogenesis is primarily responsible for Raynaud phenomenon?
Vasospasm causing excessive vasoconstriction
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