Patho CH 26

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.

Which client is at greatest risk for orthostatic hypotension?

A 66-year-old postoperative client on bed rest

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

A client with familial hypercholesterolemia

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)

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

Elevation of triglycerides

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."

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.

Which type of aortic aneurysm is the most common?

Abdominal aortic

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

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 nurse is participating in a health fair and is addressing many of the varied factors that can contribute to hypertension. The nurse should be cognizant of the higher incidence and prevalence of hypertension in which groups?

Black and South Asian people

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

Atherosclerotic peripheral vascular disease is symptomatic with at least 50% occlusion. Due to ischemia, which initial peripheral symptom is associated with this disease?

Calf pain

Which statements most accurately describe secondary hypertension? Select all that apply.

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

A nurse is planning a community education program on lifestyle modification to manage hypertension. Which topic should be included in the teaching plan? Select all that apply.

Consume a diet rich in fruits, vegetables, and low-fat dairy products. Reduce dietary sodium intake. Stop smoking. Limit alcohol consumption.

Which children may be considered high risk for developing hypertension? Select all that apply.

Diagnosed with coarctation of the aorta as an infant Recent scan showing a pheochromocytoma Takes cyclosporine daily since a kidney transplant

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

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

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.

Which intervention by the client will decrease overall cardiovascular risk?

Higher levels of fitness and exercise

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

In addition to direct invasion of the vascular wall by an infectious agent, what pathogenic mechanism is a common cause of vasculitis?

Immune-mediated inflammation

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 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 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

A teenager is diagnosed with hypertension. The nurse knows that risk factors for hypertension in children and adolescents include which of these? Select all that apply.

Obesity High salt consumption Inactive lifestyle

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

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

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 one of the following organs are the two primary sites of lipoprotein synthesis?

Small intestine and liver

A client has just 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.

Smoking cessation Dietary measures to reduce LDL levels Weight reduction if overweight

Venous thrombosis most commonly occurs in the lower extremities. Risk factors for venous thrombosis include:

Stasis of blood, hypercoagulability, vessel wall injury

A nurse is administering medication to treat familial hypercholesterolemia. Which medication lowers blood levels of low-density lipoproteins (LDL)?

Statins

A 60-year-old woman who has lost an extensive amount of blood in a work-related accident says that when her blood pressure was checked in the hospital, the top number (systolic pressure) was lower than usual but the bottom number (diastolic pressure) was about the same. The nurse recognizes that which reason accounts for this lack of change in the diastolic pressure?

Systemic vasoconstriction maintained the diastolic pressure.

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

Temporal

Which pathogenesis is primarily responsible for Raynaud phenomenon?

Vasospasm causing excessive vasoconstriction

The nurse is developing a plan of care for a postsurgical client. A major goal is to prevent the formation of deep vein thrombosis (DVT). Which nursing intervention should the nurse implement?

apply sequential pneumatic compression devices to lower extremities

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 has developed atherosclerosis. The nurse knows that a major cause for this disorder is:

Hypertension

Which lipoprotein is the main carrier of cholesterol?

Low-density lipoprotein (LDL)

Select the response that best describes the pressure-sensitive receptors that respond to changes in the stretch of the vessel wall.

Baroreceptors

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."

From which one of the following sites is a fatal pulmonary thromboembolism most likely to originate?

Deep vein thrombophlebitis of the leg

The client has been diagnosed with impaired blood flow in the deep venous channels of her legs. The nurse explains that the most common cause of this condition is:

Deep vein thrombosis (DVT)

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 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

A client asks why his blood pressure pills seem to make him go to the bathroom to urinate frequently when they are not water pills (diuretics). Which physiologic process explains the long-term regulation of blood pressure most accurately?

Renal monitoring and adjustment of extracellular fluid volume

A postsurgical client reports calf pain combined with the emergence of swelling and redness in the area, which has lead to a diagnosis of deep vein thrombosis (DVT). What treatment option will be of greatest benefit to prevent further thrombus formation?

Anticoagulation therapy and elevation of the leg

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

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?

C-reactive protein

A nurse is planning a community education program on hypertension. Which parameter should be included to explain the regulation of arterial blood pressure?

Cardiac output and systemic vascular resistance

An adult's documented blood pressure (BP) readings over the past 2 years include: 140/82 mm Hg, 144/82 mm Hg, 150/82 mm Hg, 160/82 mm Hg, and 162/82 mm Hg. Which interpretation(s) of these BP trend will the provider discuss with this client? Select all that apply.

Client's systolic BP is hypertensive. Client has increased risk for future cardiovascular events.

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

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