Pathophysiology Chapter 18 (Disorders of Blood Flow and Blood Pressure) PrepU Quizzes

A client has been diagnosed with chronic obstructive arterial disease. Which client statement indicates she understands how to manage this disease?

"I should have my LDL monitored."

When a 55 year old patients routine blood work returns, the nurse notes that their C-reactive protein (CRP) is elevated. The patient asks what that means. The nurse responds:

"This means you have elevated serum markers for systemic inflammation that has been associated with vascular disease.

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?

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

The nurse knows that systolic hypertension is characterized by systolic pressure of ____mm Hg or higher.

140

The physician's order states, "Calculate the pulse pressure of the client's B/P." The blood pressure reading is as follows: systolic pressure of 146 mm Hg and a diastolic pressure of 82 mm Hg. The pulse pressure would be:

64 mm Hg

In which of the following hospital patients would the care team most realistically anticipate finding normal cholesterol levels?

A 51-yearold male with a diagnosis of hemorrhagic stroke and consequent unilateral weakness

In which of the following patients is the emergency department staff most likely to suspect an abdominal aortic aneurysm?

A 66-year-old client with facial edema, a cough, and neck vein distention

Which of the following patients is at greatest risk for orthostatic hypotension?

A 66-year-old post-surgery patient on bed rest

The nurse observes a client care technician obtain a blood pressure on an obese client using a BP cuff that is too small. The nurse is aware that this will result in:

A reading that is too high

When trying to educate a patient about the release of free radicals and the role they play in formation of atherosclerosis, which of the following statements is most accurate?

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

A patient 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 of the following has most likely resulted in the patient's increased blood pressure?

Activation of the renin-angiotensin-aldosterone mechanism

Select the priority of care for the medical management of a client with a dissecting aortic aneurysm

Administration of sodium nitroprusside and β-adrenergic blocking medications

Select the priority of care for the medical management of a client with a dissecting aortic aneurysm.

Administration of sodium nitroprusside and β-adrenergic blocking medications

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

An alpha-2 adrenergic agonist

The nurse is developing a plan of care for a postsurgical client. A major goal is to prevent the formation of prevent deep vein thrombosis (DVT). The most important intervention for the nurse to implement would be:

Apply sequential pneumatic compression devices to lower extremities

A 70-year-old male client presents to the emergency department complaining of pain in his calf that is exacerbated when he walks. His pedal and popliteal pulses are faintly palpable and his leg distal to the pain is noticeably reddened. The nurse knows that the client is likely experiencing which of the following medical diagnosis/possible treatment plan listed below?

Atherosclerotic occlusive disease necessitating thrombolytic therapy

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

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

A client has been prescribed a thiazide diuretic, hydrochlorothiazide (HCTZ), for the initial treatment of hypertension. What effect does the nurse know this drug will have to decrease blood pressure?

Decrease vascular volume

A nurse is teaching a patient with newly diagnosed hypertension about antihypertensive drug therapy. The nurse determines that the patient understands when the patient correctly matches which of the following drug categories to the action of decreasing vascular volume by suppressing renal reabsorption of sodium and increasing salt and water excretion?

Diuretics

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?

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

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

Elevation of triglycerides

A 35-year-old man presents to the emergency department complaining of chest pain for the last 2 hours. He describes the pain as crushing, like a huge weight is on his chest. He also states that the pain goes up into his neck and down his left arm. An acute myocardial infarction (MI) is diagnosed. When taking his history, the following things are noted: ● Hyperlipoproteinemia for past 7 years ● Family history of early MI ● Cholesterol deposits along the tendons (diagnosed 1 year ago) ● Atherosclerosis (diagnosed 6 months ago) ● Diabetes mellitus (type 1) diagnosed at age 16 The nurse suspects which of the following diagnoses will be made?

Familial hypercholesterolemia (type 2A)

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

Fingers

The nurse is teaching a class on reduction of cardiovascular disease. Which of the following 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

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 and confusion

A patient comes to the clinic complaining of anorexia, weight loss, fever, fatigue along with paresthesias, pain, and weakness of the lower extremities. Assessment findings include reddish blue, mottled areas of discoloration to the skin of the lower extremities. Laboratory findings include an elevated erythrocyte sedimentation rate, leukocytosis, anemia, and abnormal liver function tests. A diagnosis of necrotizing vasculitis is confirmed through biopsy. The nurse anticipates treatment with which of the following medications?

High-dose corticosteroid therapy and cytotoxic immunosuppressant agents

The client reports a sudden onset of excruciating pain in the anterior chest and describes it as "tearing or ripping." The physician is unable to palpate a pulse in the client's right arm. Based on the client's history and physical examination, which treatment would be implemented?

Intravenous sodium nitroprusside

The nurse is counseling a client regarding a high cholesterol level. The nurse teaches the client that which of the following lipoproteins is the main carrier of cholesterol?

LDL

A patient is prescribed an angiotensin converting enzyme inhibitor (ACEI) for hypertension. The nurse knows that ACEIs are contraindicated by which clinical condition?

Renal artery stenosis

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 of the following physiologic processes?

Peripheral vascular resistance

A patient's blood pressure is persistently in the range of 130-135 mm Hg systolic and 85-88 mm Hg diastolic. The nurse knows that which of the following conditions correctly describes this patient's blood pressure?

Prehypertension

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

Which of the following is the site of chylomicron synthesis?

Small intestine

A patient is diagnosed with stage 2 hypertension. The nurse knows that which of the following is characteristic of stage 2 hypertension?

Sustained systolic pressure equal to or greater that 160 mm Hg

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 of the following accounts for this lack of change in the diastolic pressure?

Systemic vasoconstriction maintained the diastolic pressure.

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

The nurse knows that the primary long term regulation of blood pressure is exerted by which of the following?

The kidneys

Which of the following blood vessel layers is composed primarily of smooth muscle cells?

Tunica media

Which of the following blood vessel cells form the predominant cellular layer in the tunica media and produce vasoconstriction and/or dilation of blood vessels?

Vascular smooth muscle cells (SMCs)

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

A client has just been diagnosed with hypercholesterolemia and is asking what treatment will be needed. The best response would be: Select all that apply.

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

A patient is diagnosed with orthostatic hypotension. The nurse knows that drugs which can predispose a patient to orthostasis include which of the following? Select all that apply.

• Diuretics • Antihypertensives • Psychotropics

The nurse is teaching a group of clients about hypertension. The nurse determines that teaching was effective when the clients state: Select all that apply.

• It is the most common cardiovascular disorder. • The incidence increases with age. • The systolic pressure is greater than or equal to 140 mm Hg

A 78 year old male patient has undergone a total knee replacement. He just doesn't feel like getting out of bed and moving around. After 3 days of staying in bed, the physical therapist encourages him to get out of bed to the chair for meals. He starts to complain of dizziness and lightheadedness. These symptoms are primarily caused by which of the following pathophysiological principles? Select all that apply. The patient:

• Peripheral vasoconstriction mechanism has failed. • Is experiencing a reduction in plasma volume.

Although the etiology of essential hypertension is mainly unknown, several risk factors have been identified. These risk factors fall under the categories of constitutional risk factors and lifestyle factors. What are the primary risk factors for essential hypertension? (Select all that apply.)

• Race and excessive sodium chloride intake • Type 2 diabetes and obesity • Family history and excessive alcohol consumption

A clinically obese patient diagnosed with stage 2 hypertension is resistant to taking antihypertensive medication because he has no symptoms and "feels fine." The nurse will encourage this patient to attempt lowering his blood pressure in order to decrease the risk of developing which of the following? Select all that apply.

• Renal failure • Coronary artery disease • Dementia • Loss of vision

A client has just been diagnosed with hypercholesterolemia and is asking what treatment will be needed. The best response would be: Select all that apply

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