patho 18

Which intervention is the priority 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 the primary long term regulation of blood pressure is exerted by which body system?

kidneys

Which goal is a priority for a nurse caring for a patient diagnosed with orthostatic hypotension?

preventing falls

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 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. Which risk factors are nonmodifiable? Select all that apply.

race family history

A female client tells the health care provider that she has recently been experiencing episodes of changes occuring 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 patient presents to the emergency department with complaints of bilateral cyanosis and pallor of the fingers after being out in the cold weather for 5 minutes. The toes are of normal color. Which of the following is a potential diagnosis for this patient?

raynaud's disease

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

An older adult client has been diagnosed with orthostatic hypotension. When planning the client's subsequent care, the nurse should prioritize which diagnosis?

risk for falls

The smooth muscle cells produce vasoconstriction of blood vessels due to innervation by which part of the nervous system?

sympathetic

The nurse knows that the main objective of the management of hypertension is to achieve a sustainable level of blood pressure below which of the following?

140/90

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."

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 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

When will the nurse plan to assess a patient's blood pressure to confirm the possible diagnosis of orthostatic hypotension?.

In the morning before arising from bed

Which of the following is the best modality to diagnose hypertension?

Repeated blood pressure determinations

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

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 of the following lab results would the practitioner expect?

elevation of triglycerides

Which of the following individuals is at greatest risk for developing a venous thrombosis resulting from venous stasis?

patient on bed rest

A 55-year-old client has been diagnosed with atherosclerosis. The client understands that his or her lifestyle includes many of the risk factors for developing the disease, but the client asks the nurse, "What actually caused my disease?" Which is the nurse's best scientific answer?

"LDL and VLDLs stimulate endothelial cell dysfunction."

When a 55 year old patient's 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 mmHg

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

Which of the following patients should most likely be assessed for orthostatic hypotension?

An elderly patient who has experienced two falls since admission while attempting to ambulate to the bathroom.

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 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

A 56-year-old male client has been diagnosed with hypercholesterolemia. Which laboratory results that support this diagnosis?

Cholesterol 250 mg/dL and HDL 32 mg/dL

A nurse is planning a community education program on lifestyle modification to manage hypertension. Which of the following topics 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.

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

Deep vein thrombosis (DVT)

Select the statement that best describes Buerger disease.

Disease of young, heavy cigarette smokers occurring before the age of 35.

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?

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

A 50-year-old man is having routine blood work done as part of his yearly physical. The doctor informs him that his good cholesterol is low. To which form of cholesterol is the doctor referring?

HDL

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

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

The health care provider is teaching a client about modifiable risk factors for atherosclerosis. The most appropriate information to provide would be:

Hypertension

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 describes which of the following as the mechanism of action of an angiotensin-converting enzyme (ACE) inhibitor?

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

The student attends a health fair and has his serum cholestrol 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 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. TThe incidence increases with age. The systolic pressure is greater than or equal to 140 mm Hg.

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

Which lipid results on four clients will the nurse recognize as having the greatest risk for cardiovascular disease?

LDL cholesterol 205 mg/dL, HDL 40 mg/dL, and triglyceride level 150 mg/dL

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

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.

A nursing instructor is explaining the role of vascular smooth muscle cells in relation to increases in systemic circulation. During discussion, which neurotransmitter is primarily responsible for contraction of the entire muscle cell layer thus resulting in decrease vessel lumen radius?

Norepinephrine.

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

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

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 which of the following?

Pulmonary embolism

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. Which responses is best for the nurse to educate this client about? Select all that apply.

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

A client's blood pressure is persistently in the range of 130-135 mm Hg systolic and 85-88 mm Hg diastolic. The nurse knows that the client's blood pressure would be classified as which AHA definition?

Stage 1 hyperstension

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

Statins

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

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 just smoked a cigarette.

The nurse is providing education for a patient diagnosed with essential hypertension. The nurse will state that the cause of this disorder is which of the following?

Unknown

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

The 40-year-old nurse is concerned that her job requires her to stand most of the day. Which of the following therapies could be implemented to prevent tissue injury?

Wearing correctly fitted, elastic support stockings

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

The client tells the provider he has lower back pain. Although most abdominal aneurysms are asymptomatic, the provider examines the client for which of the following initial signs of this condition?

a pulsating mass in abdomen

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 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

An elderly patient is diagnosed with orthostatic hypotension. For which of the following clinical manifestations should the nurse assess?

dizziness and fainting

All veins have internal valves to aid in the unidirectional flow of blood toward the heart.

false only arteries do

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

temporal

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

tunica media