Chapter 18

14. Which of the following is a nonmodifiable risk factor for the development of primary hypertension? A) African American race B) High salt intake C) Male gender D) Obesity

A) African American race

16. A patient's primary care provider has added 20 mg of Lasix (furosemide) to his medication regimen to treat his primary hypertension. How does this diuretic achieve its therapeutic effect? A) By decreasing vascular volume by increasing sodium and water excretion B) By blocking the release of antidiuretic hormone from the posterior pituitary C) By inhibiting the conversion of angiotensin I to angiotensin II. D) By inhibiting the movement of calcium into arterial smooth muscle cells

A) By decreasing vascular volume by increasing sodium and water excretion

19. A patient is receiving homecare for the treatment of a wound on the inside of her lower leg which is 3 cm in diameter with a yellow wound bed and clear exudate. Assessment of the patient's legs reveals edema and a darkened pigmentation over the ankles and shins of both legs. What is this patient's most likely diagnosis? A) Chronic venous insufficiency B) Deep vein thrombosis C) Varicose veins D) Peripheral arterial disease

A) Chronic venous insufficiency

2. A major cause of secondary hyperlipoproteinemia is _______, which increases the production of VLDL and conversion to LDL. 2. A major cause of secondary hyperlipoproteinemia is _______, which increases the production of VLDL and conversion to LDL. A) high-calorie diet B) diabetes mellitus C) bile-binding resin D) cholesterol ingestion B) diabetes mellitus C) bile-binding resin D) cholesterol ingestion

A) high-calorie diet

3. The most important complication of atherosclerosis is _________, which may cause occlusion of small heart vessels. A) ulceration B) thrombosis C) fatty streaks D) fibrous plaque

B) thrombosis

8. Because of its location, the presence of an abdominal aortic aneurysm may first be noticed as: A) constipation. B) indigestion. C) a pulsating mass. D) mid-abdominal pain.

C) a pulsating mass.

17. A 29-year-old woman who considers herself active and health conscious is surprised to have been diagnosed with preeclampsia-eclampsia in her second trimester. What should her care provider teach her about this change in her health status? A) "We don't really understand why some women get high blood pressure when they're pregnant." B) "This is likely a result of your nervous system getting overstimulated by pregnancy." C) "Hypertension is a common result of all the hormonal changes that happen during pregnancy." D) "Even though you're a healthy person, it could be that you have an underlying heart condition."

A) "We don't really understand why some women get high blood pressure when they're pregnant."

12. 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? A) Increased levels of adrenocortical hormones B) Activation of the renin-angiotensin-aldosterone mechanism C) Increased sympathetic stimulation by the autonomic nervous system (ANS) D) Coarctation of the patient's aorta

B) Activation of the renin-angiotensin-aldosterone mechanism

6. Atherosclerotic peripheral vascular disease is symptomatic with at least 50% occlusion. The primary peripheral symptom, due to ischemia, is: A) edema. B) calf pain. C) varicosities. D) strong pulse.

B) calf pain.

13. Which of the following physiologic processes contributes most to the long-term regulation of blood pressure? A) Actions of the renin-angiotensin-aldosterone system B) Release of antidiuretic hormone (vasopressin) by the posterior pituitary C) Renal monitoring and adjustment of extracellular fluid volume D) Integration and modulation of autonomic nervous system (ANS)

C) Renal monitoring and adjustment of extracellular fluid volume

11. A 52-year-old man who is moderately obese has recently been diagnosed with hypertension by his primary care provider. Which of the patient's following statements indicates a need for further health-promotion teaching? A) "I've starting going to the gym before work three times a week." B) "I'm trying to cut back on the amount of salt that I cook with and add to my food." C) "I'm resolving to eat organic foods from now on and to drink a lot more water." D) "I'm planning to lose 15 pounds before the end of this year."

C) "I'm resolving to eat organic foods from now on and to drink a lot more water."

15. A patient with persistent, primary hypertension remains apathetic about his high blood pressure, stating, "I don't feel sick, and it doesn't seem to be causing me any problems that I can tell." How could a clinician best respond to this patient's statement? A) "Actually, high blood pressure makes you very susceptible to getting diabetes in the future." B) "That's true, but it's an indicator that you're not taking very good care of yourself." C) "You may not sense any problems, but it really increases your risk of heart disease and stroke." D) "You're right, but it's still worthwhile to monitor it in case you do develop problems."

C) "You may not sense any problems, but it really increases your risk of heart disease and stroke."

9. By definition, hypertension is systolic blood pressure of ____ mm Hg or higher or diastolic blood pressure of ____ mm Hg or higher. A) 129; 85 B) 138; 89 C) 140; 90 D) 155; 95

C) 140; 90

18. Which of the following patients should most likely be assessed for orthostatic hypotension? A) A 78-year-old woman who has begun complaining of frequent headaches unrelieved by over-the-counter analgesics. B) A patient whose vision has become much less acute in recent months and who has noticed swelling in her ankles. C) An elderly patient who has experienced two falls since admission while attempting to ambulate to the bathroom. D) A patient who has a history of poorly controlled type 1 diabetes.

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

1. Because cholesterol is insoluble in plasma, it is mainly carried by the lipoprotein: A) IDL. B) HDL. C) LDL. D) VLDL.

C) LDL.

20. A postsurgical patient's complaints of calf pain combined with the emergence of swelling and redness in the area have culminated in a diagnosis of deep vein thrombosis. What treatment options will be of greatest benefit to this patient? A) Analgesics and use of a pneumatic compression device B) Massage followed by vascular surgery C) Frequent ambulation and the use of compression stockings D) Anticoagulation therapy and elevation of the leg

D) Anticoagulation therapy and elevation of the leg

4. A serum marker for systemic inflammation, _______, is now considered a major risk factor marker for atherosclerosis, and vascular disease. A) leukocytosis B) homocysteine C) serum lipoprotein D) C-reactive protein

D) C-reactive protein

10. The patient is immobilized following a hip injury and has begun demonstrating lower leg discoloration with edema, pain, tenderness, and increased warmth in the mid-calf area. He has many of the manifestations of: A) stasis ulcerations. B) arterial insufficiency. C) primary varicose veins. D) deep vein thrombosis.

D) deep vein thrombosis.

5. Small-vessel vasculitides, a group of vascular disorders that cause vasculitis, are mainly mediated by:A) infectious agents. B) tissue necrosis. C) mononuclear cells. D) hypersensitivity reactions.

D) hypersensitivity reactions.

7. Although both are characterized by ischemia, Raynaud phenomenon is caused by _________, and thromboangiitis obliterans is caused by: A) occlusion; compression. B) thrombi; vasoconstriction. C) vasculitides; hypertension. D) vasospasm; inflammation.

D) vasospasm; inflammation.