Chapter 26 PrepU
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. a. Consume a diet rich in fruits, vegetables, and low-fat dairy products. b. Limit alcohol consumption. c. Stop smoking. d. Avoid aerobic physical activity. e. Reduce dietary sodium intake.
-Consume a diet rich in fruits, vegetables, and low-fat dairy products. -Limit alcohol consumption. -Stop smoking -Reduce dietary sodium intake
A client is diagnosed with gestational hypertension. The nurse recognizes which findings are characteristics of this condition? Select all that apply. a. Proteinuria b. Always accompanied by preeclampsia c. Development after 20th week of pregnancy d. Blood pressure greater than 140/90 e. Blood pressure back to normal by 12 weeks postpartum
-Development after 20th week of pregnancy -Blood pressure greater than 140/90 -Blood pressure back to normal by 12 weeks postpartum
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. a. Obesity b. Being female c. High salt consumption d. Poor performance in school e. Inactive lifestyle
-Obesity -High salt consumption -Inactive lifestyle
Following physical assessment, which abnormality(ies) leads the health care provider to suspect the client has metabolic syndrome? Select all that apply. a. Sitting blood pressure reading of 145/96 mm Hg b. Fasting triglyceride level of 230 mg/dL 92.6 mmol/L) c. Five foot (1.5 meter) tall female with abdominal waist measurement of 45 inches (114 cm) d. Fasting high-density lipoprotein (HDL) level of 80 mg/dL (2.07 mmol/L) e. Blood glucose level of 100 mg/dL (5.6 mmol/L)
-Sitting blood pressure reading of 145/96 mm Hg -Fasting triglyceride level of 230 mg/dL 92.6 mmol/L) -Five foot (1.5 meter) tall female with abdominal waist measurement of 45 inches (114 cm)
While working triage in the emergency department, which client report should alert the nurse to imminent danger and, thus, that client should be seen first? a. A client reporting painful urination and experiencing fever and chills. b. Athletic client reporting the kneecap popping in and out of socket. c. A client holding the abdomen and reporting a tearing and ripping feeling inside. d. A client with a history of chronic obstructive pulmonary disease (COPD) experiencing a productive cough with green sputum.
A client holding the abdomen and reporting a tearing and ripping feeling inside.
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? a. Activated cells that release free radicals oxidize LDL, which is harmful to the lining of your blood vessels. b. Activated cells roam the vascular system looking for inflammatory cells to engulf. c. The end result of oxidation is rupture of the plaque, resulting in hemorrhage. d. Oxidized free radicals produce toxic metabolic waste that can kill liver cells.
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? a. Activation of the renin-angiotensin-aldosterone mechanism b. Increased levels of adrenocortical hormones c. Coarctation of the aorta d. Increased sympathetic stimulation by the autonomic nervous system
Activation of the renin-angiotensin-aldosterone mechanism
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? a. Calcium channel blockers b. Beta-blockers c. Angiotensin-converting enzyme (ACE) inhibitors d. Angiotensin II receptor blockers
Angiotensin-converting enzyme (ACE) inhibitors
A pregnant female client is at risk for the development of preeclampsia-eclampsia. Select the most important data to assess. a. Blood pressure 160/100 mm Hg and proteinuria during the 30th week of pregnancy b. Blood pressure 90/60 and proteinuria in the second trimester c. Blood pressure 130/88 and hyperglycemia occurring during the 22nd week of pregnancy d. Blood pressure 140/90 and glucose in the urine during the 36th week of pregnancy
Blood pressure 160/100 mm Hg and proteinuria during the 30th week of pregnancy
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? a. C-reactive protein b. Lipoprotein(a) c. Homocysteine d. Triglycerides
C-reactive protein
Atherosclerotic peripheral vascular disease is symptomatic with at least 50% occlusion. Due to ischemia, which initial peripheral symptom is associated with this disease? a. Calf pain b. Bulging pulse c. Edema d. Varicosities
Calf pain
Which vascular changes can occur in older adults because of the increase in blood pressure during the aging process? a. Decreased elasticity in venous connective tissue b. Increased elasticity in venous connective tissue c. Increased elasticity in arterial connective tissue d. Decreased elasticity in arterial connective tissue
Decreased elasticity in arterial connective tissue
From which one of the following sites is a fatal pulmonary thromboembolism most likely to originate? a. Deep vein thrombophlebitis of the leg b. The hepatic vein in chronic passive congestion of the liver c. An atherosclerotic plaque in the aorta d. The endocardium over an acute myocardial infarction
Deep vein thrombophlebitis of the leg
What should the nurse teach the client with peripheral vascular disease and intermittent claudication about exercise? a. Clients with intermittent claudication should exercise only their arms. b. Exercise is not recommended in this population. c. Exercise can increase blood vessel growth and help to decrease symptoms. d. Aerobic exercise is not recommended but isometric exercise is.
Exercise can increase blood vessel growth and help to decrease symptoms.
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? a. Restlessness b. Hypotension c. Dry mouth d. Constipation
Hypotension
A nurse is teaching a client with newly diagnosed hypertension about antihypertensive drug therapy. The nurse determines that the knowledge is understood when the client correctly describes which of the following as the mechanism of action of an angiotensin-converting enzyme (ACE) inhibitor? a. Decreases the heart rate, which will cause a decrease in cardiac output b. Inhibits the movement of calcium into cardiac and vascular smooth muscle c. Inhibits the conversion of angiotensin I to angiotensin II, decreasing angiotensin II levels and reducing its effect on vasoconstriction d. Decreases vascular volume by suppressing renal reabsorption of sodium
Inhibits the conversion of angiotensin I to angiotensin II, decreasing angiotensin II levels and reducing its effect on vasoconstriction
Which lipoprotein is the main carrier of cholesterol? a. High-density lipoprotein (HDL) b. Very-low-density lipoprotein (VLDL) c. Intermediate-density lipoprotein (IDL) d. Low-density lipoprotein (LDL)
Low-density lipoprotein (LDL)
Autonomic nervous system control of blood pressure is mediated through which physiologic process? Select all that apply. a. Pain and strong emotion b. Aortic chemoreceptors c. Carotid artery chemoreceptors d. Hepatic secretions e. Baroreceptors in blood vessels
Pain and strong emotion Aortic chemoreceptors Carotid artery chemoreceptors Baroreceptors in blood vessels
Which of the following are characteristic signs of acute arterial embolism? a. Pain, increased blood pressure, and warmth b. Pallor, pulselessness, and pain c. Paralysis, warmth, and paranoia d. Purpura, muscle weakness, and shortness of breath
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? a. Rigidity of the ventricular walls b. Peripheral vascular resistance c. Release of stress hormones d. Electrical impulses in the heart
Peripheral vascular resistance
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: a. Vasculitis b. Raynaud phenomenon c. Thromboangiitis obliterans d. Atherosclerosis
Raynaud phenomenon
The nurse knows that which food is excluded from the Dietary Approaches to Stop Hypertension (DASH) diet? a. Poultry b. Whole grains c. Steak d. Nuts
Steak
A client has been diagnosed with a dissecting aortic aneurysm. It is most important for the nurse to assess the client for: a. Tearing or ripping-type pain in the chest or back b. Chest pain radiating to the right arm c. Tonic-clonic seizures d. Late hypertensive crisis
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? a. Vascular smooth muscle cells (SMCs) b. Extracellular matrix cells c. Collagen tissue d. Endothelial cells
Vascular smooth muscle cells (SMCs)
An older adult client is newly diagnosed with hypertension. Which vascular changes in the aging adult can lead to hypertension? a. increased elasticity of the venous connective tissue b. increased elasticity of the arterial connective tissue c. decreased elasticity of the aorta and large arteries d. decreased elasticity of the venous connective tissue
decreased elasticity of the aorta and large arteries
A client is prescribed an angiotensin-converting enzyme (ACE) inhibitor for hypertension. The nurse questions the prescription of an ACE inhibitor for a client with which condition? a. coronary artery disease b. heart failure c. renal artery stenosis d. diabetes
renal artery stenosis
