Chapter 26 PrepU

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

Which client is at greatest risk for orthostatic hypotension?

A 66-year-old postoperative client on bed rest

A 52-year-old man who is moderately obese has recently been diagnosed with hypertension by the health care provider. Which client statement indicates a need for further health promotion teaching?

"I'm going to eat organic foods from now on but I'm glad I don't have to watch my fat intake

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."

The nurse knows that which statements regarding the physiology of blood pressure are accurate? Select all that apply

-Blood pressure is very variable. -Constant elevation of blood pressure can be lethal. -A decrease in blood flow can be an immediate threat to life.

Following physical assessment, which abnormality(ies) leads the health care provider to suspect the client has metabolic syndrome? Select all that apply.

-Sitting blood pressure reading of 145/96 mm Hg -Five foot (1.5 meter) tall female with abdominal waist measurement of 45 inches (114 cm) -Fasting triglyceride level of 230 mg/dL 92.6 mmol/L)

Which hypertensive individual is most likely to have his or her high blood pressure diagnosed as secondary rather than essential?

51-year-old man who has been diagnosed with glomerulonephritis

Because of its location, the presence of an abdominal aortic aneurysm may first be identified by which clinical manifestation?

A pulsating mass

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

A pulsating mass in the abdomen

The nurse knows that the renin-angiotensin-aldosterone system (RAAS) is an important mechanism in blood pressure control. Which physiologic events will activate this system? Select all that apply.

Adrenergic (sympathetic) stimulation Decreased blood sodium Fall in blood pressure Decreased blood volume

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

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

Baroreceptors

Which vascular changes can occur in older adults because of the increase in blood pressure during the aging process?

Decreased elasticity in arterial connective tissue

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

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.

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

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

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?

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

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

It is the most common cardiovascular disorder. The incidence increases with age. The systolic pressure is ≥140 mm Hg

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

Which of the following are characteristic signs of acute arterial embolism?

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

Peripheral vascular resistance

The nurse knows that vasopressin (antidiuretic hormone, ADH) plays which role in blood pressure control?

Promotes retention of water

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:

Pulmonary Embolism

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

The nurse knows that which food is excluded from the Dietary Approaches to Stop Hypertension (DASH) diet?

Steak

The postoperative client has a catheter in his brachial artery for continuous blood pressure monitoring. Which assessment would be a concern for the nurse?

The client states his hand is numb.

A 54-year-old man with a long-standing diagnosis of essential hypertension is meeting with his physician. The client's physician would anticipate that which phenomenon is most likely occurring?

The conversion of angiotensin I to angiotensin II in his lungs causes increases in blood pressure and sodium reabsorption.

The client undergoes a cardiac catheterization to evaluate symptoms of chest pain and shortness of breath. The test shows lesions in the coronary arteries that have begun to reduce the size of the vessel lumen. This type of lesion is known as:

Thrombus

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)

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 with hypercholesterolemia is being treated with diet and exercise. Which assessment finding is a positive outcome of this treatment regimen?

increased high-density lipoproteins