N520_CH16_HTN_Evolve_Questions

Which statement is true about baroreceptors? a) They are sensitive to changes in cardiac output (CO) and systemic vascular resistance (SVR). b) They alter the mean arterial pressure (MAP) to regulate blood pressure. c) An increase in pressure causes an increase in impulse discharge. d) They are located in the left ventricle.

An increase in pressure causes an increase in impulse discharge. An increase in pressure (MAP) causes an increase in discharge of the baroreceptors. An increase in firing of the baroreceptors causes a decrease in sympathetic outflow. Baroreceptors alter CO and SVR. Changes in MAP affect the baroreceptors. Baroreceptors are located in the carotid sinus and arch of the aorta.

The renin-angiotensin system (RAS) alters blood pressure in response to a) decreased flow to the brain. b) decreased perfusion to the liver. c) decreased perfusion to the lungs. d) decreased perfusion to the kidney.

Decreased perfusion to the kidney When blood flow is restricted to the kidney by low blood volume, low cardiac output, or stricture of the renal artery, the kidney secretes more renin into the bloodstream, which in turn changes angiotensinogen to angiotensin I. Angiotensin-converting enzyme (ACE) then changes angiotensin I to a potent vasoconstrictor, angiotensin II. Angiotensin II then increases vascular constriction, systemic vascular resistance, and blood pressure. The renin-angiotensin system (RAS) is not associated with the brain, liver, or lungs.

Systemic vascular resistance (SVR) can be indirectly estimated with the use of which blood pressure measurement? a) Systolic pressure b) Diastolic pressure c) Pulmonary arterial pressure d) Left ventricular end-diastolic pressure

Diastolic Pressure The systemic diastolic pressure is determined by the narrowing of blood vessel diameter and therefore the resistance to blood flow, whether from peripheral vascular constriction or atherosclerosis. Systolic pressure is not as influenced by the narrowing of blood vessel diameter. Pulmonary arterial pressure is generated by the right ventricle ejecting blood into the pulmonary artery. By definition, the volume of blood within a ventricle immediately before a contraction is known as the end-diastolic volume.

Which statement is true regarding hypertension? a) Hypertension is defined as pressure greater than 160 mm Hg systolic. b) High blood pressure can be associated with headache and seizures. c) Diagnosis can be made with one elevated reading. d) Low weight contributes to high blood pressure.

High blood pressure can be associated with headache and seizures. Headache and seizures are associated with high blood pressure. The actual definition of high blood pressure is a systolic pressure greater than 140 mm Hg or a diastolic pressure greater than 90 mm Hg, or both. The diagnosis of hypertension requires the recording on two separate occasions of these elevations. Obesity, elevated sodium intake, age, ethnicity, and family history are all causes of high blood pressure.

Which situation causes an increase in blood pressure? a) Blood loss Incorrect b) Dehydration c) Prolonged bed rest d) Intracerebral hemorrhage

Intracerebral hemorrhage Intracerebral hemorrhage and intracranial hematomas are two of the neurologic causes for increased blood pressure through increased secretion of catecholamines. Blood loss, dehydration, and prolonged bed rest can result in hypotension.

Which best defines systolic blood pressure? a) occurs during passive elastic recoil of the aorta b) is the sole function of aortic compliance c) occurs during ventricular contraction d) averages 70 mmHg

Occurs during ventricular contraction Systolic blood pressure occurs during ventricular contraction and is a function of volume ejected and the compliance of the aorta. The diastolic blood pressure occurs during passive elastic recoil of the aorta and is an average of 70 mm Hg. The diastolic blood pressure occurs during passive elastic recoil of the aorta. Systolic blood pressure is a function of volume ejected and the compliance of the aorta, and averages 120 mm Hg.

Which term is determined by stroke volume, speed of ejection, and arterial distensibility? a) arterial pulse pressure b) mean arterial pressure c) diastolic pressure d) pulse pressure

Pulse pressure Pulse pressure is determined by stroke volume, speed of ejection of the stroke volume, and arterial distensibility. Arterial pulse pressure is the difference between the systolic and diastolic blood pressure. Mean arterial pressure is the average pressure in the circulating system throughout the cardiac cycle. Diastolic pressure is the pressure excreted during the rest phase of the cardiac cycle.

Which term is used to identify hypertension that has a specific disease as its cause? a) Primary b) Essential c) Idiopathic d) Secondary

Secondary Secondary is the term given to hypertension that is secondary to a specific disease. Idiopathic, primary, and essential hypertensions are interchangeable terms for hypertension that cannot be related to a specific disease/cause.

Which is a major determinant of diastolic blood pressure? a) Vascular Resistance b) Stroke volume c) Preload d) Heart rate

Vascular resistance Systemic vascular resistance is the major determinant of diastolic blood pressure. It reflects the arteriolar radius and the degree of constriction, and it is the main variable in determining afterload. Stroke volume is the primary factor impacting systolic pressure. The end-diastolic volume is determined by the amount of blood returned to the heart between contractions, and is typically called the heart's preload. Heart rate is the number of times the heart contracts within a 60-second timeframe.

Risk factors for the development of high blood pressure are which of the following? (Select all that apply.) a) Age b) Race c) Diet d) Weight e) Chronic illness

a) Age b) Race c) Diet d) Weight The older a person is, the less elastic the blood vessels are, which results in higher systemic vascular resistance. High blood pressure occurs two to three times more frequently in the African American population than in the Caucasian population. Diets high in fat and sodium have been associated with hypertension. An association with elevated body mass index and high blood pressure has been noted; however, the exact mechanism is unclear. Chronic illness will not necessarily result in hypertension.

Which is a risk factor associated with hypertension? (Select all that apply.) a) Age b) Caucasian race c) African American race d) High potassium intake e) History of tobacco smoking

a) Age c) African American race e) History of tobacco smoking Normal aging produces a rising systolic pressure over the course of a lifetime, whereas diastolic pressure increases for approximately 50 years, levels off during the sixth decade, and remains stable or declines later on. African Americans are predisposed to hypertension. Also, tobacco use has been shown to increase the risk of hypertension. Being Caucasian is not a known risk factor for hypertension. Diets high in fat and sodium, and low in potassium have been found to increase the risk of developing hypertension.

High blood pressure can be treated with lifestyle modification related to which of the following? (Select all that apply.) a) Decreased sodium intake b) Relaxation techniques c) Weight management d) Medication therapy e) Exercise

a) Decreased sodium intake b) Relaxation techniques c) Weight management e) Exercise A low-sodium diet decreases sodium retention and blood volume, altering stroke volume and cardiac output, which results in a lower blood pressure. Relaxation techniques help manage stress which helps lower blood pressure. Obesity is a major risk factor for hypertension. Exercise increases vascular tone, thus decreasing systemic vascular resistance and blood pressure. Medication therapy is not considered a lifestyle modification.

Systemic blood pressure is determined by which factor(s)? (Select all that apply.) a) Heart rate (HR) b) Stroke volume (SV) c) Cardiac output (CO) d) Systemic vascular resistance (SVR) e) Pulmonary vascular resistance (PVR)

a) Heart rate (HR) b) Stroke volume (SV) c) Cardiac output (CO) d) Systemic vascular resistance (SVR) The systemic arterial blood pressure is the physiologic result of the cardiac output (CO) and the resistance to the ejection (SVR) of blood from the heart. Cardiac output is the product of two variables: stroke volume (SV) and heart rate (HR) (CO = SV × HR). SV is the specific volume of blood leaving the heart with each contraction. Pulmonary vascular resistance (PVR) is not a factor in determining systemic blood pressure.

What stimulates the release of renin? (Select all that apply.) a) Increased heart rate b) Renal hypoperfusion c) Sympathetic activation d) Parasympathetic activation e) Decreased sodium delivery

b) Renal hypoperfusion c) sympathetic activation e) decreased sodium delivery Renal hypoperfusion, sympathetic activation, and decreased sodium delivery stimulate renin release. Increased heart rate and parasympathetic activation do not stimulate the release of renin.

Which condition is an endocrine disorder that causes elevated blood pressure? (Select all that apply.) a) Guillain-Barré syndrome b) Coarctation of the aorta c) Pheochromocytoma d) Cushing disease e) Hyperthyroidism

d) Cushing disease e) Hyperthyroidism Endocrine disorders that result in hypertension include Cushing disease and hyperthyroidism. While Guillain-Barré syndrome results in hypertension, it is neurologic disorder. While coarctation of the aorta causes high blood pressure, it is a cardiac disorder. While pheochromocytoma causes high blood pressure, it is a tumor of adrenal gland tissue.

Aortic and carotid baroreceptors are activated by ___________, resulting in ___________. a) increased blood pressure; a decrease in blood pressure b) decreased blood pressure; normalization of blood pressure c) decreased blood pressure; an increase in cardiac output (CO), systemic vascular resistance (SVR), heart rate (HR), and blood pressure d) decreased blood pressure; a decrease in cardiac output (CO), systemic vascular resistance (SVR), heart rate (HR), and blood pressure

decreased blood pressure; an increase in cardiac output (CO), systemic vascular resistance (SVR), heart rate (HR), and blood pressure The aortic and carotid baroreceptors respond to a decrease in blood pressure by stimulating the sympathetic nervous system of the heart and vascular bed, increasing heart rate, cardiac output, and systemic vascular resistance. They also inhibit the parasympathetic nervous system's influence on the heart, which results in an increased heart rate. Aortic and carotid baroreceptors are activated by a decrease in blood pressure, but the results are not the normalization of blood pressure, but rather an increase in cardiac output (CO), systemic vascular resistance (SVR), heart rate (HR), and blood pressure.

Cardiac output is the product of both a) mean arterial pressure (MAP) and systemic vascular resistance (SVR) b) systemic vascular resistance (SVR) and pulse pressure c) pulse pressure and mean arterial pressure (MAP) d) stroke volume and heart rate

stroke volume and heart rate The product of stroke volume and heart rate provides the amount of cardiac output. None of the other options (MAP, SVR, or pulse pressure) are factors in cardiac output.

Which receptor is responsible for innervation of the arterioles? a) β-1 b) β-2 c) α-1 d) α-2

α-1 α-1 receptors are responsive to stimulation by the autonomic nervous system. Stimulation of the α-1 receptor causes vasoconstriction and increased systemic vascular resistance. Renin release is increased when neurotransmitters released by the sympathetic nervous system bind to β1 receptors in the kidney. β-adrenergic agonists, also known as β2-adrenergic receptor agonists, are a class of drugs used to treat asthma and other pulmonary disease states. α2-adrenergic receptors mediate part of the diverse biological effects of the endogenous catecholamines epinephrine and norepinephrine