Patho Exam 3 Ch 18

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."

A young woman has been diagnosed by her family physician with primary Raynaud disease. The woman is distraught, stating, "I've always been healthy and I can't believe I have a disease now." What would be her physician's most appropriate response?

"If you make sure to keep yourself warm, it will have a fairly minimal effect; I'll also give you pills to enhance your circulation."

If a virus has caused inflammation resulting in endothelial dysfunction, an excessive amount of endothelins in the blood can result in:

Contraction of the underlying smooth muscles within the vessels.

Which of the following patients is at greatest risk for orthostatic hypotension?

A 66-year-old post-surgery patient on bed rest.

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 the abdomen.

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.

The nurse knows that the primary long term regulation of blood pressure is exerted by which of the following?

The kidneys.

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.

When a 55 year old patients 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."

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 would the nurse best respond to this patient's statement?

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

The nurse knows that systolic hypertension is characterized by systolic pressure of ____mm Hg or higher.

140.

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.

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 mm Hg.

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.

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

Baroreceptors.

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?

Blacks and south Asians.

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.

The nurse recognizes which of the following as normal age-related blood pressure? Select all that apply.

Blood pressure in newborn infants is approximately 50 mm Hg systolic, Blood pressure at age 10 days is 78 mm Hg systolic, and Blood pressure at age 25 years is ideal at 120 mm Hg systolic.

A 56-year-old male patient has been diagnosed with hypercholesterolemia. Which of the following are the lab results that support this diagnosis?

Cholesterol 250 mg/dL and HDL 32 mg/dL.

A patient has developed secondary hypertension. The nurse knows that causes of secondary hypertension include which of the following? Select all that apply.

Cushing's syndrome, oral contraceptives, aortic coarctation, and pheochromocytoma.

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.

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

Dizziness and fainting.

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?

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

A client has been diagnosed with diabetes mellitus. Which of the following lab results would the practitioner expect?

Elevation of triglycerides.

Raynaud disease or phenonemon is a functional disorder caused by intense vasospasm of the arteries and arterioles in which of the following?

Fingers.

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.

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 patient comes to the clinic complaining of anorexia, weight loss, fever, fatigue along with paresthesias, pain, and weakness of the lower extremities. Assessment findings include reddish blue, mottled areas of discoloration to the skin of the lower extremities. Laboratory findings include an elevated erythrocyte sedimentation rate, leukocytosis, anemia, and abnormal liver function tests. A diagnosis of necrotizing vasculitis is confirmed through biopsy. The nurse anticipates treatment with which of the following medications?

High-dose corticosteroid therapy and cytotoxic immunosuppressant agents.

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.

The nurse practitioner's examination of a client reveals xanthomas along the client's tendons. Which of the following tests will the practitioner order?

LDL level.

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.

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.

Limit alcohol consumption, stop smoking, reduce dietary sodium intake, and consume a diet rich in fruits, vegetables, and low-fat dairy products.

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, and inactive lifestyle.

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

Patient on bed rest.

The nurse is reviewing the lipid results of four clients. Select the client at greatest risk for cardiovascular disease.

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

A patient's blood pressure is persistently in the range of 130-135 mm Hg systolic and 85-88 mm Hg diastolic. The nurse knows that which of the following conditions correctly describes this patient's blood pressure?

Prehypertension.

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 an African American 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 pounds in the past year. Which of the following are nonmodifiable risk factors associated with this diagnosis? Select all that apply.

Race, and family history.

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.

Which of the following is the site of chylomicron synthesis?

Small intestine.

A client has just been diagnosed with hypercholesterolemia and is asking what treatment will be needed. The best response would be: Select all that apply.

Smoking cessation, dietary measures to reduce LDL levels, and weight reduction if overweight.

A 60-year-old woman who has lost an extensive amount of blood in a work-related accident says that when her blood pressure was checked in the hospital, the top number (systolic pressure) was lower than usual but the bottom number (diastolic pressure) was about the same. The nurse recognizes that which of the following accounts for this lack of change in the diastolic pressure?

Systemic vasoconstriction maintained the diastolic pressure.

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.

A physiotherapist is measuring the lying, sitting, and standing blood pressure of a patient who has been admitted to hospital following a syncopal episode and recent falls. Which of the following facts about the patient best relate to these health problems?

The client is 89 years old and takes a diuretic medication for his congestive heart failure.

The client has been diagnosed with Raynaud disease. Which treatment measure will the nurse teach the client?

The client must protect the entire body from cold, not just the extremities.

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

Tunica Media.

Which of the following is associated with stasis of blood, increased blood coagulability and vessel wall injury?

Venous thrombosis.

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.