1. A 74-year-old man is being assessed by a nurse as part of a weekly, basic health
assessment at the long-term care facility where he resides. His blood pressure at the time
is 148/97 mm Hg, with a consequent pulse pressure of 51 mm Hg. The nurse would
recognize that which of the following is the most significant determinant of the
resident's pulse pressure?
A) Blood volume, resistance, and flow
B) The cardiac reserve or possible increase in cardiac output over normal resting
level
C) The amount of blood that his heart ejects from the left ventricle during each beat
D) The relationship between total blood volume and resting heart rate
Ans: C
Feedback:
Pulse pressure is a reflection of the amount of blood that the heart ejects from the left
ventricle during each beat combined with the distensibility of the atrial tree. Other
factors such as blood flow characteristics, cardiac reserve, heart rate, and blood volume
are less directly associated with pulse pressure.
m
er as
co
eH w
2. At 4 AM, the hemodynamic monitor for a critically ill client in the intensive care unit
indicates that the client's mean arterial pressure is at the low end of the normal range; at
o.
6 AM, the client's MAP has fallen definitively below normal. The client is at risk for
A) rs e
pulmonary hypertension.
ou urc
B) left ventricular hypertrophy.
C) organ damage and hypovolemic shock.
D) orthostatic hypotension.
o
Ans: C
aC s
Feedback:
vi y re
The mean arterial pressure, which represents the average blood pressure in the systemic
circulation, is a good indicator of tissue perfusion. Hospitalization and bed rest
predispose to dehydration and low blood volume. Blood pressure normally follows a
diurnal pattern in which pressures are highest in the morning. The fact that this client's
ed d
MAP is falling at a time when it should be at its daily peak is the cause for grave
ar stu
concern; blood volume is likely low, and vital organs, which depend on adequate
perfusion, are at risk.
is
3. The nurse practitioner working in an overnight sleep lab is assessing and diagnosing
Th
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?
A) During apneic periods, the patient experiences hypoxemia that stimulates
sh
chemoreceptors to induce vasoconstriction.
B) When the patient starts to snore, his epiglottis is closed over the trachea.
C) When the airway is obstructed, specialized cells located in the back of the throat
send signals to the kidney to increase pulse rate.
D) When airways are obstructed, the body will retain extracellular fluid so that this
Page 1
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, fluid can be shifted to intravascular space to increase volume.
Ans: A
Feedback:
People with sleep apnea also may experience an increase in BP because of the
hypoxemia that occurs during the apneic periods. The specialized chemoreceptors are
located in carotid bodies and aortic bodies of the aorta. Retention of fluid is not the
cause of increased BP during sleep apnea episodes.
4. A 54-year-old man with a long-standing diagnosis of essential hypertension is meeting
with his physician. The patient's physician would anticipate that which of the following
phenomena is most likely occurring?
A) The patient's juxtaglomerular cells are releasing aldosterone as a result of
sympathetic stimulation.
B) Epinephrine from his adrenal gland is initiating the renin–angiotensin–aldosterone
system.
m
er as
C) Vasopressin is exerting an effect on his chemoreceptors and baroreceptors
resulting in vasoconstriction.
co
eH w
D) The conversion of angiotensin I to angiotensin II in his lungs causes increases in
blood pressure and sodium reabsorption.
o.
Ans: D
Feedback: rs e
ou urc
Angiotensin conversion in the lungs is a component of the renin–angiotensin–
aldosterone system that ultimately increases blood pressure and sodium reabsorption.
Juxtaglomerular cells release renin, and epinephrine (vasopressin) is responsible for
o
neither initiating the renin–angiotensin–aldosterone system nor directly influencing
aC s
chemoreceptors and baroreceptors.
vi y re
5. A group of novice nursing students are learning how to manually measure a client's
blood pressure using a stethoscope and sphygmomanometer. Which of the following
ed d
statements by students would the instructor most likely need to correct?
ar stu
A) “I'll inflate the cuff around 30 mm Hg above the point at which I can't palpate the
client's pulse.”
B) “If my client's arm is too big for the cuff, I'm going to get a BP reading that's
is
artificially low.”
C) “The accuracy of the whole process depends on my ability to clearly hear the
Th
Korotkoff sounds with the bell of my stethoscope.”
D) “With practice, my measurement of clients' blood pressures with this method will
be more accurate than with automated machines.”
Ans: B
sh
Feedback:
Undercuffing yields a blood pressure reading that is overestimated. The cuff should
indeed be inflated to 30 mm Hg above palpated systolic pressure and is both dependent
on clear auscultation of the Korotkoff sounds. The properly performed manual method
is more accurate than automated measurement.
Page 2
This study source was downloaded by 100000805705997 from CourseHero.com on 06-30-2021 06:41:22 GMT -05:00
https://www.coursehero.com/file/15037189/Chapter-31-Disorders-of-Blood-Pressure-Regulation/
assessment at the long-term care facility where he resides. His blood pressure at the time
is 148/97 mm Hg, with a consequent pulse pressure of 51 mm Hg. The nurse would
recognize that which of the following is the most significant determinant of the
resident's pulse pressure?
A) Blood volume, resistance, and flow
B) The cardiac reserve or possible increase in cardiac output over normal resting
level
C) The amount of blood that his heart ejects from the left ventricle during each beat
D) The relationship between total blood volume and resting heart rate
Ans: C
Feedback:
Pulse pressure is a reflection of the amount of blood that the heart ejects from the left
ventricle during each beat combined with the distensibility of the atrial tree. Other
factors such as blood flow characteristics, cardiac reserve, heart rate, and blood volume
are less directly associated with pulse pressure.
m
er as
co
eH w
2. At 4 AM, the hemodynamic monitor for a critically ill client in the intensive care unit
indicates that the client's mean arterial pressure is at the low end of the normal range; at
o.
6 AM, the client's MAP has fallen definitively below normal. The client is at risk for
A) rs e
pulmonary hypertension.
ou urc
B) left ventricular hypertrophy.
C) organ damage and hypovolemic shock.
D) orthostatic hypotension.
o
Ans: C
aC s
Feedback:
vi y re
The mean arterial pressure, which represents the average blood pressure in the systemic
circulation, is a good indicator of tissue perfusion. Hospitalization and bed rest
predispose to dehydration and low blood volume. Blood pressure normally follows a
diurnal pattern in which pressures are highest in the morning. The fact that this client's
ed d
MAP is falling at a time when it should be at its daily peak is the cause for grave
ar stu
concern; blood volume is likely low, and vital organs, which depend on adequate
perfusion, are at risk.
is
3. The nurse practitioner working in an overnight sleep lab is assessing and diagnosing
Th
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?
A) During apneic periods, the patient experiences hypoxemia that stimulates
sh
chemoreceptors to induce vasoconstriction.
B) When the patient starts to snore, his epiglottis is closed over the trachea.
C) When the airway is obstructed, specialized cells located in the back of the throat
send signals to the kidney to increase pulse rate.
D) When airways are obstructed, the body will retain extracellular fluid so that this
Page 1
This study source was downloaded by 100000805705997 from CourseHero.com on 06-30-2021 06:41:22 GMT -05:00
https://www.coursehero.com/file/15037189/Chapter-31-Disorders-of-Blood-Pressure-Regulation/
, fluid can be shifted to intravascular space to increase volume.
Ans: A
Feedback:
People with sleep apnea also may experience an increase in BP because of the
hypoxemia that occurs during the apneic periods. The specialized chemoreceptors are
located in carotid bodies and aortic bodies of the aorta. Retention of fluid is not the
cause of increased BP during sleep apnea episodes.
4. A 54-year-old man with a long-standing diagnosis of essential hypertension is meeting
with his physician. The patient's physician would anticipate that which of the following
phenomena is most likely occurring?
A) The patient's juxtaglomerular cells are releasing aldosterone as a result of
sympathetic stimulation.
B) Epinephrine from his adrenal gland is initiating the renin–angiotensin–aldosterone
system.
m
er as
C) Vasopressin is exerting an effect on his chemoreceptors and baroreceptors
resulting in vasoconstriction.
co
eH w
D) The conversion of angiotensin I to angiotensin II in his lungs causes increases in
blood pressure and sodium reabsorption.
o.
Ans: D
Feedback: rs e
ou urc
Angiotensin conversion in the lungs is a component of the renin–angiotensin–
aldosterone system that ultimately increases blood pressure and sodium reabsorption.
Juxtaglomerular cells release renin, and epinephrine (vasopressin) is responsible for
o
neither initiating the renin–angiotensin–aldosterone system nor directly influencing
aC s
chemoreceptors and baroreceptors.
vi y re
5. A group of novice nursing students are learning how to manually measure a client's
blood pressure using a stethoscope and sphygmomanometer. Which of the following
ed d
statements by students would the instructor most likely need to correct?
ar stu
A) “I'll inflate the cuff around 30 mm Hg above the point at which I can't palpate the
client's pulse.”
B) “If my client's arm is too big for the cuff, I'm going to get a BP reading that's
is
artificially low.”
C) “The accuracy of the whole process depends on my ability to clearly hear the
Th
Korotkoff sounds with the bell of my stethoscope.”
D) “With practice, my measurement of clients' blood pressures with this method will
be more accurate than with automated machines.”
Ans: B
sh
Feedback:
Undercuffing yields a blood pressure reading that is overestimated. The cuff should
indeed be inflated to 30 mm Hg above palpated systolic pressure and is both dependent
on clear auscultation of the Korotkoff sounds. The properly performed manual method
is more accurate than automated measurement.
Page 2
This study source was downloaded by 100000805705997 from CourseHero.com on 06-30-2021 06:41:22 GMT -05:00
https://www.coursehero.com/file/15037189/Chapter-31-Disorders-of-Blood-Pressure-Regulation/
