Porth's Pathophysiology, Concepts of Altered Health States 9th Edition by Sheila Grossman-Carol Mattson Porth
Porth's Pathophysiology, Concepts of Altered Health States 9th Edition by Sheila Grossman-Carol Mattson Porth
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Chapter 31- Disorders of Blood Pressure Regulation
Complete Chapter Questions With Answers
Sample Questions Are Posted Below
| 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. | ||
| 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 6 AM, the client’s MAP has fallen definitively below normal. The client is at risk for | |
| A) | pulmonary hypertension. | |
| B) | left ventricular hypertrophy. | |
| C) | organ damage and hypovolemic shock. | |
| D) | orthostatic hypotension. | |
| Ans: | C | |
| Feedback: | ||
| 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 MAP is falling at a time when it should be at its daily peak is the cause for grave concern; blood volume is likely low, and vital organs, which depend on adequate perfusion, are at risk. | ||
| 3. | The nurse practitioner working in an overnight sleep lab is 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? | |
| A) | During apneic periods, the patient experiences hypoxemia that stimulates 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 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. | |
| C) | Vasopressin is exerting an effect on his chemoreceptors and baroreceptors resulting in vasoconstriction. | |
| D) | The conversion of angiotensin I to angiotensin II in his lungs causes increases in blood pressure and sodium reabsorption. | |
| Ans: | D | |
| Feedback: | ||
| 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 neither initiating the renin–angiotensin–aldosterone system nor directly influencing chemoreceptors and baroreceptors. | ||
Original price was: $30.00.$20.00Current price is: $20.00.
Original price was: $30.00.$20.00Current price is: $20.00.
Original price was: $30.00.$20.00Current price is: $20.00.
Original price was: $30.00.$20.00Current price is: $20.00.
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