A 75-year-old obese patient with female genitalia presents to the primary care provider
reporting edema in the lower extremities. Physical examination rev... [Show More] eals that the patient has
varicose veins and chronic venous insufficiency. Upon performing the history, which of the
following is a possible cause for the varicose veins? a. Extreme exercise
b. Long periods of standing
c. Trauma to the deep veins
d. Ischemia
ANS: B
The probable cause of the patient’s varicose veins is gradual venous distension caused by the action of
gravity on blood in the legs due to long periods of standing. Varicose veins are most likely due to long
periods of standing leading to the action of gravity promoting venous distension. Exercise would help
prevent this. Trauma can occur, but usually this affects the more superficial veins. Ischemia affects
arteries, not veins.
DIF: Cognitive Level: Analyze REF: Varicose Veins and Chronic Venous Insufficiency TOP: Physiological
Integrity
2. A 52-year-old patient with male genitalia presents with pooling of blood in the veins of the
lower extremities and edema. The diagnosis is chronic venous insufficiency. What is an
expected assessment finding of this disorder? a. Deep vein thrombus formation
b. Skin hyperpigmentation
c. Gangrene
d. Edema above the knee
ANS: B
Symptoms include edema of the lower extremities and hyperpigmentation of the skin of the feet and
ankles but deep vein thrombi do not form. Edema in these areas may extend to the knees but not above.
Gangrene does not occur in veins but in arteries.
DIF: Cognitive Level: Analyze REF: Varicose Veins and Chronic Venous Insufficiency
TOP: Physiological Integrity
lOMoARcPSD|5422489
3. Superior vena cava syndrome (SVCS), causing venous distension in the upper extremities, is a
result of progressive superior vena cava: a. inflammation.
b. occlusion.
c. distension.
d. sclerosis.
ANS: B
SVCS is a progressive occlusion of the SVC that leads to venous distension in the upper extremities
and head. This distension is not a result of progressive inflammation, distension, or sclerosis.
DIF: Cognitive Level: Understand REF: Superior Vena Cava Syndrome TOP: Physiological
Integrity
4. A 50-year-old patient with male genitalia with a 30-year history of smoking was diagnosed with
bronchogenic cancer. The patient developed edema and venous distension in the upper
extremities and face. Which of the following diagnosis will the nurse observe on the chart? a.
Thromboembolism
b. Deep vein thrombosis
c. Superior vena cava syndrome (SVCS)
d. Chronic venous insufficiency
ANS: C
SVCS is a progressive occlusion of the superior vena cava that leads to venous distension in the upper
extremities and head. Thromboembolism would not lead to the generalized symptoms described in the
patient. Deep vein thrombosis would not lead to upper extremity symptoms. Chronic venous
insufficiency would primarily affect one extremity.
DIF: Cognitive Level: Analyze REF: Superior Vena Cava Syndrome
TOP: Physiological Integrity
5. When a patient is diagnosed with coronary artery disease, what condition should the nurse also
consider?
a. Myocardial hypertrophy
b. Myocardial ischemia
c. Cardiac necrosis
d. Systemic inflammation
ANS: B
lOMoARcPSD|5422489
Coronary artery disease leads to myocardial ischemia. Coronary artery disease would not lead to
hypertrophy, necrosis, or systemic inflammation.
DIF: Cognitive Level: Understand REF: Table 24.2 TOP: Physiological Integrity
6. A nurse takes an adult patient’s blood pressure and determines it to be normal. What reading did
the nurse obtain?
a. Systolic pressure between 140 and 150 mm Hg
b. Systolic pressure less than 120 mm Hg and diastolic pressure less than 80 mm Hg
c. Systolic pressure less than 100 mm Hg regardless of diastolic pressure
d. Systolic pressure greater than 140 mm Hg and a diastolic pressure of 100 mm Hg
ANS: B
Normal blood pressure has a systolic pressure less than 120 mm Hg and diastolic pressure less than 80
mm Hg. A systolic pressure of 140 mm Hg or more would indicate stage I hypertension. A systolic
pressure of less than 100 mm Hg would indicate low blood pressure. A diastolic pressure greater than
90 mm Hg would indicate hypertension.
DIF: Cognitive Level: Understand REF: Table 24.1 TOP: Physiological Integrity
7. Most cases of combined systolic and diastolic hypertension have no known cause and are
documented on the chart as _____ hypertension. a. primary
b. secondary
c. congenital
d. acquired
ANS: A
Most cases of hypertension are diagnosed as primary hypertension, not secondary, which is due to a
known cause. Most cases of hypertension are not a result of congenital or acquired causes.
DIF: Cognitive Level: Understand REF: Hypertension
TOP: Physiological Integrity
8. A 30-year-old white patient with female genitalia was recently diagnosed with primary
hypertension. She reports that she eats fairly well, and has a moderate red meat consumption.
She also reports that her father and grandmother have hypertension. A nurse determines which
of the following risk factors is most likely associated with this diagnosis? a. Ethnicity
b. Diet
c. Age
d. Family history
lOMoARcPSD|5422489
ANS: D
A family history of hypertension can be a risk factor for the development of the disease. Ethnicity and
diet may be factors, but less significant than her family history. Age is a factor, but not in this case;
since the patient is 30, genetics is a greater factor.
DIF: Cognitive Level: Understand REF: Hypertension
TOP: Physiological Integrity
9. A 52-year-old is diagnosed with primary hypertension but has no other health problems. What
might be the first consideration for managing the condition? a. A beta-adrenergic agonist
b. An alpha-adrenergic agonist
c. A recommendation to reduce sodium intake
d. A calcium channel agonist
ANS: C
Hypertension Canada recommends starting with lifestyle changes when treating hypertension.
Reducing salt intake has significant effects on lowering blood pressure. A beta-adrenergic, an alpha-
adrenergic, or a calcium channel agonist drug would be used for patients with other concurrent health
problems.
DIF: Cognitive Level: Understand REF: Superior Vena Cava Syndrome
TOP: Physiological Integrity
10. When a nurse checks the patient for orthostatic hypotension, what activity did the nurse have
the patient engage in? a. Physical exertion
b. Eating
c. Standing up
d. Lying down
ANS: C
Orthostatic hypotension refers to a drop in blood pressure when standing up, not a drop with exertion,
eating, or lying down.
DIF: Cognitive Level: Understand REF: Orthostatic (Postural) Hypotension TOP: Physiological
Integrity
11. A patient is diagnosed with orthostatic hypotension. Which of the following symptoms would
most likely be reported?
a. Headache and blurred vision
b. Nausea and vomiting
lOMoARcPSD|5422489
c. Chest pain and palpitations
d. Syncope and fainting
ANS: D
Orthostatic hypotension is often accompanied by dizziness, blurring or loss of vision, and syncope or
fainting, not by headache or blurred vision, which are symptoms of hypertension. Chest pain and
palpitations may be symptomatic of myocardial infarction. Nausea and vomiting are associated with
gastrointestinal issues.
DIF: Cognitive Level: Understand REF: Orthostatic (Postural) Hypotension TOP: Physiological
Integrity
12. A patient presents to the emergency department reporting difficulty swallowing and shortness
of breath. A CT scan would most likely reveal an aneurysm in the: a. cerebral vessels.
b. renal arteries.
c. inferior vena cava.
d. thoracic aorta.
ANS: D
Thoracic aortic aneurysms can cause dysphagia (difficulty swallowing) and dyspnea (breathlessness).
Aneurysms in cerebral vessels will produce a headache. Aneurysms in the renal arteries will produce
flank pain. Aneurysms in the inferior vena cava may produce chest pain.
DIF: Cognitive Level: Analyze REF: Aneurysm TOP: Physiological Integrity
13. An older person is diagnosed with cerebral aneurysm. Where does the nurse suspect the
cerebral aneurysm is located? a. Vertebral arteries
b. Basilar artery
c. Circle of Willis
d. Carotid arteries
ANS: C
Cerebral aneurysms often occur in the circle of Willis. Such an aneurysm is not associated with the
vertebral arteries, the basilar artery, or the carotid arteries.
DIF: Cognitive Level: Understand REF: Aneurysm TOP: Physiological Integrity
14. What term should the nurse use to document a detached blood clot?
a. Thrombus
lOMoARcPSD|5422489
b. Embolus
c. Thromboembolus
d. Infarction
ANS: C
A thrombus is a clot that remains attached to a vessel wall; a detached thrombus is a thromboembolus.
An embolus is a bolus of material floating in the bloodstream. An infarction is death of tissue.
DIF: Cognitive Level: Understand REF: Table 24.3 TOP: Physiological Integrity
15. A patient presents with severe chest pain and shortness of breath and is diagnosed with
pulmonary embolism. Where did the embolism most likely originate? a. The left ventricle
b. Systemic arteries
c. A deep vein of the leg
d. The superficial veins of the arm
ANS: C
The most likely origin of the embolism is from the deep veins of the legs. An embolism is not likely to
originate in the left ventricle, the systemic arteries, or the arms.
DIF: Cognitive Level: Understand REF: Thrombus Formation in Veins TOP: Physiological
Integrity
16. Individuals with Raynaud’s phenomenon need to be counseled to avoid which of the following
conditions? a. Allergic reactions
b. Cold exposure
c. Hot water immersion
d. Tissue injury
ANS: B
Raynaud’s phenomenon demonstrates symptoms when extremities are exposed to cold. It is not an
allergic reaction, and it is not due to hot water immersion or tissue injury.
DIF: Cognitive Level: Understand REF: Raynaud’s Phenomenon
TOP: Physiological Integrity
17. A patient is diagnosed with coronary artery disease. Which of the following modifiable risk
factors would the nurse suggest?
a. Eating out to increase variety
lOMoARcPSD|5422489
b. Change living arrangements
c. Decreasing tomato juice consumption
d. Stop smoking cigarettes
ANS: D
Cigarette smoking leads to vasoconstriction and should be the first behaviour that the patient changes.
Eating out often leads to consuming large amounts of food that is high in fat, salt, and sugar. The living
arrangement of the patient’s home would not lead to the development of coronary artery disease.
Drinking tomato juice would not lead to the development of coronary artery disease.
DIF: Cognitive Level: Understand REF: Development of Coronary Artery Disease TOP: Physiological
Integrity
18. A patient presents to a primary care provider reporting chest pain and is diagnosed with
atherosclerosis. What is this disease caused by? a. Arterial wall thinning and weakening
b. Abnormally dilated arteries and veins
c. An accumulation of lipid-laden macrophages within the arterial wall
d. Autonomic nervous system imbalances
ANS: C
Atherosclerosis is a form of arteriosclerosis caused by lipid-laden macrophages that collect in the
arterial wall. Affected arteries are narrowed, not dilated. Atherosclerosis is not related to autonomic
nervous system imbalances, which would lead to changes in rate or rhythm.
DIF: Cognitive Level: Understand REF: Atherosclerosis [Show Less]
