A 75-year-old obese patient with female genitalia presents to the primary care provider reporting
edema in the lower extremities. Physical examination
... [Show More] reveals 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.
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DIF: Cognitive Level: Analyze REF: Varicose Veins and Chronic Venous Insufficiency
TOP: Physiological Integrity
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
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c. Cardiac necrosis
d. Systemic inflammation
ANS: B
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
lO M oARcPSD| 5422489
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
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
alphaadrenergic, 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
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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
c. Chest pain and palpitations
d. Syncope and fainting [Show Less]