Deck 16: Alterations in Blood Pressure

Question 1

Angiotensin-converting enzyme (ACE) inhibitors block the

A) release of renin.
B) conversion of angiotensin I to angiotensin II.
C) conversion of angiotensinogen to angiotensin I.
D) effect of aldosterone on the kidney.

Answer 1

conversion of angiotensin I to angiotensin II.

Question 2

After being diagnosed with hypertension, a patient returns to the clinic 6 weeks later and reports "moderate" adherence to the recommended lifestyle changes. His blood pressure is 148/90. What is the most appropriate intervention at this time?

A) Continue lifestyle modifications only.
B) Continue lifestyle modifications plus diuretic.
C) Continue lifestyle modifications plus ACE inhibitor.
D) Continue lifestyle modifications plus $\beta$ -blocker.

Answer 2

Continue lifestyle modifications only.

Question 3

Because of his high blood pressure, smoking history, obesity, and sedentary lifestyle, a patient is at significant risk for developing atherosclerosis. What laboratory evaluation would be most helpful in further assessing risk for atherosclerosis?

A) Serum lipid profile
B) Serum sodium level
C) Thyroid hormone panel
D) Urinalysis

Answer 3

Serum lipid profile

Question 4

High blood pressure increases the workload of the left ventricle because it increases

A) stroke volume.
B) blood volume.
C) preload.
D) afterload.

Question 5

Vasopressin, angiotensin II, and atrial natriuretic peptide all increase blood volume and pressure.

Question 6

Which of the following findings is indicative of orthostatic hypotension in a person with a supine blood pressure (BP) of 110/70 and a heart rate (HR) of 100?

A) Sitting BP 110/72, HR 118
B) Sitting BP 108/68, HR 102
C) Sitting BP 110/78, HR 98
D) Sitting BP 120/80, HR 100

Question 7

If stroke volume is 70 ml and heart rate is 100 beats/min, the cardiac output is 700 ml/min.

Question 8

Stimulation of arterioles by $\alpha$ ₁-adrenergic receptors produces vasoconstriction and is likely to increase blood pressure.

Question 9

A hypertensive patient is reluctant to adhere to the prescribed plan because he feels fine and doesn't like his new diet. It can be explained to him that high blood pressure increases the risk of all of the following except

A) stroke.
B) renal disease.
C) diabetes.
D) ischemic heart disease.

Question 10

Systolic blood pressure is defined as the highest pressure detected in the arteries.

Question 11

Which of the following would result in an increase in systemic blood pressure?

A) Hypovolemia
B) Decreased cardiac output
C) Vasoconstriction
D) Decreased vascular resistance

Question 12

Blood pressure equals the product of cardiac output and systemic vascular resistance.

Question 13

Pulse pressure is defined as

A) two thirds of systolic pressure + diastolic pressure.
B) systolic pressure + diastolic pressure.
C) systolic pressure - diastolic pressure.
D) systolic pressure $\times$ systemic resistance.

Question 14

The mean pulmonary artery pressure is about 30 mm Hg.

Question 15

If blood pressure drops, the baroreceptors stimulate the sympathetic nervous system and inhibit the parasympathetic nervous system.

Question 16

Lack of elasticity in the aorta as occurs with age contributes to higher systolic and lower diastolic blood pressures.

Question 17

An erroneously low blood pressure measurement could be caused by

A) positioning the arm above the heart level.
B) using a cuff that is too small.
C) positioning the arm at heart level.
D) measuring blood pressure after exercise.

Question 18

A 48-year-old man was noted to have elevated blood pressure at a health fair and is in the office for follow-up. He states that 3 weeks ago his blood pressure was recorded at 162/96. He has no significant past medical history and takes no medications. He smokes 1 1/2 packs of cigarettes per day, drinks alcohol regularly, and exercises infrequently. He is about 40 pounds overweight and admits to a high-fat, high-calorie diet. At his visit today, his blood pressure is 150/92. What is the least appropriate intervention at this time?

A) Begin lifestyle modifications.
B) Begin antihypertensive drug therapy.
C) Recheck blood pressure in 4 to 6 weeks.
D) Encourage smoking cessation.

Question 19

A patient with a blood pressure consistently measured at 109/92 is correctly diagnosed as having stage 1 hypertension.

Question 20

Blood pressure in the legs of a supine individual normally is lower than that in the arms.

Question 21

A patient with long-standing hypertension is at risk for hypertensive heart disease. Which of the following clinical findings is indicative of this complication?

A) Low voltage on electrocardiogram
B) Bounding peripheral pulses
C) An S₄ heart sound
D) Tachycardia

Question 22

Diabetic patients with hypertension have a blood pressure goal of less than

A) 120/80.
B) 130/80.
C) 130/90.
D) 140/90.

Question 23

Which of the following blood pressure readings is considered to be indicative of prehypertension according to the JNC-7 criteria?

A) 118/78
B) 128/82
C) 140/88
D) 138/94

Question 24

The drug of choice for treating hypertensive diabetic patients is

A) thiazide diuretics.
B) . $\beta$ -blockers.
C) ACE inhibitors.
D) calcium channel blockers.

Question 25

Restriction of which of the following electrolytes is recommended in the management of high blood pressure?

A) Calcium
B) Potassium
C) Sodium
D) Magnesium