Question 1

Angiotensin-converting enzyme (ACE) inhibitors block the

Accepted Answer

ACE inhibitors block the conversion of angiotensin I to angiotensin II, which is a potent vasoconstrictor and contributes to the development of hypertension. This ultimately leads to vasodilation and decreased blood pressure.

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?

Accepted Answer

Lifestyle modifications are the first-line treatment for hypertension. If lifestyle modifications alone do not lower blood pressure to goal, then medication is added.

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?

Accepted Answer

A serum lipid profile would be the most helpful in assessing the patient's risk for atherosclerosis as it provides information on their cholesterol and triglyceride levels, which are major risk factors for atherosclerosis development. The other lab tests listed are not as directly relevant to atherosclerosis risk assessment.

Question 4

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

Accepted Answer

High blood pressure increases afterload, which is the resistance that the left ventricle must overcome to eject blood into the aorta. This results in an increased workload for the left ventricle.

Question 5

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

Accepted Answer

Vasopressin and angiotensin II increase blood volume and pressure, but atrial natriuretic peptide decreases blood volume and pressure by promoting sodium and water excretion.

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?

Accepted Answer

Orthostatic hypotension is indicated by a drop in systolic BP of at least 20 mmHg or diastolic BP of at least 10 mmHg within three minutes of standing or sitting, often accompanied by an increase in heart rate. In option A, the heart rate increases significantly, suggesting a compensatory response to a drop in blood pressure, which is consistent with orthostatic hypotension.

Question 7

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

Accepted Answer

Cardiac output is calculated by multiplying stroke volume by heart rate. Therefore, 70 ml/beat * 100 beats/min = 7000 ml/min, not 700 ml/min.

Question 8

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

Accepted Answer

Stimulation of α1-adrenergic receptors, which causes vasoconstriction, can increase blood pressure. The other receptors mentioned in the statement do not have a significant effect on vascular tone or 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

Accepted Answer

High blood pressure increases the risk of stroke, renal disease, and ischemic heart disease. It does not directly increase the risk of diabetes. However, uncontrolled high blood pressure can contribute to the development of type 2 diabetes over time.

Question 10

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

Accepted Answer

Systolic blood pressure is the highest pressure in the arteries, while diastolic blood pressure is the lowest pressure in the arteries.

Question 11

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

Accepted Answer

Vasoconstriction causes an increase in systemic blood pressure by narrowing the blood vessels and increasing vascular resistance, requiring the heart to pump harder to maintain adequate blood flow. Hypovolemia (A) and decreased cardiac output (B) both result in a decrease in systemic blood pressure. Decreased vascular resistance (D) would also result in a decrease in systemic blood pressure.

Question 12

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

Accepted Answer

Blood pressure is determined by the interactions between cardiac output (the volume of blood pumped by the heart per minute) and systemic vascular resistance (the resistance to blood flow offered by the blood vessels in the body). The equation for blood pressure is BP = CO x SVR.

Question 13

Pulse pressure is defined as

Accepted Answer

Pulse pressure is the difference between systolic pressure (the pressure in arteries when the heart beats) and diastolic pressure (the pressure in arteries when the heart is at rest). Therefore, it is calculated by subtracting diastolic pressure from systolic pressure, which is represented by choice C.

Question 14

The mean pulmonary artery pressure is about 30 mm Hg.

Accepted Answer

The normal mean pulmonary artery pressure is about 14 mm Hg at rest, with values above 20 mm Hg considered elevated.

Question 15

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

Accepted Answer

This is true. The baroreceptors sense a decrease in blood pressure and stimulate the sympathetic nervous system, which causes vasoconstriction and an increase in heart rate to elevate blood pressure. At the same time, they inhibit the parasympathetic nervous system, which would normally cause vasodilation and a decrease in heart rate.

Question 16

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

Accepted Answer

The elasticity of the aorta decreases with age, making it harder for the vessel to expand and contract, leading to higher systolic blood pressure and lower diastolic blood pressure.

Question 17

An erroneously low blood pressure measurement could be caused by

Accepted Answer

Positioning the arm above heart level can cause an erroneously low blood pressure reading because gravity can cause blood to pool in the lower part of the body, reducing the pressure in the arm.

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?

Accepted Answer

The patient’s blood pressure is persistently elevated and at a level that puts him at risk for cardiovascular disease. Given his lifestyle habits, it is unlikely that lifestyle modifications alone will be sufficient to lower his blood pressure to a safe level. Therefore, beginning antihypertensive drug therapy is the most appropriate intervention at this time. Rechecking blood pressure in 4 to 6 weeks and encouraging smoking cessation are also important interventions, but they should be done in conjunction with starting drug therapy.

Question 19

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

Accepted Answer

According to the American College of Cardiology/American Heart Association Blood Pressure Guidelines, a blood pressure reading of 109/92 falls under the stage 1 hypertension category.

Question 20

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

Accepted Answer

In a supine position, blood pressure in the legs is typically higher than in the arms due to the effects of gravity and the hydrostatic pressure gradient.

Quiz 16: Alterations in Blood Pressure

Angiotensin-converting enzyme (ACE) inhibitors block the

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?

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?

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

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

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?

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

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

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

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

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

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

Pulse pressure is defined as

The mean pulmonary artery pressure is about 30 mm Hg.

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

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

An erroneously low blood pressure measurement could be caused by

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

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

Quiz 16: Alterations in Blood Pressure

Angiotensin-converting enzyme (ACE) inhibitors block the

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?

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?

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

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

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?

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

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

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

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

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

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

Pulse pressure is defined as

The mean pulmonary artery pressure is about 30 mm Hg.

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

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

An erroneously low blood pressure measurement could be caused by

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

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

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