WorksheetsExam 5 (Medsurg): HTN and Headaches
Total questions: 75
Worksheet time: 40mins
HTN is a ______ risk factor of cardiovascular disease.
Modifiable
Non-modifiable
SATA: As BP increases, so does the risk of which of the following conditions?
Myocardial Infarction (MI)
Heart Failure (HF)
Stroke
Renal Disease
Retinopathy
What is the formula for blood pressure (BP)?
BP = CO (cardiac output) x SVR (systemic vascular resistance)
BP = HR (heart rate) x SVR (systemic vascular resistance)
BP = CO (cardiac output) + SVR (systemic vascular resistance)
BP = CO (cardiac output) / SVR (systemic vascular resistance)
SATA: Which of the following are components of cardiac output?
Heart Rate
Contractility
Conductivity
Nociception
Transduction
SATA: Which receptors are responsible for vasoconstriction in the SNS?
a1 adrenergic receptors
b1 adrenergic receptors
a2 adrenergic receptors
b2 adrenergic receptors
All of the above
Which neurohormones act as vasoconstrictors?
Angiotensin, norepinephrine
Oxytocin, vasopressin
Serotonin, melatonin
Dopamine, histamine
Which local regulators act as vasodilators?
Prostaglandins and nitric oxide
Endothelin and angiotensin II
Thromboxane and serotonin
Histamine and bradykinin
Systemic Vascular Resistance: Which local regulator acts as a vasoconstrictor?
Endothelin
Nitric oxide
Prostacyclin
Bradykinin
What are cardiac baroreceptors sensitive to?
Stretching
Temperature
Light
Chemical changes
Water content
Vascular endothelium produces vasoactive substances to maintain a _____ arterial tone.
low
high
Which hormones that affect BP are released from the adrenal medulla?
Epinephrine and Norepinephrine
Cortisol and Aldosterone
Insulin and Glucagon
Thyroxine and Calcitonin
Which system controls sodium excretion and extracellular fluid (ECF) volume?
Renal system
Pulmonary system
Digestive system
Nervous system
Hepatic system
HTN is defined as persistent elevation of which of the following?
Systolic BP: greater than or equal to 140
Diastolic BP: greater than or equal to 90
Systolic BP: greater than or equal to 120
Diastolic BP: greater than or equal to 80
Systolic BP: greater than or equal to 170
Diastolic BP: greater than or equal to 100
Systolic BP: greater than or equal to 220
Diastolic BP: greater than or equal to 110
________ is defined as a systolic BP between 120-139 mm Hg and a diastolic BP between 80-89 mm Hg.
Prehypertension
Hypertension
Severe Hypertension
Normal BP
Elevated BP without an identified cause accounts for what percentage of all HTN cases?
10-25%
50-65%
90-95%
40-85%
Secondary HTN is characterized by elevated BP with a specific cause.
True
False
HTN Pathophysiology: Which of the following is NOT a cardiac output abnormality associated with Primary HTN?
Renal artery stenosis
Hyperaldosteronism
Hypersecretion of ADH
Hyposecretion of ADH
HTN Pathophysiology: Name one condition that can cause increased catecholamines leading to Primary HTN.
Pheochromocytoma
Diabetes Mellitus
Hypothyroidism
Renal Artery Stenosis
Elevated serum ______ and excess dietary _____ can increase risk for HTN dramatically.
lipids, sodium
baroreceptors, glucose
proteins, iron
osmoreceptors, alcohol
HTN Pathophysiology: Hypertension is known as the ________.
silent killer
heart breaker
blood pumper
pressure master
SATA: Which of the following are symptoms of severe hypertension?
Fatigue
Dizziness
Palpitations
Rash
Angina
HTN Pathophysiology: Target organ diseases due to HTN most frequently occur in which organs?
Heart, brain, kidneys, eyes, peripheral vasculature
Liver, pancreas, spleen, skin, bones
Stomach, intestines, bladder, lungs, muscles
Thyroid, adrenal glands, lymph nodes, gallbladder, esophagus
Which diagnostic tests are used for HTN?
Urinalysis, BUN and serum creatinine, creatinine clearance
Serum electrolytes, glucose, and lipid profile
Uric acid levels, ECG, echocardiogram
All of the above
Identify the antihypertensive medication.
Atorvastatin
Clonazepam
Amlodipine
Digoxin
Lantus
Weight loss of only 10 kg may decrease SBP by how much?
5-20 mm Hg
1-4 mm Hg
21-40 mm Hg
0 mm Hg
10-50 mm Hg
Which of the following is NOT a recommended lifestyle modification for HTN?
Weight reduction
DASH eating plan
Avoidance of exercise
Avoidance of tobacco products
Moderate-intensity aerobic activity should be performed at least 30 minutes most days of the week for HTN care.
True
False
Nicotine causes _______, which leads to an elevated BP.
Vasodilation
Vasoconstriction
Angiogenesis
Vascular Rupture
Hypovolemia
Smoking cessation reduces risk factors within 1 year for HTN patients.
True
False
SATA: Which of the following is a side effect of antihypertensive therapy that should be identified, reported, and minimized?
Orthostatic hypotension
Sexual dysfunction
Dry mouth
Frequent urination
Recurrent fever
High sodium intake leads to increased afterload, increased preload, and directly affects protein synthesis of myocardial cells. These changes lead to _________?
ventricular hypertrophy
pulmonary edema
mitral valve prolapse
atrial fibrillation
ventricular fibrosis
High sodium intake leads to increased aldosterone synthesis in the myocardium, increased angiotensin receptors in myocardial cells, and increased concentration of TGF-B1. These changes lead to _________?
ventricular fibrosis
atrial dilation
mitral valve prolapse
decreased cardiac output
ventricular hypertrophy
Antihypertensive drugs with a 24 hour duration of action should be taken:
early in the morning
late at night
with every meal
with breakfast
with dinner
The forearm must never be used for blood pressure measurements.
True
False
Which of the following is NOT a disease that puts a patient at risk for developing HTN?
Renal disease
Thyroid disease
Asthma
Dyslipidemia
Menopause
When assessing for orthostatic hypotension, the RN should measure each blood pressure within no longer than ______ minutes of position change.
1-2
5-10
20-30
15-30
20-40
SATA: To assess for orthostatic hypotension, BP and pulses should be measured in which positions?
Sitting
Standing
Supine
Semi-Fowlers
Prone
Which of the following is the minimum criteria for a positive finding of orthostatic hypotension?
SBP decrease of 20+, DBP decrease of 10+, or HR increase of 20+ bpm with position change
SBP decrease of 10+, DBP decrease of 5+, or HR decrease of 20+ bpm with position change
SBP decrease of 50+, DBP decrease of 25+, or HR increase of 10+ bpm with position change
SBP decrease of 12+, DBP decrease of 5+, or HR decrease of 20+ bpm with position change
SATA: What are some reasons for patient noncompliance in treatment of HTN?
side effects and adverse effects of medication
return to normal BP readings (I don't need meds anymore because it's fixed)
lack of trust in healthcare
lack of finances and/or insurance coverage
inadequate teaching about BP meds
Fill in the blank: There is an increased incidence of HTN with ________.
age
exercise
low salt intake
hydration
What is the most common form of HTN in individuals over 50 years old?
Isometric diastolic HTN
Isolated systolic HTN
Secondary HTN
Malignant HTN
White Coat HTN
What type of HTN do some older patients experience when they find themselves in a medical setting and subsequently become stressed?
Tight Scrub Pants HTN
Healthcare HTN
White Coat HTN
Idiopathic HTN
Diastolic HTN
When taking the manual BP of a geriatric patient, there is often a ______ pause between the first Korotkoff (manual BP) sound and subsequent beats, known as the ________ gap.
long, auscultatory
short, systolic
short, diastolic
long, pulse
short, auscultatory
What is most likely the most common type of pain experienced by humans?
Back pain
Headache
Toothache
Stomach ache
What are the two main types of functional headaches mentioned in the notes?
Migraine headaches and cluster headaches
Migraine headaches and tension-type headaches
Cluster headaches and sinus headaches
Tension-type headaches and sinus headaches
Headache pain can arise from both intracranial and extracranial sources.
True
False
SATA: Which of the following cranial nerves contain pain-sensitive structures that are frequently associated with headache pain?
Trigeminal
Facial
Vagus
Trochlear
Hypoglossal
Secondary headaches are caused by another condition or disorder such as sinus infection, neck injury, or stroke.
True
False
What are the primary classifications of headache types?
Sinus, tension-type, and migraine
Tension-type, migraine, and cluster headaches
Migraine, cluster, and trauma headaches
Tension-type, sinus, and trauma headaches
Tension-type headaches are characterized typically felt _____.
Bilaterally, on both sides of the head
Unilaterally, on one side of the head
Tension-type headaches are also known as ________.
stress headaches
migraine headaches
cluster headaches
sinus headaches
Which of the following is the most common type of headache?
Migraine headaches
Cluster headaches
Tension-type headaches
Sinus headaches
Tension-type headaches can last from ________ to ________.
minutes to days
seconds to hours
hours to weeks
days to months
Tension-type headaches are subcategorized into ________ and ________.
episodic and chronic
acute and persistent
primary and secondary
mild and severe
Which of the following is associated with tension-type headaches?
Increased tone in cervical and neck muscles
Visual aura preceding the actual pain itself
Nausea, vomiting, constipation, and encopresis
Unilateral throbbing pain
An EMG, which is used to reveal sustained head and neck muscle contraction, may NOT always show increased tension, even when the EMG is performed during a headache.
True
False
Migraine headaches are more common in ________ than ________.
females; males
males; females
children; adults
adults; children
The most common age for migraine onset is between ________ years old.
20-30
10-15
40-50
60-70
Which of the following is the more common type of migraine?
Migraine WITH aura
Migraine WITHOUT aura
What is the exact cause of migraine?
Unknown
Excessive sugar intake
Lack of sleep
Vitamin C deficiency
Dehydration
Which of the following factors is/are suggested to be involved in migraines?
Vascular
Muscular
Biochemical
All of the above
Psychological
Migraines may last for _______ hours.
2-12
1-4
10-48
4-72
2-24
SATA: Which of the following foods are linked to migraines?
chocolate
cheese
oranges
tomatoes
onions
MRIs are indicated for all patients suffering from migraines.
True
False
Most migraine patients present with normal neurologic examinations.
True
False
Which type of headache is characterized by repeated severe attacks that occur for weeks or months at a time, followed by periods of remission?
Tension-type
Cluster
Migraine
Aneurysm
Neither the true cause nor pathophysiologic mechanism is known in regards to cluster headaches. However, current research links cluster headaches in some capacity to the _____ nerve.
Vagus
Facial
Glossopharyngeal
Trigeminal
Accessory
The intense pain of a cluster headache is most often described as:
dull and achy
sharp and stabbing
burning and searing
tight and constrictive
SATA: Headaches can be a symptom that is secondary to a severe illness, such as:
subarachnoid hemorrhage
brain tumors
trigeminal neuralgia
systemic illnesses
dental disorders
Which class of antidepressant is used for prophylactic treatment of tension-type headaches?
Tricyclics
SSRIs
SNRIs
Atypicals
MAOIs
Which type of medication is considered first-line treatment for migraines?
Triptans
Neuroleptics
Antihistamines
Direct Thrombin Inhibitors
SSRIs
The first-line drugs for migraine treatment work by producing _______ _______.
peripheral vasoconstriction
peripheral vasodilation
cerebral vasoconstriction
cerebral vasodilation
Botox can be used as a method of migraine prophylaxis.
True
False
The gold standard intervention for a patient with an acute cluster headache attack is inhalation of 100% oxygen at ____ L for _____ minutes.
4-5, 5-10
6-8, 10-20
1-2, 7-8
10-20, 50-60
SATA: What are some interventions for refractory cluster headaches that do not respond to pain medication?
invasive nerve blocks
ablations
cerebrospinal fluid drainage
burr holes in the skull
shock therapy
