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Exam 5 (Medsurg): HTN and Headaches

Total questions: 75

Worksheet time: 40mins

Name
Class
Date
1.

HTN is a ______ risk factor of cardiovascular disease.

a)

Modifiable

b)

Non-modifiable

2.

SATA: As BP increases, so does the risk of which of the following conditions?

a)

Myocardial Infarction (MI)

b)

Heart Failure (HF)

c)

Stroke

d)

Renal Disease

e)

Retinopathy

3.

What is the formula for blood pressure (BP)?

a)

BP = CO (cardiac output) x SVR (systemic vascular resistance)

b)

BP = HR (heart rate) x SVR (systemic vascular resistance)

c)

BP = CO (cardiac output) + SVR (systemic vascular resistance)

d)

BP = CO (cardiac output) / SVR (systemic vascular resistance)

4.

SATA: Which of the following are components of cardiac output?

a)

Heart Rate

b)

Contractility

c)

Conductivity

d)

Nociception

e)

Transduction

5.

SATA: Which receptors are responsible for vasoconstriction in the SNS?

a)

a1 adrenergic receptors

b)

b1 adrenergic receptors

c)

a2 adrenergic receptors

d)

b2 adrenergic receptors

e)

All of the above

6.

Which neurohormones act as vasoconstrictors?

a)

Angiotensin, norepinephrine

b)

Oxytocin, vasopressin

c)

Serotonin, melatonin

d)

Dopamine, histamine

7.

Which local regulators act as vasodilators?

a)

Prostaglandins and nitric oxide

b)

Endothelin and angiotensin II

c)

Thromboxane and serotonin

d)

Histamine and bradykinin

8.

Systemic Vascular Resistance: Which local regulator acts as a vasoconstrictor?

a)

Endothelin

b)

Nitric oxide

c)

Prostacyclin

d)

Bradykinin

9.

What are cardiac baroreceptors sensitive to?

a)

Stretching

b)

Temperature

c)

Light

d)

Chemical changes

e)

Water content

10.

Vascular endothelium produces vasoactive substances to maintain a _____ arterial tone.

a)

low

b)

high

11.

Which hormones that affect BP are released from the adrenal medulla?

a)

Epinephrine and Norepinephrine

b)

Cortisol and Aldosterone

c)

Insulin and Glucagon

d)

Thyroxine and Calcitonin

12.

Which system controls sodium excretion and extracellular fluid (ECF) volume?

a)

Renal system

b)

Pulmonary system

c)

Digestive system

d)

Nervous system

e)

Hepatic system

13.

HTN is defined as persistent elevation of which of the following?

a)

Systolic BP: greater than or equal to 140

Diastolic BP: greater than or equal to 90

b)

Systolic BP: greater than or equal to 120

Diastolic BP: greater than or equal to 80

c)

Systolic BP: greater than or equal to 170

Diastolic BP: greater than or equal to 100

d)

Systolic BP: greater than or equal to 220

Diastolic BP: greater than or equal to 110

14.

________ is defined as a systolic BP between 120-139 mm Hg and a diastolic BP between 80-89 mm Hg.

a)

Prehypertension

b)

Hypertension

c)

Severe Hypertension

d)

Normal BP

15.

Elevated BP without an identified cause accounts for what percentage of all HTN cases?

a)

10-25%

b)

50-65%

c)

90-95%

d)

40-85%

16.

Secondary HTN is characterized by elevated BP with a specific cause.

a)

True

b)

False

17.

HTN Pathophysiology: Which of the following is NOT a cardiac output abnormality associated with Primary HTN?

a)

Renal artery stenosis

b)

Hyperaldosteronism

c)

Hypersecretion of ADH

d)

Hyposecretion of ADH

18.

HTN Pathophysiology: Name one condition that can cause increased catecholamines leading to Primary HTN.

a)

Pheochromocytoma

b)

Diabetes Mellitus

c)

Hypothyroidism

d)

Renal Artery Stenosis

19.

Elevated serum ______ and excess dietary _____ can increase risk for HTN dramatically.

a)

lipids, sodium

b)

baroreceptors, glucose

c)

proteins, iron

d)

osmoreceptors, alcohol

20.

HTN Pathophysiology: Hypertension is known as the ________.

a)

silent killer

b)

heart breaker

c)

blood pumper

d)

pressure master

21.

SATA: Which of the following are symptoms of severe hypertension?

a)

Fatigue

b)

Dizziness

c)

Palpitations

d)

Rash

e)

Angina

22.

HTN Pathophysiology: Target organ diseases due to HTN most frequently occur in which organs?

a)

Heart, brain, kidneys, eyes, peripheral vasculature

b)

Liver, pancreas, spleen, skin, bones

c)

Stomach, intestines, bladder, lungs, muscles

d)

Thyroid, adrenal glands, lymph nodes, gallbladder, esophagus

23.

Which diagnostic tests are used for HTN?

a)

Urinalysis, BUN and serum creatinine, creatinine clearance

b)

Serum electrolytes, glucose, and lipid profile

c)

Uric acid levels, ECG, echocardiogram

d)

All of the above

24.

Identify the antihypertensive medication.

a)

Atorvastatin

b)

Clonazepam

c)

Amlodipine

d)

Digoxin

e)

Lantus

25.

Weight loss of only 10 kg may decrease SBP by how much?

a)

5-20 mm Hg

b)

1-4 mm Hg

c)

21-40 mm Hg

d)

0 mm Hg

e)

10-50 mm Hg

26.

Which of the following is NOT a recommended lifestyle modification for HTN?

a)

Weight reduction

b)

DASH eating plan

c)

Avoidance of exercise

d)

Avoidance of tobacco products

27.

Moderate-intensity aerobic activity should be performed at least 30 minutes most days of the week for HTN care.

a)

True

b)

False

28.

Nicotine causes _______, which leads to an elevated BP.

a)

Vasodilation

b)

Vasoconstriction

c)

Angiogenesis

d)

Vascular Rupture

e)

Hypovolemia

29.

Smoking cessation reduces risk factors within 1 year for HTN patients.

a)

True

b)

False

30.

SATA: Which of the following is a side effect of antihypertensive therapy that should be identified, reported, and minimized?

a)

Orthostatic hypotension

b)

Sexual dysfunction

c)

Dry mouth

d)

Frequent urination

e)

Recurrent fever

31.

High sodium intake leads to increased afterload, increased preload, and directly affects protein synthesis of myocardial cells. These changes lead to _________?

a)

ventricular hypertrophy

b)

pulmonary edema

c)

mitral valve prolapse

d)

atrial fibrillation

e)

ventricular fibrosis

32.

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 _________?

a)

ventricular fibrosis

b)

atrial dilation

c)

mitral valve prolapse

d)

decreased cardiac output

e)

ventricular hypertrophy

33.

Antihypertensive drugs with a 24 hour duration of action should be taken:

a)

early in the morning

b)

late at night

c)

with every meal

d)

with breakfast

e)

with dinner

34.

The forearm must never be used for blood pressure measurements.

a)

True

b)

False

35.

Which of the following is NOT a disease that puts a patient at risk for developing HTN?

a)

Renal disease

b)

Thyroid disease

c)

Asthma

d)

Dyslipidemia

e)

Menopause

36.

When assessing for orthostatic hypotension, the RN should measure each blood pressure within no longer than ______ minutes of position change.

a)

1-2

b)

5-10

c)

20-30

d)

15-30

e)

20-40

37.

SATA: To assess for orthostatic hypotension, BP and pulses should be measured in which positions?

a)

Sitting

b)

Standing

c)

Supine

d)

Semi-Fowlers

e)

Prone

38.

Which of the following is the minimum criteria for a positive finding of orthostatic hypotension?

a)

SBP decrease of 20+, DBP decrease of 10+, or HR increase of 20+ bpm with position change

b)

SBP decrease of 10+, DBP decrease of 5+, or HR decrease of 20+ bpm with position change

c)

SBP decrease of 50+, DBP decrease of 25+, or HR increase of 10+ bpm with position change

d)

SBP decrease of 12+, DBP decrease of 5+, or HR decrease of 20+ bpm with position change

39.

SATA: What are some reasons for patient noncompliance in treatment of HTN?

a)

side effects and adverse effects of medication

b)

return to normal BP readings (I don't need meds anymore because it's fixed)

c)

lack of trust in healthcare

d)

lack of finances and/or insurance coverage

e)

inadequate teaching about BP meds

40.

Fill in the blank: There is an increased incidence of HTN with ________.

a)

age

b)

exercise

c)

low salt intake

d)

hydration

41.

What is the most common form of HTN in individuals over 50 years old?

a)

Isometric diastolic HTN

b)

Isolated systolic HTN

c)

Secondary HTN

d)

Malignant HTN

e)

White Coat HTN

42.

What type of HTN do some older patients experience when they find themselves in a medical setting and subsequently become stressed?

a)

Tight Scrub Pants HTN

b)

Healthcare HTN

c)

White Coat HTN

d)

Idiopathic HTN

e)

Diastolic HTN

43.

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.

a)

long, auscultatory

b)

short, systolic

c)

short, diastolic

d)

long, pulse

e)

short, auscultatory

44.

What is most likely the most common type of pain experienced by humans?

a)

Back pain

b)

Headache

c)

Toothache

d)

Stomach ache

45.

What are the two main types of functional headaches mentioned in the notes?

a)

Migraine headaches and cluster headaches

b)

Migraine headaches and tension-type headaches

c)

Cluster headaches and sinus headaches

d)

Tension-type headaches and sinus headaches

46.

Headache pain can arise from both intracranial and extracranial sources.

a)

True

b)

False

47.

SATA: Which of the following cranial nerves contain pain-sensitive structures that are frequently associated with headache pain?

a)

Trigeminal

b)

Facial

c)

Vagus

d)

Trochlear

e)

Hypoglossal

48.

Secondary headaches are caused by another condition or disorder such as sinus infection, neck injury, or stroke.

a)

True

b)

False

49.

What are the primary classifications of headache types?

a)

Sinus, tension-type, and migraine

b)

Tension-type, migraine, and cluster headaches

c)

Migraine, cluster, and trauma headaches

d)

Tension-type, sinus, and trauma headaches

50.

Tension-type headaches are characterized typically felt _____.

a)

Bilaterally, on both sides of the head

b)

Unilaterally, on one side of the head

51.

Tension-type headaches are also known as ________.

a)

stress headaches

b)

migraine headaches

c)

cluster headaches

d)

sinus headaches

52.

Which of the following is the most common type of headache?

a)

Migraine headaches

b)

Cluster headaches

c)

Tension-type headaches

d)

Sinus headaches

53.

Tension-type headaches can last from ________ to ________.

a)

minutes to days

b)

seconds to hours

c)

hours to weeks

d)

days to months

54.

Tension-type headaches are subcategorized into ________ and ________.

a)

episodic and chronic

b)

acute and persistent

c)

primary and secondary

d)

mild and severe

55.

Which of the following is associated with tension-type headaches?

a)

Increased tone in cervical and neck muscles

b)

Visual aura preceding the actual pain itself

c)

Nausea, vomiting, constipation, and encopresis

d)

Unilateral throbbing pain

56.

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.

a)

True

b)

False

57.

Migraine headaches are more common in ________ than ________.

a)

females; males

b)

males; females

c)

children; adults

d)

adults; children

58.

The most common age for migraine onset is between ________ years old.

a)

20-30

b)

10-15

c)

40-50

d)

60-70

59.

Which of the following is the more common type of migraine?

a)

Migraine WITH aura

b)

Migraine WITHOUT aura

60.

What is the exact cause of migraine?

a)

Unknown

b)

Excessive sugar intake

c)

Lack of sleep

d)

Vitamin C deficiency

e)

Dehydration

61.

Which of the following factors is/are suggested to be involved in migraines?

a)

Vascular

b)

Muscular

c)

Biochemical

d)

All of the above

e)

Psychological

62.

Migraines may last for _______ hours.

a)

2-12

b)

1-4

c)

10-48

d)

4-72

e)

2-24

63.

SATA: Which of the following foods are linked to migraines?

a)

chocolate

b)

cheese

c)

oranges

d)

tomatoes

e)

onions

64.

MRIs are indicated for all patients suffering from migraines.

a)

True

b)

False

65.

Most migraine patients present with normal neurologic examinations.

a)

True

b)

False

66.

Which type of headache is characterized by repeated severe attacks that occur for weeks or months at a time, followed by periods of remission?

a)

Tension-type

b)

Cluster

c)

Migraine

d)

Aneurysm

67.

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.

a)

Vagus

b)

Facial

c)

Glossopharyngeal

d)

Trigeminal

e)

Accessory

68.

The intense pain of a cluster headache is most often described as:

a)

dull and achy

b)

sharp and stabbing

c)

burning and searing

d)

tight and constrictive

69.

SATA: Headaches can be a symptom that is secondary to a severe illness, such as:

a)

subarachnoid hemorrhage

b)

brain tumors

c)

trigeminal neuralgia

d)

systemic illnesses

e)

dental disorders

70.

Which class of antidepressant is used for prophylactic treatment of tension-type headaches?

a)

Tricyclics

b)

SSRIs

c)

SNRIs

d)

Atypicals

e)

MAOIs

71.

Which type of medication is considered first-line treatment for migraines?

a)

Triptans

b)

Neuroleptics

c)

Antihistamines

d)

Direct Thrombin Inhibitors

e)

SSRIs

72.

The first-line drugs for migraine treatment work by producing _______ _______.

a)

peripheral vasoconstriction

b)

peripheral vasodilation

c)

cerebral vasoconstriction

d)

cerebral vasodilation

73.

Botox can be used as a method of migraine prophylaxis.

a)

True

b)

False

74.

The gold standard intervention for a patient with an acute cluster headache attack is inhalation of 100% oxygen at ____ L for _____ minutes.

a)

4-5, 5-10

b)

6-8, 10-20

c)

1-2, 7-8

d)

10-20, 50-60

75.

SATA: What are some interventions for refractory cluster headaches that do not respond to pain medication?

a)

invasive nerve blocks

b)

ablations

c)

cerebrospinal fluid drainage

d)

burr holes in the skull

e)

shock therapy