Exam with Actual Detailed Answers
2025-2026 Updated.
Hypertension - Answer -modifiable risk factor to prevent CVD
-blood pressure = force exerted by the blood against the walls of the blood vessels; increased BP
= increased forced
-primary HTN - essential or idiopathic HTC; increased BP due to unknown causes; 90-95% cases;
factors: overweight, diabetes, excess alcohol, increased SNS/NA intake
-secondary HTN - increased BP due to known causes; 5-10% of cases; factors: cirrhosis(chronic
liver disease; usually due to alcoholism/hepatitis), sleep apnea, aortic problems,
endocrine/neurologic/renal problems, pregnancy, meds, increased ICP
-risk factors - age, gender, alcohol/tobacco use, diabetes, obesity, family hx, ethnicity, sedentary
lifestyle, stress, increased serum lipid intake, NA intake
--african Americans have a higher prevalence, and have the more resistant HTN; Hispanics are
less likely to get treatment if diagnosed with HTN
--men are more likely to get HTN before middle age; women more likely after menopause, and
are more likely to increase their chances of getting it by 2-3x if they use oral contraceptives
-clinical manifestations
--HTN is the "silent killer"; fatigue, dizziness, palpitations, angina, dyspnea
--complications more frequently in the heart( CAD, HF, left-ventricular hypertrophy(heart
enlargement)), stroke, atherosclerosis that leads to PVD/aortic aneurysm, blurry/loss of vision,
nephrosclerosis that leads to chronic kidney disease
-diagnostic studies
--measure BP; labs to identify and rule out secondary HTN; evaluate target organ disease,
determine CV risk, and establish baselines
--labs: BMP, CBC, uric acid, U/A, renal function test, serum lipid, ECG, ophthalmic
-nursing interventions
--achieve and maintain goal BP; reduce CV risk and target organ disease
--lifestyle changes = weight reduction; dash diet; decrease NA intake; moderate alcohol use;
increase exerci
Heart Failure - Answer -temporary imbalance between coronary artery's ability to supply
oxygen and cardiac muscles demand for oxygen; interference with the regulation CO; conditions
that directly damage the heart/increase workload of heart
, -assessment of chest pain = use PQRST
-treatment for angina = nitroglycerin(every 5 minutes for up to 3 doses); lowers BP so monitor
BP before and after administration
-risk factors = HTN, CAD
-Left-sided HF = left ventricle can't pump enough blood --> pooling of blood --> congestion in
the lungs(crackles); most common form of HF
--caused by HTN, CAD, left ventricular hypertrophy(heart enlargement), vascular
disease( aortic/mitral valve stenosis/insufficiency)
--clinical manifestations
---decreased CO = weakness, fatigue, dizzy, restless/anxious, acute confusion, dysuria/oliguria
---lung congestion causes dyspnea, cough, crackles, decreases in SPO2, 3rd heart sound, pink
frothy sputum
-Right-sided HF- right ventricles can't empty completely; increases volume and pressure in
venous system, and causes peripheral edema
--caused by left ventricle failure, right ventricle MI, pulmonary HTN
-clinical manifestations
--JVD, increased abdominal girth, edema, weight gain, fatigue, ascites, hepatomegaly,
hepatojugular reflex
-compensatory mechanisms of HF - increased SNS stimulation = increases HR/BP = increases CO
--RAAS = decreases blood flow to kidneys; Na and H2o retention
--BNP = brain-type natriuretic peptide(best indicator for HF; normally <100)
--pituitary-ADH in response to low CO
--myocardial muscle wall thickening
-diagnostic studies
--assessment = PT hx(HTN, smoke, MI), weight gain, meds, activity, diet, sleep
--subjective - elimination, functional health patterns, cognitive/perceptual
--objective - skin color and temp, edema, RR+sounds, HR+sounds, ab distention, LOC
--labs = electrolytes, BNP, urin
Chronic Stable Angina - Answer -EKG within 10 min of onset, Monitor frequent vital signs, O2
2-4 liters if SPO2 is less than 94%, Nitroglycerin SL every 5 min X 3
-Risk Factors: Family hx, smoker, diabetic, high B/P, high cholesterol, and high triglycerides
-Clinical Manifestations: SOB,chest pain that radiates down the arm, and nausea