CNUR 202-part 2 Practice Exam With
100% Accurate Solutions 2025-2026
Updated.
Cardiovascular disorders - Answer Most vascular diseases result from malfunction of
endothelial cells or smooth muscle cells
Major factor in atherosclerosis, acute coronary syndromes, hypertension, and thromboembolic
disorders, capillaries media (muscle and elastic tissues), CT
Regulation of blood pressure - Answer Blood pressure is the pressure of blood in the
arteries, two major determinants of arterial blood pressure are cardiac output- CO= HR x SV,
peripheral vascular resistance (diastolic pressure)- Afterload, arterial BP, compensatory effects,
Neural
¡Sympathetic nervous system
Hormonal
¡Renin-angiotensin-aldosterone (RAA system)
¡Antidiuretic hormone (vasopressin)
Vascular
Substances released from endothelial cells
Vasoconstriction
Vasodilators
Vascular Remodeling- endothelial dysfunction, thickened arterial walls- decreased lumen
How does hypertension alter cardiovascular function? - Answer ▫increasing the workload =
thickening and sclerosis of arterial walls.
▫increased cardiac workload = myocardium hypertrophies = heart failure
▫endothelial dysfunction and arterial changes cause narrow arterial lumen, decrease blood
supply to tissue, increase risk for thrombocytosis
Hypertension - Answer Is defined as a SBP greater than140 mm Hg or a DBP greater than 90
mm Hg on multiple blood pressure measurements
¡in patients without renal disease, diabetes, or proteinuria
A systolic pressure of 140 or less, with a diastolic pressure below 90, is called isolated systolic
hypertension and is more common amongst older adults. is a significant risk factor for
,¡renal failure
¡peripheral vascular disease
¡dementia
¡atrial fibrillation
¡erectile dysfunction, silent killer
Canadian Hypertension Education Program - Answer Recommendations
¡Home blood pressure (BP) monitoring
¡Annual BP assessment for individuals with prehypertension (130-139/85-89 mm Hg)
¡Ongoing routine assessment of blood pressure at clinic visits
¡Assessment of overall cardiovascular risk, Lifestyle modifications
¡Healthy diet
¡Regular physical activity
¡Moderation in alcohol
¡Reduction in dietary sodium
¡Stress reduction, Treat to target
¡less than 140/90 mm Hg
¡less than 130/80 mm Hg in those with diabetes or chronic kidney disease
Combinations of therapies
Regular follow- up
Focus on adherence- major focus for nursing care
BP classification - Answer Four stages based on blood pressure measurements:
1.Normal 120/80-129/89
2.Prehypertension 130/85-139/89
3.Stage 1 hypertension 140/90-159/99
4.Stage 2 hypertension 160+/100+
Unknown cause
¡Is called essential, idiopathic, or primary hypertension
¡Accounts for 90% of the cases
Known cause
,Types of antihypertensive drugs - Answer Angiotensin-converting enzyme inhibitors (ACE-I)
Angiotensin II receptor blockers (ARBs)
Calcium channel blockers (CCBs)
Adrenergic drugs (a-2 receptor agonists & beta blockers)
Vasodilators (direct acting)
Diuretics
Angiotension Converting Enzyme Inhibitors - Answer ACE inhibitors - "prils"
ramipril, lisinopril- newer, longer half life, one dose, prodrug needs to be activatedd in liver,
captopril(capoten)- short half life, slow, how it affects pt(HF), q6h, low dose, liver dysfunction
First line therapy for HTN and HF
Often used in combination:
¡thiazide diuretics or calcium channel blockers, not for monotherapy in darker skinned
individuals
MOA- Cardiac and renal effects
Inhibit the conversion of angiotensin I to angiotensin II
Prevent the breakdown of bradykinin and substance P (vasodilators)
Inhibit aldosterone secretion
Results:
¡Decreased SVR
¡Decreased afterload -
¡Prevention of sodium and water resorption
¡Diuresis and reduced preload - filling pressure at the end of diastole, Indications- Hypertension
(discussing today)
Heart failure- slows LVHF after MI
Post myocardial infarction
Renal failure patients with diabetes, Contraindications- Allergy: especially a previous reaction of
angioedema- laryngeal swelling
Pregnant/Lactating women
Used with caution in women of child bearing age
Children
, Impaired taste
Rash
Blood dycrasias (neutropenia, thrombocytopenia)
•Dizziness
•Mood changes
•Hyperkalemia
•Pruritis
ØDry, nonproductive cough, which reverses when therapy is stopped (10-20%)
ØAngioedema: 0.1 - 0.68% incidence
ØNOTE: first-dose hypotension may occur! Black individuals and women may have increase risk,
Interactions- NSAIDS- increase afterload
Lithium- toxicity
Potassium supplements and potassium-sparing diuretics- hyperkalemia
Angiotension 11 Receptor Blockers - Answer ARBs - "sartans": losartan, valsartan
Newer class
Similar to ACE-I - bp/ hemodynamic effects
Well tolerated
Less likely to cause hyperkalemia, Mechanism of Action: decrease BP, SVR
Block binding of angiotensin II to receptors
Blocks vasoconstriction
Block secretion of aldosterone
Used to treat hypertension and heart failure (adjunct)
Used primarily in clients who cannot tolerate ACE-I, vascular smooth muscle- adrenal glands
prevent sodium and water retention, May be used alone or with other drugs such as diuretics
¡Hyzaar is a combination of losartan (ARB)and hydrochlorothiazide (Diuretic)
Combinations of an ACE I with an ARB:
¡do not reduce cardiovascular events more than the ACE-I alone
¡have more adverse effects therefore are not generally recommended- not on ACE-I and ARB,
protein urea, nephropathy- caution with HF, Contraindications: •Most patients can take these
drugs
•Drug allergy
100% Accurate Solutions 2025-2026
Updated.
Cardiovascular disorders - Answer Most vascular diseases result from malfunction of
endothelial cells or smooth muscle cells
Major factor in atherosclerosis, acute coronary syndromes, hypertension, and thromboembolic
disorders, capillaries media (muscle and elastic tissues), CT
Regulation of blood pressure - Answer Blood pressure is the pressure of blood in the
arteries, two major determinants of arterial blood pressure are cardiac output- CO= HR x SV,
peripheral vascular resistance (diastolic pressure)- Afterload, arterial BP, compensatory effects,
Neural
¡Sympathetic nervous system
Hormonal
¡Renin-angiotensin-aldosterone (RAA system)
¡Antidiuretic hormone (vasopressin)
Vascular
Substances released from endothelial cells
Vasoconstriction
Vasodilators
Vascular Remodeling- endothelial dysfunction, thickened arterial walls- decreased lumen
How does hypertension alter cardiovascular function? - Answer ▫increasing the workload =
thickening and sclerosis of arterial walls.
▫increased cardiac workload = myocardium hypertrophies = heart failure
▫endothelial dysfunction and arterial changes cause narrow arterial lumen, decrease blood
supply to tissue, increase risk for thrombocytosis
Hypertension - Answer Is defined as a SBP greater than140 mm Hg or a DBP greater than 90
mm Hg on multiple blood pressure measurements
¡in patients without renal disease, diabetes, or proteinuria
A systolic pressure of 140 or less, with a diastolic pressure below 90, is called isolated systolic
hypertension and is more common amongst older adults. is a significant risk factor for
,¡renal failure
¡peripheral vascular disease
¡dementia
¡atrial fibrillation
¡erectile dysfunction, silent killer
Canadian Hypertension Education Program - Answer Recommendations
¡Home blood pressure (BP) monitoring
¡Annual BP assessment for individuals with prehypertension (130-139/85-89 mm Hg)
¡Ongoing routine assessment of blood pressure at clinic visits
¡Assessment of overall cardiovascular risk, Lifestyle modifications
¡Healthy diet
¡Regular physical activity
¡Moderation in alcohol
¡Reduction in dietary sodium
¡Stress reduction, Treat to target
¡less than 140/90 mm Hg
¡less than 130/80 mm Hg in those with diabetes or chronic kidney disease
Combinations of therapies
Regular follow- up
Focus on adherence- major focus for nursing care
BP classification - Answer Four stages based on blood pressure measurements:
1.Normal 120/80-129/89
2.Prehypertension 130/85-139/89
3.Stage 1 hypertension 140/90-159/99
4.Stage 2 hypertension 160+/100+
Unknown cause
¡Is called essential, idiopathic, or primary hypertension
¡Accounts for 90% of the cases
Known cause
,Types of antihypertensive drugs - Answer Angiotensin-converting enzyme inhibitors (ACE-I)
Angiotensin II receptor blockers (ARBs)
Calcium channel blockers (CCBs)
Adrenergic drugs (a-2 receptor agonists & beta blockers)
Vasodilators (direct acting)
Diuretics
Angiotension Converting Enzyme Inhibitors - Answer ACE inhibitors - "prils"
ramipril, lisinopril- newer, longer half life, one dose, prodrug needs to be activatedd in liver,
captopril(capoten)- short half life, slow, how it affects pt(HF), q6h, low dose, liver dysfunction
First line therapy for HTN and HF
Often used in combination:
¡thiazide diuretics or calcium channel blockers, not for monotherapy in darker skinned
individuals
MOA- Cardiac and renal effects
Inhibit the conversion of angiotensin I to angiotensin II
Prevent the breakdown of bradykinin and substance P (vasodilators)
Inhibit aldosterone secretion
Results:
¡Decreased SVR
¡Decreased afterload -
¡Prevention of sodium and water resorption
¡Diuresis and reduced preload - filling pressure at the end of diastole, Indications- Hypertension
(discussing today)
Heart failure- slows LVHF after MI
Post myocardial infarction
Renal failure patients with diabetes, Contraindications- Allergy: especially a previous reaction of
angioedema- laryngeal swelling
Pregnant/Lactating women
Used with caution in women of child bearing age
Children
, Impaired taste
Rash
Blood dycrasias (neutropenia, thrombocytopenia)
•Dizziness
•Mood changes
•Hyperkalemia
•Pruritis
ØDry, nonproductive cough, which reverses when therapy is stopped (10-20%)
ØAngioedema: 0.1 - 0.68% incidence
ØNOTE: first-dose hypotension may occur! Black individuals and women may have increase risk,
Interactions- NSAIDS- increase afterload
Lithium- toxicity
Potassium supplements and potassium-sparing diuretics- hyperkalemia
Angiotension 11 Receptor Blockers - Answer ARBs - "sartans": losartan, valsartan
Newer class
Similar to ACE-I - bp/ hemodynamic effects
Well tolerated
Less likely to cause hyperkalemia, Mechanism of Action: decrease BP, SVR
Block binding of angiotensin II to receptors
Blocks vasoconstriction
Block secretion of aldosterone
Used to treat hypertension and heart failure (adjunct)
Used primarily in clients who cannot tolerate ACE-I, vascular smooth muscle- adrenal glands
prevent sodium and water retention, May be used alone or with other drugs such as diuretics
¡Hyzaar is a combination of losartan (ARB)and hydrochlorothiazide (Diuretic)
Combinations of an ACE I with an ARB:
¡do not reduce cardiovascular events more than the ACE-I alone
¡have more adverse effects therefore are not generally recommended- not on ACE-I and ARB,
protein urea, nephropathy- caution with HF, Contraindications: •Most patients can take these
drugs
•Drug allergy
