A patient has been diagnosed with secondary hypertension. The nurse understands that secondary hypertension:
leads to extensive organ damage in most cases.
has no known cause.
will resolve when the underlying condition is treated.
is known as the silent killer.
The Correct Answer is C
Choice A rationale
While secondary hypertension can cause organ damage if left untreated, this is not its defining characteristic. Both primary and secondary hypertension can lead to complications like stroke, kidney failure, and heart disease. The distinguishing factor of secondary hypertension is its etiology rather than its severity. Organ damage is often more a function of the duration and magnitude of the blood pressure elevation rather than whether the underlying cause is identified or is considered to be idiopathic in nature.
Choice B rationale
This statement describes primary or essential hypertension, which accounts for about 90 to 95 percent of all hypertension cases. Primary hypertension has no single identifiable cause and is thought to result from a complex interaction of genetics and lifestyle factors. Secondary hypertension, by definition, has a specific, identifiable underlying cause. Common causes of secondary hypertension include chronic kidney disease, primary aldosteronism, renovascular disease, sleep apnea, or certain medications like oral contraceptives and nonsteroidal anti-inflammatory drugs.
Choice C rationale
Secondary hypertension is high blood pressure that is caused by another medical condition. Because it is a symptom of an underlying issue, treating that specific condition often results in the blood pressure returning to normal or becoming much easier to manage. For example, if a patient has a pheochromocytoma, removing the tumor usually cures the hypertension. This distinguishes it from essential hypertension, which requires lifelong management with lifestyle changes and medications because the root cause cannot be definitively removed.
Choice D rationale
The term silent killer is used to describe hypertension in general, both primary and secondary, because it often has no obvious symptoms while it causes progressive damage to the cardiovascular system. Patients can have dangerously high blood pressure for years without feeling any different. However, this nickname does not specifically define what secondary hypertension is or how it differs from the primary form. The focus of the term is on the asymptomatic nature of high blood pressure rather than its underlying cause.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A rationale
Infection of the endocardium describes endocarditis, which is an inflammatory process usually involving the heart valves and the inner lining of the heart chambers. This condition is typically caused by bacteria entering the bloodstream and colonizing damaged heart tissue. While serious, it is a different pathological process from a myocardial infarction, which is primarily a vascular event involving the coronary arteries rather than a primary infectious process of the heart lining.
Choice B rationale
A temporary deficit of oxygen that resolves with rest is the physiological definition of angina pectoris, specifically stable angina. In this state, the heart muscle experiences ischemia, which causes pain, but the cells do not suffer permanent damage or death because blood flow is restored quickly. Myocardial infarction is distinguished from this by the fact that the deprivation of oxygen is prolonged enough to cause irreversible tissue death and cellular necrosis.
Choice C rationale
Myocardial infarction occurs when a coronary artery is completely or nearly completely obstructed, often by a ruptured plaque followed by thrombus formation. This total blockage halts the delivery of oxygen and nutrients to the downstream cardiac tissue. Without blood flow, the myocytes undergo anaerobic metabolism, eventually leading to cell death and the loss of contractile function. This permanent structural damage is the defining characteristic of an infarction versus transient ischemia.
Choice D rationale
An increase in oxygen consumption by myocardial cells can trigger ischemia if the supply cannot keep up, but it does not describe the primary mechanism of an infarction. While high heart rates or hypertension increase demand, an infarction is defined by the failure of the supply line, usually due to a physical blockage. Increased demand is more often the precipitating factor for stable angina in a patient who already has narrowed, but not blocked, arteries.
Correct Answer is C
Explanation
Choice A rationale
Heart rate is the frequency of cardiac cycles measured in beats per minute. This parameter represents the chronotropic state of the heart rather than a volume-related measurement. Normal resting adult heart rate typically ranges from 60 to 100 beats per minute. Preload specifically concerns the end-diastolic volume, whereas Choice A describes a temporal measure of cardiac activity that contributes to total cardiac output but does not define the mechanical stretching of the ventricular fibers before contraction.
Choice B rationale
This description refers to afterload, which is the systemic vascular resistance the left ventricle must push against during systole. Afterload is determined by factors like aortic pressure and systemic vascular tone. While preload is a volume measurement occurring before contraction, afterload is the tension or stress developed in the wall of the left ventricle during ejection. Increased afterload can lead to decreased stroke volume if the heart cannot compensate for the increased resistance within the arterial system.
Choice C rationale
Preload is defined as the initial stretching of the cardiac myocytes prior to contraction. It is directly related to ventricular filling and the end-diastolic volume. According to the Frank-Starling law, as preload increases, the force of contraction increases to a point. Normal central venous pressure, which reflects right-sided preload, is 2 to 6 mmHg. Increasing blood return to the heart stretches the myocardial fibers, optimizing the overlap of actin and myosin filaments for an effective contraction.
Choice D rationale
This statement describes diastolic blood pressure, which is the minimum pressure remaining in the arteries when the heart is in a state of relaxation. Normal diastolic blood pressure for an adult is typically less than 80 mmHg. While this occurs during the same phase of the cardiac cycle as preload, it measures the pressure exerted on vessel walls rather than the volume or stretch within the cardiac chambers themselves. It is a component of systemic vascular resistance.
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