Deck 19: Care of Patients With Hypertension and Peripheral Vascular Disease

Question 1

The nurse is planning the care for a patient who is to have a saphenous vein stripping.What will be the priority intervention?

A)Bed rest and leg elevation for the first 12 to 24 hours
B)Assessing the need for significant pain relief
C)Massaging the legs to stimulate sluggish circulation
D)Elevating the legs to prevent hematoma

Answer 1

Bed rest and leg elevation for the first 12 to 24 hours

Question 2

An 86-year-old patient asks why her ankles have a brownish discoloration and the skin looks so thick.Which is the most accurate response by the nurse?

A)"The valves in the vessels in your legs aren't working as well as they used to, which causes the discoloration and thickening of your skin."
B)"You probably aren't getting enough iron in your diet. We should talk to your doctor about adding an iron supplement."
C)"How many years have you smoked? Nicotine will cause these changes in your skin."
D)"These are just normal changes seen in most elderly people."

Answer 2

"The valves in the vessels in your legs aren't working as well as they used to, which causes the discoloration and thickening of your skin."

Question 3

The 75-year-old diabetic patient has an inflamed area at the shin caused by scratching.Which intervention should the nurse perform first?

A)Record the skin break.
B)Apply antibiotic ointment.
C)Wrap with an ACE bandage.
D)Cover with clear occlusive dressing.

Answer 3

Cover with clear occlusive dressing.

Question 4

The Unna paste boot is wrapped in a variety of directions to make the most of muscular action.These dressings are usually changed:

A)twice a day.
B)once a day.
C)every 2 to 3 days.
D)twice a month.

Question 5

The nurse is initiating the care plan for a patient with peripheral arterial disease,who complains of pain in the lower extremities at a 3/10,has a 0.5 cm ´ 1 cm ulcer on the left lower leg,and the lower legs are shiny and hairless bilaterally.What is the priority nursing diagnosis?

A)Injury related to loss of peripheral circulation
B)Acute pain related to ischemia to lower extremities
C)Impaired skin integrity related to ulcer on lower extremity
D)Deficient knowledge related to management of medical condition

Question 6

Hypertension is diagnosed by the finding of a blood pressure reading greater than:

A)120/80 twice, 2 weeks apart.
B)140/90 twice, 2 weeks apart.
C)120/80 on 3 consecutive days.
D)140/90 every day for a week.

Question 7

The nurse is providing patient teaching to a pregnant patient who works as a cashier in a grocery store.Which suggestion by the nurse will help most in preventing varicose veins?

A)Add vitamin C to diet.
B)"March in place" while standing at the counter.
C)Avoid tight support hose.
D)Wear supportive shoes.

Question 8

The patient scheduled for a percutaneous angioplasty (PTA)is instructed that a ________ is left in the artery to keep it patent.

A)bolus of alteplase
B)dose of reteplase
C)stent
D)graft

Question 9

The home health nurse is alarmed that the hypertensive patient's blood pressure has risen to 200/160,but he denies any discomfort.The nurse interprets these assessments as being indicative of:

A)malignant hypertension.
B)hypertensive crisis.
C)essential hypertension.
D)secondary hypertension.

Question 10

The nurse cautions the patient with uncontrolled hypertension that the consequences of the disease will include: (Select all that apply.)

A)threat of a stroke.
B)possible kidney failure.
C)risk for heart attack.
D)probability of congestive heart failure.
E)development of DVT.

Question 11

The patient has been prescribed a low-sodium diet.Which food omissions from the diet will indicate the patient has an adequate understanding of the recommended diet?

A)Fresh spinach
B)Hot dogs
C)Pasta
D)Grapefruit

Question 12

The student nurse is planning a presentation on hypertension to present in a community setting.Which group of individuals should the student identify as having the highest incidence of hypertension?

A)Muslims
B)African Americans
C)Whites
D)Latinos

Question 13

The patient with a deep venous thrombosis is on a protocol of IV urokinase.The nurse clarifies that this drug will:

A)reduce the threat of pulmonary embolus.
B)dissolve the clot.
C)prevent platelet aggregation.
D)reduce inflammation and pain.

Question 14

The patient is instructed that the most common and effective antiplatelet aggregation agent is:

A)warfarin.
B)aspirin.
C)alteplase (Activase).
D)reteplase (Retavase).

Question 15

The nurse is caring for a patient diagnosed with an abdominal aortic aneurysm.The patient is complaining of intense abdominal pain and lightheadedness.The patient's blood pressure has dropped and pulse is rising.What is the priority nursing intervention?

A)Monitor the patient's blood pressure every 15 minutes.
B)Contact the physician immediately.
C)Notify the patient's family of the change in condition.
D)Instruct the patient to inform you if the pain intensifies.

Question 16

Peripheral vascular disease (PVD)is characterized by: (Select all that apply.)

A)narrowing of arteries.
B)obstruction of veins.
C)involvement of all extremities only.
D)defective valve function.
E)production of thrombophlebitis.

Question 17

The nurse assessing a patient with a deep venous thrombosis (DVT)becomes concerned when the patient demonstrates which sign or symptom?

A)Hematuria
B)Tingling in the limbs
C)Hematemesis
D)Hemoptysis

Question 18

Because of reduced sensitivity of the baroreceptors in the older adult who is also on a diuretic,the nurse instructs the patient to:

A)walk for 20 minutes a day.
B)reduce sodium in the diet.
C)sit on the side of the bed before standing.
D)use a walker for all ambulation.

Question 19

The patient who is on daily doses of warfarin is instructed in the use of a coagulation monitoring device.The patient is taught that the device will monitor which blood clotting time?

A)PT
B)PTT
C)INR
D)ACT

Question 20

The nurse adds an intervention to the care plan of a patient who has just been prescribed a thiazide diuretic,which is to increase:

A)intake of foods containing potassium.
B)carbohydrates in the diet.
C)foods high in sodium.
D)fluid intake.

Question 21

The nurse is caring for a patient with Raynaud's disease who is employed as a construction worker,has hypertension,and smokes 1/2 to 1 pack of cigarettes per day.What teaching points should the nurse include in discharge instructions? (Select all that apply.)

A)Wear gloves during cool weather.
B)Drink plenty of warm beverages, such as coffee.
C)Insulated socks are advisable when working in cool weather.
D)Attend a smoking program.
E)Wear gloves when handling hot objects at work.

Question 22

The nurse instructs that the "6 Ps" of arterial disease include: (Select all that apply.)

A)pain.
B)paresthesia.
C)putrefaction.
D)pooling.
E)pallor.

Question 23

The patient who has a history of smoking and alcohol abuse is most likely to develop __________ hypertension.

Question 24

The nurse in a long-term care facility designs a teaching program for the residents to help prevent peripheral vascular disease (PVD)caused by age-related changes,which include: (Select all that apply.)

A)decreasing blood viscosity.
B)loss of elasticity in vessel walls.
C)atherosclerotic vessels.
D)sedentary practices.
E)weakened leg muscles.

Question 25

The nurse plans to enhance blood flow in the 80-year-old long-term care facility resident by interventions such as: (Select all that apply.)

A)using lap throws or light blankets over legs while sitting.
B)elevating legs with knee gatch.
C)encouraging walking.
D)coaching isometric exercises.
E)keeping environment warm.

Question 26

The nurse outlines methods of prevention of peripheral vascular disease (PVD),which include: (Select all that apply.)

A)relieving stress.
B)controlling diabetes.
C)maintaining appropriate weight.
D)routinely exercising.
E)stopping smoking.
F) None of the above

Question 27

The nurse anticipates that the patient with venous insufficiency will need an intervention for: (Select all that apply.)

A)assessment for phlebitis.
B)elevating feet to reduce edema.
C)NSAIDs for pain control.
D)strategies to decrease itching.
E)approach to regular exercise.