Deck 36: Care of Patients with Vascular Problems

Question 1

A nurse is working with a client who takes atorvastatin (Lipitor).The client's recent laboratory results include a blood urea nitrogen (BUN)of 33 mg/dL and creatinine of 2.8 mg/dL.What action by the nurse is best?

A) Ask if the client eats grapefruit.
B) Assess the client for dehydration.
C) Facilitate admission to the hospital.
D) Obtain a random urinalysis.

Answer 1

Ask if the client eats grapefruit.

Question 2

A client is 4 hours postoperative after a femoropopliteal bypass.The client reports throbbing leg pain on the affected side,rated as 7/10.What action by the nurse takes priority?

A) Administer pain medication as ordered.
B) Assess distal pulses and skin color.
C) Document the findings in the client's chart.
D) Notify the surgeon immediately.

Answer 2

Assess distal pulses and skin color.

Question 3

A client has been diagnosed with hypertension but does not take the antihypertensive medications because of a lack of symptoms.What response by the nurse is best?

A) "Do you have trouble affording your medications?"
B) "Most people with hypertension do not have symptoms."
C) "You are lucky; most people get severe morning headaches."
D) "You need to take your medicine or you will get kidney failure."

Answer 3

"Most people with hypertension do not have symptoms."

Question 4

A nurse is teaching a larger female client about alcohol intake and how it affects hypertension.The client asks if drinking two beers a night is an acceptable intake.What answer by the nurse is best?

A) "No, women should only have one beer a day as a general rule."
B) "No, you should not drink any alcohol with hypertension."
C) "Yes, since you are larger, you can have more alcohol."
D) "Yes, two beers per day is an acceptable amount of alcohol."

Question 5

The nurse is reviewing the lipid panel of a male client who has atherosclerosis.Which finding is most concerning?

A) Cholesterol: 126 mg/dL
B) High-density lipoprotein cholesterol (HDL-C): 48 mg/dL
C) Low-density lipoprotein cholesterol (LDL-C): 122 mg/dL
D) Triglycerides: 198 mg/dL

Question 6

A student nurse is assessing the peripheral vascular system of an older adult.What action by the student would cause the faculty member to intervene?

A) Assessing blood pressure in both upper extremities
B) Auscultating the carotid arteries for any bruits
C) Classifying capillary refill of 4 seconds as normal
D) Palpating both carotid arteries at the same time

Question 7

A nurse is assessing a client with peripheral artery disease (PAD).The client states walking five blocks is possible without pain.What question asked next by the nurse will give the best information?

A) "Could you walk further than that a few months ago?"
B) "Do you walk mostly uphill, downhill, or on flat surfaces?"
C) "Have you ever considered swimming instead of walking?"
D) "How much pain medication do you take each day?"

Question 8

A nursing student is caring for a client with an abdominal aneurysm.What action by the student requires the registered nurse to intervene?

A) Assesses the client for back pain
B) Auscultates over abdominal bruit
C) Measures the abdominal girth
D) Palpates the abdomen in four quadrants

Question 9

A nurse is caring for four clients.Which one should the nurse see first?

A) Client who needs a beta blocker, and has a blood pressure of 92/58 mm Hg
B) Client who had a first dose of captopril (Capoten) and needs to use the bathroom
C) Hypertensive client with a blood pressure of 188/92 mm Hg
D) Client who needs pain medication prior to a dressing change of a surgical wound

Question 10

A nurse is caring for a client with a deep vein thrombosis (DVT).What nursing assessment indicates a priority outcome has been met?

A) Ambulates with assistance
B) Oxygen saturation of 98%
C) Pain of 2/10 after medication
D) Verbalizing risk factors

Question 11

A client is taking warfarin (Coumadin)and asks the nurse if taking St.John's wort is acceptable.What response by the nurse is best?

A) "No, it may interfere with the warfarin."
B) "There isn't any information about that."
C) "Why would you want to take that?"
D) "Yes, it is a good supplement for you."

Question 12

An older client with peripheral vascular disease (PVD)is explaining the daily foot care regimen to the family practice clinic nurse.What statement by the client may indicate a barrier to proper foot care?

A) "I nearly always wear comfy sweatpants and house shoes."
B) "I'm glad I get energy assistance so my house isn't so cold."
C) "My daughter makes sure I have plenty of lotion for my feet."
D) "My hands shake when I try to do things requiring coordination."

Question 13

A student nurse asks what "essential hypertension" is.What response by the registered nurse is best?

A) "It means it is caused by another disease."
B) "It means it is 'essential' that it be treated."
C) "It is hypertension with no specific cause."
D) "It refers to severe and life-threatening hypertension."

Question 14

A client had a femoropopliteal bypass graft with a synthetic graft.What action by the nurse is most important to prevent wound infection?

A) Appropriate hand hygiene before giving care
B) Assessing the client's temperature every 4 hours
C) Clean technique when changing dressings
D) Monitoring the client's daily white blood cell count

Question 15

A client is receiving an infusion of alteplase (Activase)for an intra-arterial clot.The client begins to mumble and is disoriented.What action by the nurse takes priority?

A) Assess the client's neurologic status.
B) Notify the Rapid Response Team.
C) Prepare to administer vitamin K.
D) Turn down the infusion rate.

Question 16

A client has hypertension and high risk factors for cardiovascular disease.The client is overwhelmed with the recommended lifestyle changes.What action by the nurse is best?

A) Assess the client's support system.
B) Assist in finding one change the client can control.
C) Determine what stressors the client faces in daily life.
D) Inquire about delegating some of the client's obligations.

Question 17

The nurse is evaluating a 3-day diet history with a client who has an elevated lipid panel.What meal selection indicates the client is managing this condition well with diet?

A) A 4-ounce steak, French fries, iceberg lettuce
B) Baked chicken breast, broccoli, tomatoes
C) Fried catfish, cornbread, peas
D) Spaghetti with meat sauce, garlic bread

Question 18

A client had a percutaneous transluminal coronary angioplasty for peripheral arterial disease.What assessment finding by the nurse indicates a priority outcome for this client has been met?

A) Pain rated as 2/10 after medication
B) Distal pulse on affected extremity 2+/4+
C) Remains on bedrest as directed
D) Verbalizes understanding of procedure

Question 19

The nurse is caring for four hypertensive clients.Which drug-laboratory value combination should the nurse report immediately to the health care provider?

A) Furosemide (Lasix)/potassium: 2.1 mEq/L
B) Hydrochlorothiazide (Hydrodiuril)/potassium: 4.2 mEq/L
C) Spironolactone (Aldactone)/potassium: 5.1 mEq/L
D) Torsemide (Demadex)/sodium: 142 mEq/L

Question 20

A nurse is interested in providing community education and screening on hypertension.In order to reach a priority population,to what target audience should the nurse provide this service?

A) African-American churches
B) Asian-American groceries
C) High school sports camps
D) Women's health clinics

Question 21

A nurse wants to provide community service that helps meet the goals of Healthy People 2020 (HP2020)related to cardiovascular disease and stroke.What activity would best meet this goal?

A) Teach high school students heart-healthy living.
B) Participate in blood pressure screenings at the mall.
C) Provide pamphlets on heart disease at the grocery store.
D) Set up an "Ask the nurse" booth at the pet store.

Question 22

A client with a known abdominal aortic aneurysm reports dizziness and severe abdominal pain.The nurse assesses the client's blood pressure at 82/40 mm Hg.What actions by the nurse are most important? (Select all that apply.)

A) Administer pain medication.
B) Assess distal pulses every 10 minutes.
C) Have the client sign a surgical consent.
D) Notify the Rapid Response Team.
E) Take vital signs every 10 minutes.

Question 23

A client has been bedridden for several days after major abdominal surgery.What action does the nurse delegate to the unlicensed assistive personnel (UAP)for deep vein thrombosis (DVT)prevention? (Select all that apply.)

A) Apply compression stockings.
B) Assist with ambulation.
C) Encourage coughing and deep breathing.
D) Offer fluids frequently.
E) Teach leg exercises.

Question 24

The nurse is assessing a client on admission to the hospital.The client's leg appears as shown below:

What action by the nurse is best?

A) Assess the client's ankle-brachial index.
B) Elevate the client's leg above the heart.
C) Obtain an ice pack to provide comfort.
D) Prepare to teach about heparin sodium.

Question 25

A client presents to the emergency department with a severely lacerated artery.What is the priority action for the nurse?

A) Administer oxygen via non-rebreather mask.
B) Ensure the client has a patent airway.
C) Prepare to assist with suturing the artery.
D) Start two large-bore IVs with normal saline.

Question 26

A client has peripheral arterial disease (PAD).What statement by the client indicates misunderstanding about self-management activities?

A) "I can use a heating pad on my legs if it's set on low."
B) "I should not cross my legs when sitting or lying down."
C) "I will go out and buy some warm, heavy socks to wear."
D) "It's going to be really hard but I will stop smoking."

Question 27

A client with a history of heart failure and hypertension is in the clinic for a follow-up visit.The client is on lisinopril (Prinivil)and warfarin (Coumadin).The client reports new-onset cough.What action by the nurse is most appropriate?

A) Assess the client's lung sounds and oxygenation.
B) Instruct the client on another antihypertensive.
C) Obtain a set of vital signs and document them.
D) Remind the client that cough is a side effect of Prinivil.

Question 28

Which statements by the client indicate good understanding of foot care in peripheral vascular disease? (Select all that apply.)

A) "A good abrasive pumice stone will keep my feet soft."
B) "I'll always wear shoes if I can buy cheap flip-flops."
C) "I will keep my feet dry, especially between the toes."
D) "Lotion is important to keep my feet smooth and soft."
E) "Washing my feet in room-temperature water is best."

Question 29

A nurse is assessing an obese client in the clinic for follow-up after an episode of deep vein thrombosis.The client has lost 20 pounds since the last visit.What action by the nurse is best?

A) Ask if the weight loss was intended.
B) Encourage a high-protein, high-fiber diet.
C) Measure for new compression stockings.
D) Review a 3-day food recall diary.

Question 30

A nurse is caring for a client with a nonhealing arterial lower leg ulcer.What action by the nurse is best?

A) Consult with the Wound Ostomy Care Nurse.
B) Give pain medication prior to dressing changes.
C) Maintain sterile technique for dressing changes.
D) Prepare the client for eventual amputation.

Question 31

The nurse working in the emergency department knows that which factors are commonly related to aneurysm formation? (Select all that apply.)

A) Atherosclerosis
B) Down syndrome
C) Frequent heartburn
D) History of hypertension
E) History of smoking

Question 32

A nurse is caring for a client on IV infusion of heparin.What actions does this nurse include in the client's plan of care? (Select all that apply.)

A) Assess the client for bleeding.
B) Monitor the daily activated partial thromboplastin time (aPTT) results.
C) Stop the IV for aPTT above baseline.
D) Use an IV pump for the infusion.
E) Weigh the client daily on the same scale.

Question 33

A nurse is caring for a client with a nonhealing arterial ulcer.The physician has informed the client about possibly needing to amputate the client's leg.The client is crying and upset.What actions by the nurse are best? (Select all that apply.)

A) Ask the client to describe his or her current emotions.
B) Assess the client for support systems and family.
C) Offer to stay with the client if he or she desires.
D) Relate how smoking contributed to this situation.
E) Tell the client that many people have amputations.

Question 34

A nurse is preparing a client for a femoropopliteal bypass operation.What actions does the nurse delegate to the unlicensed assistive personnel (UAP)? (Select all that apply.)

A) Administering preoperative medication
B) Ensuring the consent is signed
C) Marking pulses with a pen
D) Raising the siderails on the bed
E) Recording baseline vital signs

Question 35

A client has a deep vein thrombosis (DVT).What comfort measure does the nurse delegate to the unlicensed assistive personnel (UAP)?

A) Ambulate the client.
B) Apply a warm moist pack.
C) Massage the client's leg.
D) Provide an ice pack.

Question 36

A client has been diagnosed with a deep vein thrombosis and is to be discharged on warfarin (Coumadin).The client is adamant about refusing the drug because "it's dangerous." What action by the nurse is best?

A) Assess the reason behind the client's fear.
B) Remind the client about laboratory monitoring.
C) Tell the client drugs are safer today than before.
D) Warn the client about consequences of noncompliance.

Question 37

A nurse is caring for a client who weighs 220 pounds and is started on enoxaparin (Lovenox).How much enoxaparin does the nurse anticipate administering? (Record your answer using a whole number.)_____ mg

Question 38

What nonpharmacologic comfort measures should the nurse include in the plan of care for a client with severe varicose veins? (Select all that apply.)

A) Administering mild analgesics for pain
B) Applying elastic compression stockings
C) Elevating the legs when sitting or lying
D) Reminding the client to do leg exercises
E) Teaching the client about surgical options

Question 39

A client is being discharged on warfarin (Coumadin)therapy.What discharge instructions is the nurse required to provide? (Select all that apply.)

A) Dietary restrictions
B) Driving restrictions
C) Follow-up laboratory monitoring
D) Possible drug-drug interactions
E) Reason to take medication