Deck 19: Disorders of the Venous System

Question 1

The tunica media is
1) an endothelial cell lining.
2) the smooth muscle layer of the wall of a vein.
3) made up of connective tissue.
4) also called the tunica adventitia.

Answer 1

2

Question 2

Which is a cause for the occurrence of varicose veins?
1) Valvular incompetence in the legs
2) Sluggish circulation
3) Poor tissue oxygenation
4) Impaired removal of fluid and waste products

Answer 2

1

Question 3

A client works as a sales associate in a garment outlet and has to stand for the duration of each work shift. Clinical examination reveals a presence of a dusky discoloration around the ankle, instep, and lower leg. What condition do these findings indicate?
1) Deep venous thromboembolism
2) Pulmonary embolism
3) Chronic venous insufficiency
4) Varicose vein

Answer 3

3

Question 4

A client reports to the hospital with a swollen mass on the left leg. Physical examination reveals that the swollen mass is red, tender, and is textured like a rope. A review of the client's records show that the client has recently undergone an orthopedic surgery on his right leg. Which condition has the client developed?
1) Deep venous thromboembolism
2) Pulmonary embolism
3) Chronic venous insufficiency
4) Varicose vein

Question 5

Which test is most commonly used to diagnose varicose vein?
1) D-dimer test
2) Duplex ultrasound
3) Wells criteria
4) Magnetic resonance imaging

Question 6

Which specific sign or symptom indicates that a client is suffering from varicose veins?
1) Itching and aching lower leg muscles
2) Ropiness over a vein in the leg
3) Tenderness in the vein
4) Irregular margins in the medial ankle region
Exhibit

Question 7

What is the outermost layer of the walls of a vein?
1) Tunica adventitia
2) Parietal layer
3) Tunica intima
4) Visceral layer
5) Tunica media

Question 8

Which drug administered to clients with deep venous thromboembolism (DVT) requires an international normalized ratio monitoring?
1) Low molecular weight heparin
2) Factor Xa inhibitor
3) Warfarin
4) None of the above

Question 9

What is the purpose of a Greenfield filter?
1) To prevent the formation of a blood clot
2) To help burst a blood clot
3) To prevent a blood clot from traveling
4) To detect a blood clot

Question 10

A client comes to the clinic with dark red edema on the lower leg, with irregular margins of skin breakdown especially in the medial ankle region. The primary health-care provider diagnoses necrosis and tissue damage surrounding the affected area. What treatment would the nurse expect to be prescribed for this client?
1) Sclerotherapy
2) Antiplatelet drugs
3) Topical medications
4) Pneumatic compression device

Question 11

A nurse is reviewing the prescription records of four clients being treated for deep vein thromboembolism (DVT). Which client needs a prothrombin time lab test to monitor the therapeutic effects of the drug?
1) Client 1
2) Client 2
3) Client 3
4) Client 4

Question 12

A nurse is caring for a client with chronic venous insufficiency. Which instruction is appropriate to include in the client's care plan?
1) Try to reduce your walking throughout the day.
2) Wear constriction garments.
3) Apply a cold compression.
4) Elevate your legs periodically during the day.

Question 13

The nurse uses Homan's sign to assess a client for the presence of deep venous thromboembolism (DVT). Pain in what area is an indication of positive Homan's sign?
1) Hip
2) Calf
3) Knee
4) Thighs

Question 14

A client with left lower extremity swelling and tenderness along a vein has to be assessed to rule out deep vein thrombosis (DVT). Which criteria would rule out DVT?
1) A negative D-dimer assay and Wells criteria score of 3
2) A positive D-dimer assay and Wells criteria score of less than 1
3) A negative D-dimer assay and Wells criteria score of less than 2
4) A positive D-dimer assay and Wells criteria score of 0

Question 15

A nurse is assessing four clients for deep vein thromboembolism (DVT). Which client is at a risk of developing DVT?
1) Client 1
2) Client 2
3) Client 3
4) Client 4

Question 16

A client presents with a painful, swollen mass at the ankle of the right leg. Physical examination revealed that the edema is dark red in color, with drainage just above the medial malleolus of the leg. Which condition has the client developed?
1) Deep venous thromboembolism
2) Pulmonary embolism
3) Venous ulcer
4) Varicose vein

Question 17

What condition can develop from a deep venous thrombosis (DVT) if it is not caught and treated early enough?
1) Necrosis
2) Skin breakdown
3) Tissue damage
4) Pulmonary embolism

Question 18

A 60-year-old client is seen at the clinic with skin inflammation. There is dusky discoloration around the ankle and in the lower leg of the client. What might be the cause of this condition?
1) Reduced blood pressure in the veins
2) Insufficient oxygenation to the tissues
3) Buildup of hemosiderin
4) Blockage of sweat gland

Question 19

A registered nurse is teaching a group of nursing students about Homan's sign. Which statement made by the student nurse indicates effective learning?
1) "Place the client in the supine position with a straight knee and dorsiflex the client's foot."
2) "Place the client in a prone position and flex the knee to a right angle."
3) "Place the client such that the back is rested and knees are flexed, and then dorsiflex the ankle.
4) "Place the client in a sitting position and extend the legs one at a time, and then both together.

Question 20

Which diagnostic test is used to identify the pattern of collateral blood flow?
1) Venography
2) Ultrasonography
3) Photoplethysmography
4) None of the above

Question 21

What are the diagnostic tests used for peripheral venous disorders?
1) Magnetic Resonance Imaging (MRI)
2) Photoplethysmography
3) Computed tomography (CT)
4) Doppler ultrasonography
5) Venography

Question 22

Which of the risk factors form part of Virchow's triad?
1) Venous stasis
2) Smoking
3) Vascular damage
4) Obesity
5) Hypercoagulability

Question 23

Arrange the pathophysiological changes involved in a pulmonary embolism (A-D). (Enter the number of each step in the proper sequence; do not use commas or spaces.)
A. The thrombus becomes an embolus and travels into the inferior vena cava.
B. The thrombus travels into the right side of the heart.
C. Inflammation and thrombus form in the vein.
D. The thrombus then enters the pulmonary artery.

Question 24

A student nurse is learning to care for a variety of clients in a hospital setting. Which clients are most at risk for developing venous insufficiency?
1) An obese client
2) A client with pulmonary embolism
3) A pregnant client at 30 weeks gestation
4) A client who is recovering from a shoulder surgery
5) A client who uses a walker for support
Other

Question 25

Arrange the symptoms in the proper order to describe the pathophysiology of varicose veins (A-D). (Enter the number of each step in the proper sequence; do not use commas or spaces.)
A. Damaged valves
B. Pressure on the valves
C. Blood stagnation and pooling in the lower extremities
D. Compromised venous return