Question 1

After receiving report,which patient admitted to the emergency department should the nurse assess first?

Accepted Answer

The patient's presentation is consistent with dissecting thoracic aneurysm,which will require rapid intervention.The other patients do not need urgent interventions.

Question 2

An 80-year-old patient with a history of an abdominal aortic aneurysm arrives at the emergency department (ED)with severe back pain and absent pedal pulses.Which actions should the nurse take first?

Accepted Answer

Because the patient appears to be experiencing aortic dissection,the nurse's first action should be to determine the hemodynamic status by assessing blood pressure.The other actions also may be done,but they will not provide information that will determine what interventions are needed immediately for this patient.

Question 3

When developing a teaching plan for a 76-year-old patient newly diagnosed with peripheral artery disease (PAD),which instructions should the nurse include?

Accepted Answer

Smoking cessation is essential for slowing the progression of PAD to critical limb ischemia and reducing the risk of myocardial infarction and death.Circulation to the legs will decrease if the legs are elevated.Patients with PAD are taught to exercise to the point of feeling pain,rest,and then resume walking.Support hose are not used for patients with PAD.

Question 4

The nurse is caring for a patient with critical limb ischemia who has just arrived on the nursing unit after having percutaneous transluminal balloon angioplasty.Which action should the nurse perform first?

Accepted Answer

Bleeding is a possible complication after catheterization of the femoral artery,so the nurse's first action should be to assess for changes in vital signs that might indicate hemorrhage.The other actions are also appropriate but can be done after determining that bleeding is not occurring.

Question 5

The nurse is caring for a patient immediately after repair of an abdominal aortic aneurysm.On assessment,the patient has absent popliteal,posterior tibial,and dorsalis pedis pulses.The legs are cool and mottled.Which action should the nurse take first?

Accepted Answer

Lower extremity pulses may be absent for a short time after surgery because of vasospasm and hypothermia.Decreased or absent pulses together with a cool and mottled extremity may indicate embolization or graft occlusion.These findings should be reported to the physician immediately because this is an emergency situation.Because pulses are marked prior to surgery,the nurse would know whether pulses were present prior to surgery before notifying the health care providers about the absent pulses.Because the patient's symptoms may indicate graft occlusion or multiple emboli and a possible need to return to surgery,it is not appropriate to wait 15 minutes before taking action.A warming blanket will not improve the circulation to the patient's legs.

Question 6

The nurse is caring for a patient with a descending aortic dissection.Which assessment finding is most important to report to the health care provider?

Accepted Answer

The blood pressure is typically kept at less than 120 mm Hg systolic to minimize extension of the dissection.The nurse will need to notify the health care provider so that b-blockers or other antihypertensive medications can be prescribed.The other findings are typical with aortic dissection and should also be reported but do not require immediate action.

Question 7

A patient is being evaluated for post-thrombotic syndrome.Which assessment will the nurse perform?

Accepted Answer

Clinical signs of post-thrombotic syndrome include lipodermatosclerosis.In this situation,the skin on the lower leg becomes scarred,and the leg becomes tapered like an "inverted bottle." The other assessments would be done for patients with peripheral arterial disease.

Question 8

Which actions could the nurse delegate to unlicensed assistive personnel (UAP)who are providing care for a patient who is at risk for venous thromboembolism?

Accepted Answer

UAP training includes the use of equipment that requires minimal nursing judgment,such as sequential compression devices.Patient assessment and teaching require more education and critical thinking and should be done by the registered nurse (RN).

Question 9

When assessing a patient with possible peripheral artery disease (PAD),the nurse obtains a brachial BP of 147/82 and an ankle pressure of 112/74.The nurse calculates the patient's ankle-brachial index (ABI)as ________ (round up to the nearest hundredth).

Accepted Answer

The answer of When assessing a patient with possible peripheral...

Question 10

A patient who is 2 days post-femoral-popliteal bypass graft to the right leg is being cared for on the vascular unit.Which action by a licensed practical/vocational nurse (LPN/LVN)caring for the patient requires the registered nurse (RN)to intervene?

Accepted Answer

The patient should avoid sitting for long periods because of the increased stress on the suture line caused by leg edema and because of the risk for venous thromboembolism (VTE).The other actions by the LPN/LVN are appropriate.

Question 11

The nurse reviews the admission orders shown in the accompanying figure for a patient newly diagnosed with peripheral artery disease.Which admission order should the nurse question?

Accepted Answer

Because the antiplatelet effect of clopidogrel is reduced when it is used with omeprazole,the nurse should clarify this prescription with the health care provider.The other interventions are appropriate for a patient with peripheral artery disease.

Question 12

When caring for a patient on the first postoperative day after an abdominal aortic aneurysm repair,which assessment finding is most important for the nurse to communicate to the health care provider?

Accepted Answer

Loose,bloody stools at this time may indicate intestinal ischemia or infarction,and should be reported immediately because the patient may need an emergency bowel resection.The other findings are normal on the first postoperative day after abdominal surgery.

Question 13

A 46-year-old is diagnosed with thromboangiitis obliterans (Buerger's disease).When the nurse is developing a discharge teaching plan for the patient,which outcome has the highest priority for this patient?

Accepted Answer

Absolute cessation of nicotine use is needed to reduce the risk for amputation in patients with Buerger's disease.Other therapies have limited success in treatment of this disease.

Question 14

Which assessment finding for a patient who has been admitted with a right calf venous thromboembolism (VTE)requires immediate action by the nurse?

Accepted Answer

New onset dyspnea suggests a pulmonary embolus,which will require rapid actions such as oxygen administration and notification of the health care provider.The other findings are typical of VTE.

Question 15

Which nursing intervention for a patient who had an open repair of an abdominal aortic aneurysm 2 days previously is appropriate for the nurse to delegate to unlicensed assistive personnel (UAP)?

Accepted Answer

Assisting a patient who has already been taught how to cough is part of routine postoperative care and within the education and scope of practice for UAP.Patient teaching and assessment of essential postoperative functions such as circulation and movement should be done by RNs.

Question 16

The nurse who works in the vascular clinic has several patients with venous insufficiency scheduled today.Which patient should the nurse assign to an experienced licensed practical/vocational nurse (LPN/LVN)?

Accepted Answer

LPN education and scope of practice includes wound care.The other patients,which require more complex assessments or education,should be managed by the RN.

Quiz 38: Nursing Management: Vascular Disorders

After receiving report,which patient admitted to the emergency department should the nurse assess first?

An 80-year-old patient with a history of an abdominal aortic aneurysm arrives at the emergency department (ED) with severe back pain and absent pedal pulses.Which actions should the nurse take first?

When developing a teaching plan for a 76-year-old patient newly diagnosed with peripheral artery disease (PAD) ,which instructions should the nurse include?

The nurse is caring for a patient with critical limb ischemia who has just arrived on the nursing unit after having percutaneous transluminal balloon angioplasty.Which action should the nurse perform first?

The nurse is caring for a patient immediately after repair of an abdominal aortic aneurysm.On assessment,the patient has absent popliteal,posterior tibial,and dorsalis pedis pulses.The legs are cool and mottled.Which action should the nurse take first?

The nurse is caring for a patient with a descending aortic dissection.Which assessment finding is most important to report to the health care provider?

A patient is being evaluated for post-thrombotic syndrome.Which assessment will the nurse perform?

Which actions could the nurse delegate to unlicensed assistive personnel (UAP) who are providing care for a patient who is at risk for venous thromboembolism?

When assessing a patient with possible peripheral artery disease (PAD),the nurse obtains a brachial BP of 147/82 and an ankle pressure of 112/74.The nurse calculates the patient's ankle-brachial index (ABI)as ________ (round up to the nearest hundredth).

A patient who is 2 days post-femoral-popliteal bypass graft to the right leg is being cared for on the vascular unit.Which action by a licensed practical/vocational nurse (LPN/LVN) caring for the patient requires the registered nurse (RN) to intervene?

The nurse reviews the admission orders shown in the accompanying figure for a patient newly diagnosed with peripheral artery disease.Which admission order should the nurse question?

When caring for a patient on the first postoperative day after an abdominal aortic aneurysm repair,which assessment finding is most important for the nurse to communicate to the health care provider?

A 46-year-old is diagnosed with thromboangiitis obliterans (Buerger's disease) .When the nurse is developing a discharge teaching plan for the patient,which outcome has the highest priority for this patient?

Which assessment finding for a patient who has been admitted with a right calf venous thromboembolism (VTE) requires immediate action by the nurse?

Which nursing intervention for a patient who had an open repair of an abdominal aortic aneurysm 2 days previously is appropriate for the nurse to delegate to unlicensed assistive personnel (UAP) ?

The nurse who works in the vascular clinic has several patients with venous insufficiency scheduled today.Which patient should the nurse assign to an experienced licensed practical/vocational nurse (LPN/LVN) ?