Question 1

When evaluating the discharge teaching for a patient with chronic peripheral artery disease (PAD),the nurse determines a need for further instruction when the patient says,"I will

Accepted Answer

Because the patient has impaired circulation and sensation to the feet,the use of a heating pad could lead to burns.The other patient statements are correct and indicate that teaching has been successful.

Question 2

Which topic should the nurse include in patient teaching for a patient with a venous stasis ulcer on the left lower leg?

Accepted Answer

Compression of the leg is essential to healing of venous stasis ulcers.High dietary intake of protein,rather than carbohydrates,is needed.Prophylactic antibiotics are not routinely used for venous ulcers.Moist dressings are used to hasten wound healing.

Question 3

A patient has a 6-cm thoracic aortic aneurysm that was discovered during a routine chest x-ray.When obtaining an admission history from the patient,it will be most important for the nurse to ask about

Accepted Answer

Difficulty swallowing may occur with a thoracic aneurysm because of pressure on the esophagus.The other symptoms will be important to assess for in patients with abdominal aortic aneurysms.

Question 4

The health care provider has prescribed bed rest with the feet elevated for a patient admitted to the hospital with venous thromboembolism.Which action by the nurse to elevate the patient's feet is best?

Accepted Answer

The purpose of elevating the feet is to enhance venous flow from the feet to the right atrium,which is best accomplished by placing two pillows under the feet and one under the thighs.Placing the patient in the Trendelenburg position will lower the head below heart level,which is not indicated for this patient.Placing pillows under the calf or elevating the bed at the knee may cause blood stasis at the calf level.

Question 5

A patient with a venous thromboembolism (VTE)is started on enoxaparin (Lovenox)and warfarin (Coumadin).The patient asks the nurse why two medications are necessary.Which response by the nurse is most appropriate?

Accepted Answer

Low molecular weight heparin (LMWH)is used because of the immediate effect on coagulation and discontinued once the international normalized ratio (INR)value indicates that the warfarin has reached a therapeutic level.LMWH has no thrombolytic properties.The use of two anticoagulants is not related to the risk for pulmonary embolism,and two are not necessary to reduce the risk for another VTE.Furthermore,anticoagulants should not be described as blood thinners.

Question 6

A 73-year-old patient with chronic atrial fibrillation develops sudden severe pain,pulselessness,pallor,and coolness in the right leg.The nurse should notify the health care provider and immediately

Accepted Answer

The patient's history and clinical manifestations are consistent with acute arterial occlusion,and resting the leg will decrease the oxygen demand of the tissues and minimize ischemic damage until circulation can be restored.Elevating the leg or applying an elastic wrap will further compromise blood flow to the leg.Exercise will increase oxygen demand for the tissues of the leg.

Question 7

A patient at the clinic says,"I have always taken a walk after dinner,but lately my leg cramps and hurts after just a few minutes of starting.The pain goes away after I stop walking,though." The nurse should

Accepted Answer

The nurse should assess for other clinical manifestations of peripheral arterial disease in a patient who describes intermittent claudication.Changes in skin color that occur in response to cold are consistent with Raynaud's phenomenon.Tortuous veins on the legs suggest venous insufficiency.Unilateral leg swelling,redness,and tenderness indicate venous thromboembolism (VTE).

Question 8

The nurse has started discharge teaching for a patient who is to continue warfarin (Coumadin)following hospitalization for venous thromboembolism (VTE).The nurse determines that additional teaching is needed when the patient says which of the following?

Accepted Answer

Patients taking warfarin are taught to follow a consistent diet with regard to foods that are high in vitamin K,such as green,leafy vegetables.The other patient statements are accurate.

Question 9

Which nursing action should be included in the plan of care after endovascular repair of an abdominal aortic aneurysm?

Accepted Answer

Because renal artery occlusion can occur after endovascular repair,the nurse should monitor parameters of renal function such as intake and output.Chest tubes will not be needed for endovascular surgery,the recovery period will be short,and there will not be an abdominal wound.

Question 10

After teaching a patient with newly diagnosed Raynaud's phenomenon about how to manage the condition,which action by the patient demonstrates that the teaching has been effective?

Accepted Answer

Patients should avoid temperature extremes by exercising indoors when it is cold.To avoid burn injuries,the patient should use warm,rather than hot,water to warm the hands.Pseudoephedrine is a vasoconstrictor,and should be avoided.There is no reason to avoid taking NSAIDs with Raynaud's phenomenon.

Question 11

When discussing risk factor modification for a 63-year-old patient who has a 5-cm abdominal aortic aneurysm,the nurse will focus discharge teaching on which patient risk factor?

Accepted Answer

All of the factors contribute to the patient's risk,but only hypertension can potentially be modified to decrease the patient's risk for further expansion of the aneurysm.

Question 12

Which action by a nurse who is giving fondaparinux (Arixtra)to a patient with a lower leg venous thromboembolism (VTE)indicates that more education about the drug is needed?

Accepted Answer

The air bubble is not ejected before giving fondaparinux to avoid loss of medication.The other actions by the nurse are appropriate.

Question 13

A 67-year-old patient is admitted to the hospital with a diagnosis of venous insufficiency.Which patient statement is most supportive of the diagnosis?

Accepted Answer

Because the edema associated with venous insufficiency increases when the patient has been standing,shoes will feel tighter at the end of the day.The other patient statements are characteristic of peripheral artery disease (PAD).

Question 14

A patient in the outpatient clinic has a new diagnosis of peripheral artery disease (PAD).Which group of medications will the nurse plan to include when providing patient teaching about PAD management?

Accepted Answer

Current research indicates that statin use by patients with PAD improves multiple outcomes.There is no research that supports the use of the other medication categories in PAD.

Question 15

While working in the outpatient clinic,the nurse notes that a patient has a history of intermittent claudication.Which statement by the patient would support this information?

Accepted Answer

Cramping that is precipitated by a consistent level of exercise is descriptive of intermittent claudication.Finger pain associated with cold weather is typical of Raynaud's phenomenon.Shortness of breath that occurs with exercise is not typical of intermittent claudication,which is reproducible.Swelling associated with prolonged standing is typical of venous disease.

Question 16

A 46-year-old service-counter worker undergoes sclerotherapy for treatment of superficial varicose veins at an outpatient center.Which instructions should the nurse provide to the patient before discharge?

Accepted Answer

Elastic compression stockings are applied with the legs elevated to reduce pressure in the lower legs.Walking is recommended to prevent recurrent varicosities.Sitting and standing are both risk factors for varicose veins and venous insufficiency.An aspirin a day is not adequate to prevent venous thrombosis and would not be recommended for the patient who had just had sclerotherapy.

Question 17

A 23-year-old patient tells the health care provider about experiencing cold,numb fingers when running during the winter and Raynaud's phenomenon is suspected.The nurse will anticipate teaching the patient about tests for

Accepted Answer

Secondary Raynaud's phenomenon may occur in conjunction with autoimmune diseases such as rheumatoid arthritis.Patients should be screened for autoimmune disorders.Raynaud's phenomenon is not associated with hyperlipidemia,hyperglycemia,or coronary artery disease.

Question 18

Several hours after an open surgical repair of an abdominal aortic aneurysm,the UAP reports to the nurse that urinary output for the past 2 hours has been 40 mL.The nurse notifies the health care provider and anticipates an order for a(n)

Accepted Answer

The decreased urine output suggests decreased renal perfusion,and monitoring of renal function is needed.There is no indication that infection is a concern,so antibiotic therapy and a WBC count are not needed.The IV rate may be increased because hypovolemia may be contributing to the patient's decreased urinary output.

Question 19

The health care provider prescribes an infusion of heparin (Hep-Lock)and daily partial thromboplastin time (PTT)testing for a patient with venous thromboembolism (VTE).The nurse will plan to

Accepted Answer

IM injections are avoided in patients receiving anticoagulation.A PTT of 65 seconds is within the therapeutic range.Vitamin K is used to reverse warfarin.Pulse quality is not affected by VTE.

Question 20

The nurse performing an assessment with a patient who has chronic peripheral artery disease (PAD)of the legs and an ulcer on the right second toe would expect to find

Accepted Answer

Capillary refill is prolonged in PAD because of the slower and decreased blood flow to the periphery.The other listed clinical manifestations are consistent with chronic venous disease.

Quiz 34: Nursing Management: Vascular Disorders

When evaluating the discharge teaching for a patient with chronic peripheral artery disease (PAD) ,the nurse determines a need for further instruction when the patient says,"I will

Which topic should the nurse include in patient teaching for a patient with a venous stasis ulcer on the left lower leg?

A patient has a 6-cm thoracic aortic aneurysm that was discovered during a routine chest x-ray.When obtaining an admission history from the patient,it will be most important for the nurse to ask about

The health care provider has prescribed bed rest with the feet elevated for a patient admitted to the hospital with venous thromboembolism.Which action by the nurse to elevate the patient's feet is best?

A patient with a venous thromboembolism (VTE) is started on enoxaparin (Lovenox) and warfarin (Coumadin) .The patient asks the nurse why two medications are necessary.Which response by the nurse is most appropriate?

A 73-year-old patient with chronic atrial fibrillation develops sudden severe pain,pulselessness,pallor,and coolness in the right leg.The nurse should notify the health care provider and immediately

A patient at the clinic says,"I have always taken a walk after dinner,but lately my leg cramps and hurts after just a few minutes of starting.The pain goes away after I stop walking,though." The nurse should

The nurse has started discharge teaching for a patient who is to continue warfarin (Coumadin) following hospitalization for venous thromboembolism (VTE) .The nurse determines that additional teaching is needed when the patient says which of the following?

Which nursing action should be included in the plan of care after endovascular repair of an abdominal aortic aneurysm?

After teaching a patient with newly diagnosed Raynaud's phenomenon about how to manage the condition,which action by the patient demonstrates that the teaching has been effective?

When discussing risk factor modification for a 63-year-old patient who has a 5-cm abdominal aortic aneurysm,the nurse will focus discharge teaching on which patient risk factor?

Which action by a nurse who is giving fondaparinux (Arixtra) to a patient with a lower leg venous thromboembolism (VTE) indicates that more education about the drug is needed?

A 67-year-old patient is admitted to the hospital with a diagnosis of venous insufficiency.Which patient statement is most supportive of the diagnosis?

A patient in the outpatient clinic has a new diagnosis of peripheral artery disease (PAD) .Which group of medications will the nurse plan to include when providing patient teaching about PAD management?

While working in the outpatient clinic,the nurse notes that a patient has a history of intermittent claudication.Which statement by the patient would support this information?

A 46-year-old service-counter worker undergoes sclerotherapy for treatment of superficial varicose veins at an outpatient center.Which instructions should the nurse provide to the patient before discharge?

A 23-year-old patient tells the health care provider about experiencing cold,numb fingers when running during the winter and Raynaud's phenomenon is suspected.The nurse will anticipate teaching the patient about tests for

Several hours after an open surgical repair of an abdominal aortic aneurysm,the UAP reports to the nurse that urinary output for the past 2 hours has been 40 mL.The nurse notifies the health care provider and anticipates an order for a(n)

The health care provider prescribes an infusion of heparin (Hep-Lock) and daily partial thromboplastin time (PTT) testing for a patient with venous thromboembolism (VTE) .The nurse will plan to

The nurse performing an assessment with a patient who has chronic peripheral artery disease (PAD) of the legs and an ulcer on the right second toe would expect to find