Question 1

Which of the following is a characteristic of a venous ulcer?

Accepted Answer

Venous ulcers often present with skin that is warm to touch due to increased blood flow and inflammation in the affected area.

Question 2

When teaching a patient with Raynaud's phenomenon how to manage the condition,which of the following behaviours by the patient indicates that the teaching has been effective?

Accepted Answer

Exercising indoors during the winter months helps to avoid exposure to cold temperatures, which can trigger Raynaud's phenomenon symptoms. Keeping the body warm and avoiding cold exposure is a key management strategy for Raynaud's phenomenon.

Question 3

To determine the extent of a patient's PAD,how does the nurse perform an ankle-brachial index?

Accepted Answer

An ankle-brachial index (ABI) is determined by dividing the systolic blood pressure at the ankle by the systolic blood pressure at the brachial artery. This provides a ratio that can indicate the presence and severity of peripheral artery disease. A ratio less than 0.90 is suggestive of PAD. Doppler ultrasound is often used to obtain the blood pressure measurements at both the ankle and brachial artery.

Question 4

How frequently should the nurse check the operative extremity in the immediate postoperative period for a patient who has had surgical intervention for peripheral artery disease?

Accepted Answer

In the immediate postoperative period, it is crucial to monitor the operative extremity closely to detect any complications early. Checking every 15 minutes allows for timely identification of issues such as bleeding, decreased perfusion, or other complications.

Question 5

When caring for a patient following an AAA repair,which information is most helpful to the nurse in assessing the patient's gastrointestinal function?

Accepted Answer

Bowel sounds are the most helpful in assessing gastrointestinal function. Decreased or absent bowel sounds could indicate paralytic ileus, a potential complication following abdominal surgery, including AAA repair. Serum lipase measures pancreatic enzyme activity, stool character indicates bowel elimination patterns, and central venous pressure assesses fluid status. While these factors may be relevant to the patient's overall care, they do not offer the same insight into gastrointestinal function as bowel sounds.

Question 6

Which of the following is a characteristic of PAD?

Accepted Answer

Peripheral Artery Disease (PAD) often presents with symptoms like lower leg edema due to poor circulation, making the absence of edema a characteristic.

Question 7

When performing an assessment with a patient who has chronic PAD,what should the nurse expect to find?

Accepted Answer

Chronic Peripheral Artery Disease (PAD) is characterized by poor blood flow to the extremities, leading to prolonged capillary refill time due to reduced perfusion. Edema and ulcerations are more commonly associated with venous insufficiency.

Question 8

A patient with a history of a 4-cm fusiform abdominal aortic aneurysm (AAA)is admitted to the emergency department with severe back pain and bilateral flank ecchymosis.His vital signs are blood pressure (BP)90/58 mm Hg,pulse 138 beats/min,and respiration 34 breaths/min.The nurse plans interventions for the patient based on the expectation that which of the following treatments will be included?

Accepted Answer

The patient's symptoms indicate a possible rupture or impending rupture of the AAA, which is a life-threatening emergency. Immediate surgery is needed to repair or replace the aneurysm and prevent further complications. An angiogram or diagnostic tests may be done as part of the preoperative workup, but prompt surgical intervention is the priority in this case. Fluid replacement and stabilization of vital signs are also important, but these interventions alone will not address the underlying problem of the AAA. Therefore, choice A is the most appropriate option.

Question 9

A 69-year old man is admitted to the hospital for elective repair of an AAA.His history includes hypertension for 25 years,dyslipidemia for 15 years,and smoking for 50 years.The patient's wife asks the nurse what caused her husband's aneurysm.The nurse's best response will include which following information?

Accepted Answer

Aneurysms, particularly abdominal aortic aneurysms (AAA), are often associated with atherosclerosis, where atherosclerotic plaques damage the artery wall, leading to its weakening and eventual dilation. The patient's history of hypertension, dyslipidemia, and smoking significantly contributes to the development of atherosclerosis, thus increasing the risk of aneurysm formation.

Question 10

Several hours following an endovascular aneurysm repair,the patient develops left flank pain,and his urinary output has been 20 mL/hour for the past 2 hours.The nurse recognizes that these findings may indicate which of the following complications?

Accepted Answer

Left flank pain and decreased urinary output suggest possible renal complications, such as renal artery occlusion, following an endovascular aneurysm repair. This requires prompt assessment and intervention to prevent further damage to the kidneys.

Question 11

After repair of an AAA,the nurse notes that the patient does not have popliteal,posterior tibial,or dorsalis pedis pulses.The legs are cool and mottled.Which action is appropriate for the nurse to take first?

Accepted Answer

The answer of After repair of an AAA,the nurse notes...

Question 12

Which one of the following therapies is not recommended to treat claudication?

Accepted Answer

The answer of Which one of the following therapies is...

Question 13

A 72-year-old man is hospitalized for an aortic dissection of the abdominal aorta that stabilizes with treatment.What emphasis should the nurse include when developing a teaching plan for the patient's discharge?

Accepted Answer

The emphasis should be on using prescribed antihypertensive medications to keep his blood pressure as low as possible to prevent further stress on the aorta and reduce the risk of complications.

Question 14

A 65-year-old patient has a 5-cm thoracic aortic aneurysm that was discovered during a routine chest X-ray examination.When obtaining a nursing history from the patient,what would the nurse specifically ask the patient about?

Accepted Answer

The answer of A 65-year-old patient has a 5-cm thoracic...

Question 15

Duplex scanning confirms the presence of a large deep-vein thrombosis (DVT),and the physician orders continuous IV heparin infusion for a patient who has swelling and pain of the upper leg.While the patient is receiving the heparin infusion,what should the nurse do?

Accepted Answer

The nurse should avoid any intramuscular (IM) medications to prevent localized bleeding, as heparin is an anticoagulant medication and can increase the risk of bleeding. The other options are not appropriate actions related to heparin infusion. The nurse should notify the physician if the activated partial thromboplastin time (aPTT) value is outside the therapeutic range, but the value mentioned in the option is not specific or appropriate. Vitamin K is not a reversal agent for heparin and should not be given routinely. Starting instruction for self-administered subcutaneous heparin injections for long-term home therapy is not appropriate during the acute phase of treatment with continuous IV heparin infusion.

Question 16

What is a nursing intervention that is indicated for the collaborative problem of "potential complication: cardiac dysrhythmia" in a patient who has had a repair of a descending thoracic aortic aneurysm?

Accepted Answer

Titrating oxygen to keep oxygen saturation greater than 90% is indicated for the collaborative problem of potential complication: cardiac dysrhythmia in a patient who has had a repair of a descending thoracic aortic aneurysm. Dysrhythmias can occur due to changes in cardiac function after thoracic surgery, and maintaining adequate oxygenation can help prevent them. Assessing neurological signs hourly, maintaining the patient on complete bed rest, and monitoring urinary output and daily blood urea nitrogen and serum creatinine levels are not specifically indicated for this collaborative problem.

Question 17

The nurse identifies the nursing diagnosis of ineffective peripheral perfusion related to decreased arterial blood flow for a patient with chronic PAD.In evaluating the patient outcomes following patient teaching,the nurse determines a need for further instruction when the patient makes which of the following statements?

Accepted Answer

Using a heating pad on the feet can increase the risk of burns in patients with PAD due to decreased sensation and impaired circulation. The other options are appropriate for managing PAD symptoms.

Question 18

A 36-year-old patient who has a history of thromboangiitis obliterans (Buerger's disease)is admitted to the hospital with a gangrenous lesion of his right small toe.In planning expected outcomes with the patient,which outcome should the nurse give the highest priority?

Accepted Answer

The highest priority outcome for a patient with thromboangiitis obliterans presenting with a gangrenous lesion is cessation of smoking, as smoking is a major risk factor for the development and progression of the disease. Maintenance of appropriate weight and control of serum lipid levels are important, but not as critical as smoking cessation in this case. Demonstration of meticulous foot care is also important, but would not be the highest priority in this situation.

Question 19

During an assessment of a 63-year-old man at the clinic,the patient tells the nurse that for years he has taken an evening walk,but lately even a short walk causes leg pain and muscle cramps.If he stops for a while,the pain goes away.What should the nurse do?

Accepted Answer

The patient's symptoms suggest peripheral artery disease, which is a condition that is caused by decreased blood flow to the legs. Palpating the dorsalis pedis and posterior tibial pulses can help to assess for this condition. Choice A is incorrect because it would be more relevant if the patient had symptoms of Raynaud's phenomenon, which causes skin colour changes in response to cold exposure. Choice B is incorrect because tortuous veins suggest varicose veins, which are not likely to cause the patient's symptoms. Choice C is incorrect because unilateral swelling, redness and tenderness suggest deep vein thrombosis, which is a medical emergency and requires urgent referral to a healthcare provider.

Question 20

A patient admitted to the hospital with a chronic venous insufficiency has physician's orders for bed rest with the feet elevated.How should the nurse elevate the patient's feet?

Accepted Answer

Elevating the foot of the bed above the level of the patient's heart provides the maximum amount of elevation and ensures proper venous return to the heart. Using pillows under the calf of the affected leg or under the patient's feet alone may provide insufficient elevation, while elevating the bed at the knee may cause pressure on the popliteal vein and hinder venous return. Placing pillows under the patient's thighs and lower legs may also not provide enough elevation for adequate venous return.

Quiz 40: Nursing Management: Vascular Disorders