Deck 32: Nursing Care of Patients with Vascular and Lymphatic Disorders

Question 1

A patient is demonstrating signs of ineffective peripheral tissue perfusion. Which of the following interventions would be appropriate for this patient?

A)Encourage patient to reduce level of exercise.
B)Discuss smoking cessation techniques.
C)Keep extremities cool.
D)Assist with pillow placement under knees.

Answer 1

Discuss smoking cessation techniques.

Question 2

A patient is being discharged on long-term oral anticoagulant therapy for arterial thrombus formation in the lower extremity. Which of the following should be included in this patient's discharge instructions?

A)Slight bleeding from the nose is expected.
B)Contact the physician's office for follow-up laboratory studies.
C)Pain in the limb is a sign of healing.
D)Take two doses of the prescribed anticoagulant if a dose is missed one day.

Answer 2

Contact the physician's office for follow-up laboratory studies.

Question 3

A patient is demonstrating signs of thrombophlebitis. With this disorder, the nurse realizes that three mechanisms occur, which include which of the following? Select all that apply.

A)pooling of blood in the vessel
B)blood hypercoagulation
C)sluggish blood flow
D)elevated systemic blood pressure
E)vessel damage

Answer 3

blood hypercoagulation
sluggish blood flow
vessel damage

Question 4

Appropriate technique of blood pressure assessment includes using a cuff that ______ and covers ___________ of the upper arm. Fill in the blanks.

A)is centered over the antecubital space; at least two-thirds
B)is loosely applied; at least one-half
C)is placed 5-6 cm above the antecubital space; at least one-third
D)completely encircles the arm; at least two-thirds

Question 5

A patient with a deep vein thrombosis (DVT) is going to be weaned from intravenous heparin. When does the nurse anticipate that oral warfarin sodium should be prescribed?

A)the same day the heparin is discontinued
B)the day before the heparin is discontinued
C)four to five days before the heparin is discontinued
D)the same day as the heparin is started

Question 6

A 75-year-old patient is diagnosed with chronic venous insufficiency. Which of the following instructions are appropriate for this patient?

A)Keep legs in a dependent position as much as possible.
B)Avoid the use of knee-high hose or girdles.
C)Limit ambulation.
D)Dangle legs over the side of the bed several times per day.

Question 7

The nurse is instructing a patient with hypertension about lifestyle modifications. Which of the following would be appropriate to include in the teaching for this patient? Select all that apply.

A)Review the DASH diet.
B)Begin a walking program, and progress to 30 minutes 5 to 6 days each week.
C)Plan a weight lifting regimen.
D)Eliminate dairy products from the diet.
E)Restrict fluid intake.

Question 8

A patient with diabetes is beginning treatment for hypertension. The nurse shares with the patient that the blood pressure reading goal is which of the following?

A)140/90 mmHg
B)135/85 mmHg
C)130/80 mmHg
D)120/80 mmHg

Question 9

A patient is seen for increasing edema in his left lower extremity and pain in the limb with ambulation. Which of the following disorders do these symptoms suggest?

A)arterial occlusion
B)deep vein thrombosis
C)superficial vein thrombosis (SVT)
D)varicose veins

Question 10

During the abdominal assessment of an elderly patient, the nurse palpates a mass in the mid-abdomen. Which of the following should the nurse do next?

A)Percuss the mass.
B)Ask the patient to cough.
C)Get the physician.
D)Auscultate the mass.

Question 11

A patient's blood pressure continues to be elevated despite being prescribed an ACE inhibitor for several weeks. Which of the following would be most appropriate for the nurse to do at this time?

A)Ask if the patient is taking the prescribed medication.
B)Suggest to the physician that another medication be added.
C)Schedule the patient to have the blood pressure checked again in a week.
D)Realize the patient is anxious because of the diagnosis.

Question 12

A patient is having segmental pressure measurements conducted to help diagnose peripheral vascular disease. Which of the following would indicate the presence of this disorder?

A)thigh pressure higher than the arm
B)calf pressure higher than the arm
C)calf pressure lower than the arm
D)no difference between the arm or leg

Question 13

The nurse suspects that a patient is experiencing the effects of peripheral atherosclerosis. Which of the following did the nurse most likely assess in this patient?

A)rubor with extremity elevation
B)normal hair distribution bilaterally over lower extremities
C)peripheral pulses present bilaterally
D)complaints of leg pain upon rest

Question 14

The nurse measures a patient's blood pressure as 144/88 mmHg. Which of the following interventions would be most appropriate for this patient?

A)Provide stress-reduction techniques.
B)Inform the physician so anti-hypertensive medication can be prescribed.
C)Offer the patient a glass of water.
D)Remeasure the blood pressure in a few minutes.

Question 15

A patient who is being treated for a deep vein thrombosis (DVT) complains of chest pain and shortness of breath. Which of the following should the nurse do first?

A)Elevate the head of the bed and begin oxygen therapy.
B)Measure the patient's blood pressure.
C)Assess the extremity with the thrombosis.
D)Assess the pulses on the extremity with the thrombosis.

Question 16

An elderly patient is prescribed elastic graduated compression stockings. The nurse should instruct this patient to do which of the following?

A)Wear the stockings continuously, except when showering.
B)Expect areas of skin breakdown under the stockings.
C)Wear the stockings primarily while sleeping.
D)Remove the stockings once per day and while sleeping.

Question 17

The nurse is planning care for a patient who was diagnosed with deep vein thrombosis (DVT). Which of the following should be included in this plan of care?

A)Activity as tolerated.
B)Measure and apply graduated compression stockings.
C)Encourage the patient to sit out of bed several hours every day.
D)Assist patient with putting on tight-fitting pants.

Question 18

A patient is being started on enalapril (Vasotec). The most common complaint from patients who routinely take this medication is which of the following?

A)increased thirst
B)reduced urine output
C)persistent cough
D)sore throat

Question 19

A patient is diagnosed with thromboangiitis obliterans. Appropriate teaching for this patient includes which of the following?

A)Medications are the only cure.
B)Surgical procedures can be performed to cure this disorder.
C)Management depends upon the patient's willingness to stop smoking.
D)Nothing can help manage this disorder.

Question 20

The nurse suspects a patient who is recovering from an abdominal aortic aneurysm repair is experiencing graft leaking. Which of the following are indications of this event? Select all that apply. Select all that apply.

A)urine output 45 mL/hr
B)complaint of groin pain
C)abdominal dressing dry and intact
D)respiratory rate 16 and regular
E)complaint of back discomfort

Question 21

A patient needs a blood transfusion. The nurse realizes that the function of the blood includes which of the following? Select all that apply.

A)digestion of protein
B)oxygenation of body tissues
C)transmit impulses
D)aids in joint mobility
E)regulate fluid and electrolyte balance

Question 22

The nurse is teaching a community education class on hypertension and risk factors for this disorder. Of the following risk factors, which is the primary one leading to the higher incidence of hypertension in older adults?

A)being a black adult
B)being a white male
C)having a family history of hypertension
D)age-related increase in the systolic blood pressure

Question 23

A patient has a low red blood cell count. The nurse realizes that the patient's body will produce more red blood cells (RBCs) in response to which of the following?

A)hypoxia
B)calcium
C)eating
D)activity

Question 24

A patient experiencing intermittent claudication points to the area of the body where this occurs. Place an "X" on the diagram below indicating which body part is involved.

Question 25

A patient is diagnosed with an alteration in peripheral vascular resistance. The nurse realizes that this resistance is determined by which of the following? Select all that apply.

A)blood flow
B)blood viscosity
C)vessel length
D)blood pressure
E)vessel diameter

Question 26

The nurse sees that a patient's hemoglobin level is low. The purpose of hemoglobin is to do which of the following?

A)Remove toxic wastes.
B)Bind with urea.
C)Filter sodium.
D)Transport oxygen.

Question 27

A patient is experiencing a disorder in which large amounts of red blood cells (RBCs) are being destroyed. An outcome of this disorder can be demonstrated as which of the following?

A)dysphagia
B)jaundice
C)nausea
D)anxiety

Question 28

A patient is diagnosed with a disorder in which deoxygenated blood is having difficulty returning to the heart and lungs for reoxygenation. In which part of the peripheral vascular system is the origin of this patient's disorder?

A)arteries
B)arterioles
C)capillaries
D)venules

Question 29

The nurse is assessing jugular venous pressure (JVP). Place the following steps in this assessment in the appropriate order. Click and drag the options below to move them up or down.

A)Turn the patient's head to the opposite side.
B)Shine a light tangentially across the patient's neck.
C)Elevate the head of the bed 30 to 45 degrees.
D)Remove clothing from the patient's head and neck.
E)Repeat the measurement on the opposite side.
F)Measure from the highest point of visible distention to the sternal angle.

Question 30

A patient is demonstrating a sign of blood pressure stabilization accompanied by a decreased urine output. The nurse explains that the body mechanism responsible for this blood pressure stabilization is which of the following?

A)response to chemoreceptors in the aortic arch
B)renal conservation of sodium and water
C)change in body temperature
D)intake of dietary fat and protein

Question 31

A patient is admitted with a disorder that is affecting his bone marrow. The nurse realizes that this disorder will negatively impact which body system?

A)gastrointestinal
B)hematologic
C)musculoskeletal
D)nervous

Question 32

During the analyzing of a patient's complete blood count, the nurse determines that the patient's white blood cell (WBC) count is elevated. This is also considered which of the following?

A)lymphoma
B)leukopenia
C)polycythemia
D)leukocytosis

Question 33

A patient is diagnosed with an abnormally low red blood cell (RBC) count. The nurse realizes that this disorder is which of the following?

A)polycythemia
B)leukemia
C)anemia
D)bacteremia

Question 34

A co-worker asks the nurse is to review the discharge instructions (see above) with an assigned patient. Based on the content to be reviewed, the nurse recognizes this patient's diagnosis is which of the following? $$\begin{array} { | c | l | } \hline \begin{array} { l } \text { Discharge } \\\text { Instructions }\end{array} & \text { Name: } \\\hline 1 . & \begin{array} { l } \text { Follow-up appointment with smoking cessation program on (date } \\\text { included). }\end{array} \\\hline 2 . & \begin{array} { l } \text { Avoid exposure to cold temperatures or handling cold objects. Wear } \\\text { gloves. Dress warmly. }\end{array} \\\hline 3 . & \text { Prevent injury to the extremities. } \\\hline 4 . & \begin{array} { l } \text { Take calcium channel blocker medication nifedipine (Procardia) as } \\\text { prescribed. }\end{array} \\\hline 5 . & \begin{array} { l } \text { Follow-up appointment with stress management program on (date } \\\text { included). }\end{array} \\\hline 6 . & \text { Call physician's office for one-month follow-up appointment. } \\\hline\end{array}$$

A)thromboangiitis obliterans
B)atherosclerosis.
C)atherosclerosis
D)Raynaud's disease
E)Buerger's disease

Question 35

The nurse calls a patient at home with the laboratory results from his visit of earlier in the day. Based on a review of these results, what will the nurse advise this patient? 11ea992e_0a24_a348_9f38_8d8aed164d63

A)Maintain the same daily dose of heparin.
B)Maintain the same daily dose of warfarin (Coumadin).
C)Increase the dose of warfarin according to the previous instructions by the physician.
D)Stop taking the warfarin until his next clinic appointment.

Question 36

A patient with a low red blood cell count is receiving a blood transfusion. The nurse realizes that the body needs which length of time to create more red blood cells?

A)2 weeks
B)10 days
C)3 to 5 days
D)48 hours

Question 37

A patient with some blood loss is maintaining a blood pressure of 100/60 mmHg. The nurse interprets this to mean that the patient's blood pressure is being maintained through the help of which of the following?

A)arterioles
B)venules
C)capillaries
D)veins

Question 38

A patient who is diagnosed with a blood disorder has a platelet value of >400,000/mL. The nurse interprets this to mean that this patient is exhibiting which of the following?

A)thrombocytosis
B)anemia
C)leukemia
D)thrombocytopenia

Question 39

A patient's blood pressure is 128/98 mmHg. The nurse interprets this to mean that the diastolic blood pressure reading represents which of the following?

A)pressure at the peak of ventricular contraction
B)pressure at the peak of atrial contraction
C)pressure at the closure of the mitral valve
D)pressure at the peak of ventricular relaxation

Question 40

A patient has an inflammation of his gastrointestinal tract. When interpreting the lab test results for this patient, the nurse expects an increase in which of the following types of white blood cells (WBCs)? Select all that apply.

A)lymphocytes
B)basophils
C)eosinophils
D)neutrophils
E)monoblasts

Question 41

A patient is admitted to the hospital with an inflammatory disorder. The nurse expects that the physician will order which of the following diagnostic tests?

A)red blood cell count
B)hemoglobin
C)sedimentation rate
D)platelet count

Question 42

The nurse is preparing to assess a patient's hematologic, peripheral vascular, and lymphatic systems. Which of the following assessment techniques is not typically utilized for this assessment?

A)inspection
B)palpation
C)percussion
D)auscultation

Question 43

AA patient is admitted with an enlarged lymph node. The nurse explains to the patient that the purpose of the lymph system is to do which of the following?

A)filter blood
B)break down old red blood cells
C)synthesize lymphocytes
D)remove infectious organisms