Question 1

Immediately after repair of an abdominal aortic aneurysm, a client has absent popliteal, posterior tibial, and dorsalis pedis pulses. The legs are cool and mottled. Which of the following actions should the nurse take first?
A)Wrap both the legs in warm blankets.
B)Notify the surgeon and anaesthesiologist.
C)Document that the pulses are absent and recheck in 30 minutes.
D)Review the preoperative assessment form for data about the pulses.

Accepted Answer

Many clients with aortic aneurysms also have peripheral arterial disease, so the nurse should check the preoperative assessment to determine whether pulses were present before surgery before notifying the health care providers about the absent pulses. Because the client's symptoms may indicate graft occlusion or multiple emboli and a possible need to return to surgery, it is not appropriate to wait 30 minutes before taking action. Warm blankets will not improve the circulation to the client's legs.

Question 2

A client asks the nurse if there are any natural products that would decrease anticoagulant effects. The nurse tells the client that which of the following natural products causes a decrease in anticoagulant effects?
A)Horse chestnut
B)Licorice root
C)Turmeric
D)Green tea

Accepted Answer

Green tea is a natural product that would decrease anticoagulant effects. Horse chestnut, licorice root, and turmeric are natural products that would increase anticoagulant effects.

Question 3

The nurse is admitting a client to the emergency department with a history of an abdominal aortic aneurysm with severe back pain and absent pedal pulses. Which of the following actions should the nurse take first?
A)Obtain the blood pressure.
B)Ask the client about tobacco use.
C)Draw blood for ordered laboratory testing.
D)Assess for the presence of an abdominal bruit.

Accepted Answer

Since the client 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 client.

Question 4

The nurse is caring for a client with peripheral artery disease who is Aspirin intolerant. Which of the following medications should the nurse anticipate the health care provider prescribing for the client related to this intolerance?
A)Pentoxifylline
B)Clopidogrel
C)Ramipril
D)Warfarin

Accepted Answer

For clients who are Aspirin intolerant clopidogrel (75 mg/day) is indicated. Pentoxifylline is used to treat intermittent claudication. Ramipril is an ACE inhibitor. Warfarin is an anticoagulant and is not recommended for the prevention of coronary artery disease in clients with PAD.

Question 5

The nurse is assessing a client with possible peripheral artery disease (PAD) and obtains a brachial BP of 140/80 and an ankle pressure of 110/70. The nurse calculates the client's ankle-brachial index (ABI) as .

Accepted Answer

The answer of The nurse is assessing a client with...

Question 6

The nurse is caring for a client with a right calf venous thrombo-embolism. Which of the following information requires immediate action by the nurse?
A)Complaint of left calf pain
B)New onset shortness of breath
C)Red skin colour of left lower leg
D)Temperature of 38°C (100.4°F)

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 7

The nurse is developing a teaching plan for a client newly diagnosed with peripheral artery disease (PAD). Which of the following information should the nurse include?
A)"Exercise only if you do not experience any pain."
B)"It is very important that you stop smoking cigarettes."
C)"Try to keep your legs elevated whenever you are sitting."
D)"Put on support hose early in the day before swelling occurs."

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. Clients with PAD are taught to exercise to the point of feeling pain, rest, and then resume walking. Support hose are not used for clients with PAD.

Question 8

The nurse is caring for a client on the first postoperative day after an abdominal aortic aneurysm repair. Which of the following assessment findings is most important to communicate to the health care provider?
A)Absence of flatus
B)Loose, bloody stools
C)Hypotonic bowel sounds
D)Abdominal pain with palpation

Accepted Answer

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

Question 9

Which of the following responses by a client that is on anticoagulant therapy indicates the need for further teaching?
A)"I can still have a glass of wine with my dinner"
B)"For pain relief I will take ibuprofen"
C)"I take my pills at two o'clock every day"
D)"I will use an electric razor for shaving"

Accepted Answer

Clients on anticoagulant therapy should avoid all NSAIDs; therefore ibuprofen should not be taken for pain relief. It is acceptable to have an alcohol intake of a glass of wine daily. It is important that medications be taken at the same time every day. Clients are taught to avoid the use of a straight razor.

Question 10

Which of the following clients admitted to the emergency department should the nurse assess first?
A)62-year-old who has gangrenous ulcers on both feet
B)50-year-old who is complaining of "tearing" chest pain
C)45-year-old who is taking anticoagulants and has bloody stools
D)36-year-old who has right calf tenderness, redness, and swelling

Accepted Answer

The client's presentation is consistent with aortic dissection, which will require rapid intervention. The other clients do not need urgent interventions.

Question 11

The nurse is planning expected outcomes for a client with thromboangiitis obliterans (Buerger's disease). Which of the following outcomes has the highest priority for this client?
A)Cessation of smoking
B)Control of serum lipid levels
C)Maintenance of appropriate weight
D)Demonstration of meticulous foot care

Accepted Answer

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

Quiz 40: Nursing Management Vascular Disorders

Immediately after repair of an abdominal aortic aneurysm, a client has absent popliteal, posterior tibial, and dorsalis pedis pulses. The legs are cool and mottled. Which of the following actions should the nurse take first?

A client asks the nurse if there are any natural products that would decrease anticoagulant effects. The nurse tells the client that which of the following natural products causes a decrease in anticoagulant effects?

The nurse is admitting a client to the emergency department with a history of an abdominal aortic aneurysm with severe back pain and absent pedal pulses. Which of the following actions should the nurse take first?

The nurse is caring for a client with peripheral artery disease who is Aspirin intolerant. Which of the following medications should the nurse anticipate the health care provider prescribing for the client related to this intolerance?

The nurse is assessing a client with possible peripheral artery disease (PAD) and obtains a brachial BP of 140/80 and an ankle pressure of 110/70. The nurse calculates the client's ankle-brachial index (ABI) as .

The nurse is caring for a client with a right calf venous thrombo-embolism. Which of the following information requires immediate action by the nurse?

The nurse is developing a teaching plan for a client newly diagnosed with peripheral artery disease (PAD) . Which of the following information should the nurse include?

The nurse is caring for a client on the first postoperative day after an abdominal aortic aneurysm repair. Which of the following assessment findings is most important to communicate to the health care provider?

Which of the following responses by a client that is on anticoagulant therapy indicates the need for further teaching?

Which of the following clients admitted to the emergency department should the nurse assess first?

The nurse is planning expected outcomes for a client with thromboangiitis obliterans (Buerger's disease) . Which of the following outcomes has the highest priority for this client?