Question 1

A patient with peripheral arterial disease has a nursing diagnosis of Ineffective Tissue Perfusion. Which nursing intervention is most appropriate for this nursing diagnosis?

Accepted Answer

Elevating the patient's legs can improve blood flow and therefore improve tissue perfusion. Hot baths and limiting activity may not be appropriate interventions for all patients with peripheral arterial disease. Limiting visitors may be helpful in preventing the spread of infection, but it is not directly related to this nursing diagnosis.

Question 2

A patient who has had a dissecting aneurysm repaired is being prepared for discharge. The patient has a history of hypertension. The nurse is careful to emphasize the importance of which precaution?. Select all that apply.

Accepted Answer

It is crucial for the patient to maintain their prescribed medication regimen (A) to manage hypertension and prevent complications. Monitoring the incision for signs of infection (D) is important for post-surgical recovery. Keeping blood pressure well managed (E) is essential to prevent stress on the repaired aneurysm.

Question 3

A diabetic 68-year-old female patient arrives at the clinic with a history of smoking, hypertension, family history of cardiac disease, COPD, and infrequent exercise. The nurse identifies which of these as the most significant risk factors for peripheral arterial disease (PAD)?

Accepted Answer

Hypertension and smoking are the most significant risk factors for PAD in this patient as both are known to contribute to the development and progression of the disease. While other factors such as COPD and family history of cardiac disease may also increase the patient's risk, they are not as strongly associated with PAD as hypertension and smoking. Age and gender are not modifiable risk factors, and a sedentary lifestyle and diabetes may increase the risk for PAD but are not as significant as hypertension and smoking in this particular patient's case.

Question 4

A patient's visit to the health care clinic reveals a blood pressure of 130/

Accepted Answer

The answer of A patient's visit to the health care...

Question 5

A patient with peripheral arterial disease (PAD) is a smoker. The nurse has established a nursing diagnosis of Deficient Knowledge of Self-Care Needs and Treatment Plan related to tobacco use. Which intervention should the nurse choose to implement?

Accepted Answer

Discussing a smoking cessation plan with the patient addresses the nursing diagnosis of Deficient Knowledge of Self-Care Needs and Treatment Plan related to tobacco use. Encouraging the patient to use medications or discussing the use of herbal therapies may be appropriate interventions, but they do not specifically address the nursing diagnosis. Instructing the patient in increasing exercise is not directly related to smoking cessation.

Question 6

A patient presents to the emergency department with complaints of "feeling like something is ripping in my chest" and sudden onset of mid-back pain. The patient has a history of hypertension. What is the top priority in the care of this patient?

Accepted Answer

The patient is presenting with symptoms of aortic dissection, which is a medical emergency. An immediate CT scan is necessary to confirm the diagnosis and determine the extent of the dissection. This is the top priority for the patient's care. Contacting the family and obtaining a surgical history can occur once the patient's condition has stabilized. Pain medication may be appropriate after the diagnosis is confirmed and other interventions have been initiated.

Question 7

A patient who has been diagnosed with peripheral arterial disease (PAD) has a nursing diagnosis of Risk for Impaired Skin Integrity related to reduced peripheral circulation. Which instruction is most appropriate to address this diagnosis?

Accepted Answer

Protecting the legs from injury is the most appropriate instruction to address the nursing diagnosis of Risk for Impaired Skin Integrity related to reduced peripheral circulation in a patient with PAD. PAD reduces blood flow to the legs, making them more vulnerable to skin breakdown and injury. Therefore, protecting the legs from injury is crucial to prevent further complications. PAD signs and symptoms, pain control measures, and risk factors that may increase problems with PAD are also important, but they do not specifically address the nursing diagnosis of Risk for Impaired Skin Integrity.

Question 8

A patient with Raynaud's disease presents with pallor of the fingers. The patient states that the hands turn white, then blue, then red. How should the nurse explain these symptoms to the patient?

Accepted Answer

Raynaud's disease is caused by spasm of the small arteries and arterioles in the hands and feet, resulting in restricted blood flow and changing color of the affected area. Option A and D are incorrect and irrelevant to the pathophysiology of Raynaud's disease. Option B is incorrect, as there is no evidence of inflammation or clot formation in Raynaud's disease.

Question 9

A patient receiving enoxaparin (Lovenox) is scheduled for surgery. Why should the nurse discuss this medication with the anesthesia care provider?

Accepted Answer

Enoxaparin is an anticoagulant medication and can increase the risk of bleeding during and after surgery. This increases the risk of complications if the patient receiving an epidural, which involves puncturing a needle into the spinal cord. Therefore, the nurse should discuss the medication with the anesthesia care provider to ensure that the epidural is not administered.

Question 10

A number of patients on the unit are at risk for deep venous thrombosis (DVT). The nurse would consider which patient at highest risk?

Accepted Answer

Patients who have undergone surgery, especially orthopedic surgery such as a hip replacement, are at highest risk for developing DVT.

Question 11

The nurse notes that a patient with Raynaud's disease is more anxious than usual and states, "I don't understand why my hands keep turning colors. It seems to happen when I get upset." What is the nurse's most appropriate action?

Accepted Answer

The nurse should educate the patient on the link between stress and vasospasms in Raynaud's disease and work with the patient to develop a stress management plan. This will address the patient's concerns and help manage their symptoms. Options B and D do not address the patient's underlying concern and option C is too general.

Question 12

A patient on clopidogrel (Plavix) is receiving discharge instructions. What information should the nurse provide?

Accepted Answer

Clopidogrel should be taken with food to increase its absorption and effectiveness. This medication should not be taken with NSAIDs, including aspirin, as it may increase the risk of bleeding. There are no significant food interactions with clopidogrel. Vitamin C, vitamin E, and vitamin A supplements are not necessary for clopidogrel therapy.

Question 13

A 65-year-old male patient arrives in the clinic complaining of numbness and tingling of the lower extremities and pain in the legs upon exercise. Which questions would the nurse ask to determine the patient's possible risk factors for peripheral arterial disease (PAD)?. Select all that apply.

Accepted Answer

Risk factors for peripheral arterial disease (PAD) include smoking, diabetes, and lack of exercise. Marital status and place of birth are not significant risk factors for PAD.

Question 14

A patient has been diagnosed with stage 2 hypertension. What should the nurse teach this patient about managing the disease?. Select all that apply.

Accepted Answer

The nurse should teach the patient to take prescribed medication as directed and to eat balanced meals to help manage hypertension.

Question 15

A patient on whom an endovascular repair of the aorta has just been performed is now complaining of numbness and tingling in the toes. The nurse inspects the patient's legs and discovers weak pulses bilaterally, cool lower extremities, and capillary refill greater than 3 seconds. What immediate nursing action is indicated?

Accepted Answer

The symptoms of numbness and tingling in the toes, weak pulses, cool lower extremities, and capillary refill greater than 3 seconds are indicative of interruption of arterial flow, which is a potential complication after endovascular repair of the aorta. Therefore, the immediate nursing action should be to contact the health care provider for prompt evaluation and intervention.

Question 16

The nurse is providing preoperative instructions to a patient scheduled for endovascular repair to reduce peripheral vascular disease. The patient asks where the incision will be located. How should the nurse reply?

Accepted Answer

Endovascular repair to reduce peripheral vascular disease is typically performed by accessing the femoral artery in the groin area, therefore a small incision in that area would be needed.

Question 17

A 38-year-old, 150-pound male has been diagnosed with deep venous thrombosis (DVT). The patient's history includes recent cardiac bypass surgery, working in a pesticide plant, and hypertension. The family asks what might have put the patient at risk for DVT. How should the nurse respond?

Accepted Answer

The patient's recent cardiac bypass surgery and prolonged immobilization are known risk factors for the development of DVT. Hypertension and weight may also contribute, but they are not necessarily the primary factors in this specific case. Prior employment in a pesticide plant may also be a possible contributing factor, but there is insufficient information to determine its role in this particular case.

Question 18

A patient who is pondering surgical repair of varicose veins asks the nurse how long the hospital stay would be. How should the nurse respond?

Accepted Answer

Surgical repair of varicose veins is generally an outpatient procedure, meaning the patient will not be admitted to the hospital overnight. The patient can often go home the same day as the procedure, but may need someone to take them home and stay with them for a few hours. Option A and D are incorrect as they suggest an overnight or multi-day stay, which is not typically required for this procedure. Option B is also incorrect as it suggests multiple hospital visits, which is not typically the case.

Question 19

A patient who has just been diagnosed with peripheral arterial disease (PAD) asks what "intermittent claudication" means. How should the nurse describe this condition?

Accepted Answer

Intermittent claudication is leg pain or cramping that occurs with exercise or activity and resolves with rest.

Question 20

A patient's visit to the health care clinic reveals a blood pressure of 142/

Accepted Answer

The nurse should first check the patient's record for past blood pressure readings to determine if this is an isolated incident or part of a trend, which will help in deciding the next steps.

Quiz 35: Caring for the Patient With Peripheral Vascular Disorders