Question 1

Several hours after an open surgical repair of an abdominal aortic aneurysm, the patient develops a urinary output of 20 mL/hr for 2 hours. The nurse notifies the health care provider and anticipates orders for

Accepted Answer

A)   an additional antibiotic.
B)   a white blood cell ( WBC )  count.
C)   a decrease in IV infusion rate.
D)   a blood urea nitrogen ( BUN )  level. D

Question 2

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

Accepted Answer

A)   avoid giving any IM medications to prevent localized bleeding.
B)   discontinue the infusion for PTT values greater than 50 seconds.
C)   monitor posterior tibial and dorsalis pedis pulses with the Doppler.
D)   have vitamin K available in case reversal of the argatroban is needed. A

Question 3

The nurse has initiated discharge teaching for a patient who is to be maintained on warfarin (Coumadin) following hospitalization for venous thromboembolism (VTE). The nurse determines that additional teaching is needed when the patient says,

Accepted Answer

A)   "I should reduce the amount of green, leafy vegetables that I eat."
B)   "I should wear a Medic Alert bracelet stating that I take Coumadin."
C)   "I will need to have blood tests routinely to monitor the effects of the Coumadin."
D)   "I will check with my health care provider before I begin or stop any medication." A

Question 4

When developing a teaching plan for a patient newly diagnosed with peripheral artery disease ( PAD ), which information should the nurse include?

Accepted Answer

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."

Question 5

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

Accepted Answer

A)   The nurse avoids rubbing the injection site after giving the medication.
B)   The nurse injects the medication into the abdominal subcutaneous tissue.
C)   The nurse fails to assess the partial thromboplastin time ( PTT )  before administration of the medication.
D)   The nurse ejects the air bubble in the syringe before administering the Arixtra.

Question 6

A patient is admitted to the hospital with a diagnosis of chronic venous insufficiency. Which of these statements by the patient is most consistent with the diagnosis?

Accepted Answer

A)   "I can't get my shoes on at the end of the day."
B)   "I can never seem to get my feet warm enough."
C)   "I wake up during the night because my legs hurt."
D)   "I have burning leg pains after I walk three blocks."

Question 7

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

Accepted Answer

The answer of When assessing a patient with possible peripheral...

Question 8

A 46-year-old is diagnosed with thromboangiitis obliterans (Buerger's disease). When the nurse is planning expected outcomes for the patient, which outcome has the highest priority for this patient?

Accepted Answer

A)   Cessation of smoking
B)   Control of serum lipid levels
C)   Maintenance of appropriate weight
D)   Demonstration of meticulous foot care

Question 9

When caring for a patient with critical limb ischemia who has just arrived on the nursing unit after having percutaneous transluminal balloon angioplasty, which action should the nurse take first?

Accepted Answer

A)   Take the blood pressure and pulse rate.
B)   Check for the presence of pedal pulses.
C)   Assess the appearance of any ischemic ulcers.
D)   Start discharge teaching about antiplatelet drugs.

Question 10

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

Accepted Answer

A)   Adequate carbohydrate intake
B)   Prophylactic antibiotic therapy
C)   Application of compression to the leg
D)   Methods of keeping the wound area dry

Question 11

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

Accepted Answer

A)   Record hourly chest tube drainage.
B)   Monitor fluid intake and urine output.
C)   Check the abdominal wound for redness or swelling.
D)   Teach the reason for a prolonged rehabilitation process.

Question 12

The health care provider has prescribed bed rest with the feet elevated for a patient admitted to the hospital with deep vein thrombosis. The best method for the nurse to use in elevating the patient's feet is to

Accepted Answer

A)   place the patient in the Trendelenburg position.
B)   place two pillows under the calf of the affected leg.
C)   elevate the bed at the knee and put pillows under the feet.
D)   put one pillow under the thighs and two pillows under the lower legs.

Question 13

A patient with a history of an abdominal aortic aneurysm is admitted to the emergency department ( ED ) with severe back pain and absent pedal pulses. Which action should the nurse take first?

Accepted Answer

A)   Obtain the blood pressure.
B)   Ask the patient about tobacco use.
C)   Draw blood for ordered laboratory testing.
D)   Assess for the presence of an abdominal bruit.

Question 14

Which nursing action in the care plan for a patient who had an open repair of an abdominal aortic aneurysm 3 days previously is appropriate for the nurse to delegate to experienced nursing assistive personnel (NAP)?

Accepted Answer

A)   Check the lower extremity strength and movement.
B)   Monitor the quality and presence of the pedal pulses.
C)   Teach the patient the signs of possible wound infection.
D)   Help the patient to use a pillow to splint while coughing.

Question 15

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

Accepted Answer

A)   hypertension.
B)   hyperlipidemia.
C)   autoimmune disorders.
D)   coronary artery disease.

Question 16

In evaluating the patient outcomes following teaching for a patient with chronic peripheral artery disease ( PAD ), the nurse determines a need for further instruction when the patient says,

Accepted Answer

A)   "I will have to buy some loose clothing that does not bind across my legs or waist."
B)   "I will use a heating pad on my feet at night to increase the circulation and warmth in my feet."
C)   "I will walk to the point of pain, rest, and walk again until I develop pain for a half hour daily."
D)   "I will change my position every hour and avoid long periods of sitting with my legs down."

Question 17

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

Accepted Answer

A)   attempt to palpate the dorsalis pedis and posterior tibial pulses.
B)   check for the presence of tortuous veins bilaterally on the legs.
C)   ask about any skin color changes that occur in response to cold.
D)   assess for unilateral swelling, redness, and tenderness of either leg.

Question 18

Which information about a patient who has been admitted with a right calf venous thromboembolism ( VTE ) requires immediate action by the nurse?

Accepted Answer

A)   Complaint of left calf pain
B)   New onset shortness of breath
C)   Red skin color of left lower leg
D)   Temperature of 100.4° F ( 38° C )

Question 19

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

Accepted Answer

A)   Statins
B)   Vitamins
C)   Thrombolytics
D)   Anticoagulants

Question 20

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 accurate?

Accepted Answer

A)   "Administration of two anticoagulants reduces the risk for recurrent venous thrombosis."
B)   "Lovenox will start to dissolve the clot, and Coumadin will prevent any more clots from occurring."
C)   "The Lovenox will work immediately, but the Coumadin takes several days to have an effect on coagulation."
D)   "Because of the potential for a pulmonary embolism, it is important for you to have more than one anticoagulant."

Exam 38: Nursing Management: Vascular Disorders

Several hours after an open surgical repair of an abdominal aortic aneurysm, the patient develops a urinary output of 20 mL/hr for 2 hours. The nurse notifies the health care provider and anticipates orders for

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

The nurse has initiated discharge teaching for a patient who is to be maintained on warfarin (Coumadin) following hospitalization for venous thromboembolism (VTE) . The nurse determines that additional teaching is needed when the patient says,

When developing a teaching plan for a patient newly diagnosed with peripheral artery disease ( PAD ) , which information should the nurse include?

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

A patient is admitted to the hospital with a diagnosis of chronic venous insufficiency. Which of these statements by the patient is most consistent with the diagnosis?

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

A 46-year-old is diagnosed with thromboangiitis obliterans (Buerger's disease) . When the nurse is planning expected outcomes for the patient, which outcome has the highest priority for this patient?

When caring for a patient with critical limb ischemia who has just arrived on the nursing unit after having percutaneous transluminal balloon angioplasty, which action should the nurse take first?

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

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

The health care provider has prescribed bed rest with the feet elevated for a patient admitted to the hospital with deep vein thrombosis. The best method for the nurse to use in elevating the patient's feet is to

A patient with a history of an abdominal aortic aneurysm is admitted to the emergency department ( ED ) with severe back pain and absent pedal pulses. Which action should the nurse take first?

Which nursing action in the care plan for a patient who had an open repair of an abdominal aortic aneurysm 3 days previously is appropriate for the nurse to delegate to experienced nursing assistive personnel (NAP) ?

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

In evaluating the patient outcomes following teaching for a patient with chronic peripheral artery disease ( PAD ) , the nurse determines a need for further instruction when the patient says,

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

Which information about a patient who has been admitted with a right calf venous thromboembolism ( VTE ) requires immediate action by the nurse?

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

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 accurate?