Question 1

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?

Accepted Answer

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

Question 2

The nurse is discussing risk factor modification for a client who has a 4-cm abdominal aortic aneurysm. The nurse should focus client teaching on which of the following risk factors?

Accepted Answer

A)  Male gender
B)  Marfan syndrome
C)  Abdominal trauma history
D)  Uncontrolled hypertension D

Question 3

The health care provider prescribes an infusion of argatroban and daily partial thromboplastin time (PTT) testing for a client with venous thrombo-embolism (VTE). Which of the following actions should the nurse include in the plan of care?

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 4

The nurse is caring for a client with chronic atrial fibrillation who develops sudden severe pain, pulselessness, pallor, and coolness in the left leg. Which of the following actions should the nurse implement first?

Accepted Answer

A)  Elevate the left leg on a pillow.
B)  Apply an elastic wrap to the leg.
C)  Assist the client in gently exercising the leg.
D)  Notify the health care provider.

Question 5

The nurse has initiated discharge teaching for a client who is to be maintained on warfarin following hospitalization for venous thrombo-embolism (VTE). Which of the following client statements indicates that additional teaching is required?

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 warfarin."
C)  "I will need to have blood tests routinely to monitor the effects of the warfarin."
D)  "I will check with my health care provider before I begin or stop any medication."

Question 6

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

Accepted Answer

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

Question 7

A client with a venous thrombo-embolism (VTE) is started on enoxaparin and warfarin. The client asks the nurse why two medications are necessary. Which of the following responses by the nurse is accurate?

Accepted Answer

A)  "Administration of two anticoagulants reduces the risk for recurrent venous thrombosis."
B)  "Enoxaparin will start to dissolve the clot, and warfarin will prevent any more clots from occurring."
C)  "The enoxaparin will work immediately, but the warfarin 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."

Question 8

While working in the outpatient clinic, the nurse notes that the medical record states that a client has intermittent claudication. Which of the following client statements is consistent with this information?

Accepted Answer

A)  "When I stand too long, my feet start to swell up."
B)  "Sometimes I get tired when I climb a lot of stairs."
C)  "My fingers hurt when I go outside in cold weather."
D)  "My legs cramp whenever I walk more than a block."

Question 9

Which of the following actions by a nurse who is administering fondaparinux to a client with venous thrombo-embolism (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 medication.

Question 10

Aclient 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." Which of the following actions should the nurse implement?

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 colour changes that occur in response to cold.
D)  Assess for unilateral swelling, redness, and tenderness of either leg.

Question 11

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?

Accepted Answer

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)

Question 12

A client tells the health care provider about experiencing cold, numb fingers when running during the winter and is diagnosed with Raynaud's phenomenon. Based upon this diagnosis, the client should be investigated for which of the following conditions?

Accepted Answer

A)  Hypertension
B)  Hyperlipidemia
C)  Autoimmune disorders
D)  Coronary artery disease

Question 13

A client is admitted to the hospital with a diagnosis of chronic venous insufficiency. Which of the following client statements is most consistent with this 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 14

The nurse notes bruising and discoloration of the right leg of a client that has just arrived in the recovery unit from having vein ligation surgery. Which of the following interventions is priority?

Accepted Answer

A)  Place the client in the Trendelenburg position.
B)  Contact the health care provider.
C)  Elevate the bed at the knee and put pillows under the feet.
D)  Elevate the legs 15 degrees to limit edema.

Question 15

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?

Accepted Answer

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.

Question 16

The nurse is providing teaching to a client with critical limb ischemia. Which of the following client statements indicate further teaching is required?

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 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?

Accepted Answer

A)  Horse chestnut
B)  Licorice root
C)  Turmeric
D)  Green tea

Question 18

Several hours after an open surgical repair of an abdominal aortic aneurysm, the client develops a urinary output of 20 mL/hour for 2 hours. Which of the following prescriptions should the nurse anticipate?

Accepted Answer

A)  An additional antibiotic
B)  White blood cell (WB
C)   count
C)  Decrease in IV infusion rate
D)  Blood urea nitrogen (BUN)  level

Question 19

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?

Accepted Answer

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.

Question 20

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

Accepted Answer

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"

Exam 40: Nursing Management Vascular Disorders

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?