Question 1

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

Accepted Answer

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

Question 2

While working in the outpatient clinic,the nurse notes that a patient has a history of intermittent claudication.Which statement by the patient would support this information?

Accepted Answer

A)   "When I stand too long, my feet start to swell."
B)   "I get short of breath 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." D

Question 3

The nurse reviews the admission orders shown in the accompanying figure for a patient newly diagnosed with peripheral artery disease.Which admission order should the nurse question?

Accepted Answer

A)   Use of treadmill for exercise
B)   Referral for dietary instruction
C)   Exercising to the point of discomfort
D)   Combined clopidogrel and omeprazole therapy D

Question 4

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 most appropriate?

Accepted Answer

A)   "Taking two blood thinners reduces the risk for another clot to form."
B)   "Lovenox will start to dissolve the clot, and Coumadin will prevent any more clots from forming."
C)   "Lovenox will work right away, but Coumadin takes several days to have an effect on preventing clots."
D)   "Because of the risk for a blood clot in the lungs, it is important for you to take more than one blood thinner."

Question 5

When discussing risk factor modification for a 63-year-old patient who has a 5-cm abdominal aortic aneurysm,the nurse will focus discharge teaching on which patient risk factor?

Accepted Answer

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

Question 6

After receiving report,which patient admitted to the emergency department should the nurse assess first?

Accepted Answer

A)   67-year-old who has a gangrenous left foot ulcer with a weak pedal pulse
B)   58-year-old who is taking anticoagulants for atrial fibrillation and has black stools
C)   50-year-old who is complaining of sudden "sharp" and "worst ever" upper back pain
D)   39-year-old who has right calf tenderness, redness, and swelling after a long plane ride

Question 7

A 67-year-old patient is admitted to the hospital with a diagnosis of venous insufficiency.Which patient statement is most supportive of the diagnosis?

Accepted Answer

A)   "I can't get my shoes on at the end of the day."
B)   "I can't seem to ever get my feet warm enough."
C)   "I have burning leg pains after I walk two blocks."
D)   "I wake up during the night because my legs hurt."

Question 8

The nurse performing an assessment with a patient who has chronic peripheral artery disease (PAD)of the legs and an ulcer on the right second toe would expect to find

Accepted Answer

A)   dilated superficial veins.
B)   swollen, dry, scaly ankles.
C)   prolonged capillary refill in all the toes.
D)   a serosanguineous drainage from the ulcer.

Question 9

The nurse is 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 perform first?

Accepted Answer

A)   Begin oral intake.
B)   Obtain vital signs.
C)   Assess pedal pulses.
D)   Start discharge teaching.

Question 10

A 73-year-old patient with chronic atrial fibrillation develops sudden severe pain,pulselessness,pallor,and coolness in the right leg.The nurse should notify the health care provider and immediately

Accepted Answer

A)   apply a compression stocking to the leg.
B)   elevate the leg above the level of the heart.
C)   assist the patient in gently exercising the leg.
D)   keep the patient in bed in the supine position.

Question 11

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

Accepted Answer

A)   Need to increase carbohydrate intake
B)   Methods of keeping the wound area dry
C)   Purpose of prophylactic antibiotic therapy
D)   Application of elastic compression stockings

Question 12

A patient is being evaluated for post-thrombotic syndrome.Which assessment will the nurse perform?

Accepted Answer

A)   Ask about leg pain with exercise.
B)   Determine the ankle-brachial index.
C)   Assess capillary refill in the patient's toes.
D)   Check for presence of lipodermatosclerosis.

Question 13

When developing a teaching plan for a 76-year-old patient newly diagnosed with peripheral artery disease (PAD),which instructions 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 elastic compression stockings on early in the morning."

Question 14

The nurse has started discharge teaching for a patient who is to continue warfarin (Coumadin)following hospitalization for venous thromboembolism (VTE).The nurse determines that additional teaching is needed when the patient says which of the following?

Accepted Answer

A)   "I should get a Medic Alert device stating that I take Coumadin."
B)   "I should reduce the amount of green, leafy vegetables that I eat."
C)   "I will need routine blood tests to monitor the effects of the Coumadin."
D)   "I will check with my health care provider before I begin any new medications."

Question 15

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

Accepted Answer

A)   Erythema of right lower leg
B)   Complaint of right calf pain
C)   New onset shortness of breath
D)   Temperature of 100.4° F (38° 
C)

Question 16

A 46-year-old is diagnosed with thromboangiitis obliterans (Buerger's disease).When the nurse is developing a discharge teaching plan for the patient,which outcome has the highest priority for this patient?

Accepted Answer

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

Question 17

When evaluating the discharge teaching for a patient with chronic peripheral artery disease (PAD),the nurse determines a need for further instruction when the patient says,"I will

Accepted Answer

A)   have to buy some loose clothes that do not bind across my legs or waist."
B)   use a heating pad on my feet at night to increase the circulation and warmth in my feet."
C)   change my position every hour and avoid long periods of sitting with my legs crossed."
D)   walk to the point of pain, rest, and walk again until the pain returns for at least 30 minutes 3 times a week."

Question 18

A patient who is 2 days post-femoral-popliteal bypass graft to the right leg is being cared for on the vascular unit.Which action by a licensed practical/vocational nurse (LPN/LVN)caring for the patient requires the registered nurse (RN)to intervene?

Accepted Answer

A)   The LPN/LVN has the patient sit in a chair for 90 minutes.
B)   The LPN/LVN assists the patient to walk 40 feet in the hallway.
C)   The LPN/LVN gives the ordered aspirin 160 mg after breakfast.
D)   The LPN/LVN places the patient in a Fowler's position for meals.

Question 19

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

Accepted Answer

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

Question 20

A patient has a 6-cm thoracic aortic aneurysm that was discovered during a routine chest x-ray.When obtaining an admission history from the patient,it will be most important for the nurse to ask about

Accepted Answer

A)   low back pain.
B)   trouble swallowing.
C)   abdominal tenderness.
D)   changes in bowel habits.

Exam 34: Nursing Management: Vascular Disorders

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

While working in the outpatient clinic,the nurse notes that a patient has a history of intermittent claudication.Which statement by the patient would support this information?

The nurse reviews the admission orders shown in the accompanying figure for a patient newly diagnosed with peripheral artery disease.Which admission order should the nurse question?

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 most appropriate?

When discussing risk factor modification for a 63-year-old patient who has a 5-cm abdominal aortic aneurysm,the nurse will focus discharge teaching on which patient risk factor?

After receiving report,which patient admitted to the emergency department should the nurse assess first?

A 67-year-old patient is admitted to the hospital with a diagnosis of venous insufficiency.Which patient statement is most supportive of the diagnosis?

The nurse performing an assessment with a patient who has chronic peripheral artery disease (PAD) of the legs and an ulcer on the right second toe would expect to find

The nurse is 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 perform first?

A 73-year-old patient with chronic atrial fibrillation develops sudden severe pain,pulselessness,pallor,and coolness in the right leg.The nurse should notify the health care provider and immediately

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

A patient is being evaluated for post-thrombotic syndrome.Which assessment will the nurse perform?

When developing a teaching plan for a 76-year-old patient newly diagnosed with peripheral artery disease (PAD) ,which instructions should the nurse include?

The nurse has started discharge teaching for a patient who is to continue warfarin (Coumadin) following hospitalization for venous thromboembolism (VTE) .The nurse determines that additional teaching is needed when the patient says which of the following?

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

A 46-year-old is diagnosed with thromboangiitis obliterans (Buerger's disease) .When the nurse is developing a discharge teaching plan for the patient,which outcome has the highest priority for this patient?

When evaluating the discharge teaching for a patient with chronic peripheral artery disease (PAD) ,the nurse determines a need for further instruction when the patient says,"I will

A patient who is 2 days post-femoral-popliteal bypass graft to the right leg is being cared for on the vascular unit.Which action by a licensed practical/vocational nurse (LPN/LVN) caring for the patient requires the registered nurse (RN) to intervene?

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

A patient has a 6-cm thoracic aortic aneurysm that was discovered during a routine chest x-ray.When obtaining an admission history from the patient,it will be most important for the nurse to ask about