Chapter 37 1 of 3

The nurse provides information to a patient with diabetes mellitus about foot care to lower the risk of peripheral artery disease (PAD). Which statements made by the patient indicate a need for additional teaching? Select all that apply.

"I should have my capillary refill checked annually by my health care provider." "I should wear nylon socks."

The nurse provides teaching to a patient with critical limb ischemia about foot care. Which statement made by the patient indicates the need for further instruction?

"I will soak my feet every evening."

An ankle-brachial index (ABI) test was performed on a male patient who presents with symptoms of peripheral artery disease (PAD). The test results include a classification of PAD severity as 0.80 and an ABI of 1.2. The nurse expects that the patient's treatment plan will include what interventions? Select all that apply. 1 Advising the patient to maintain a body mass index (BMI) of less than 25 kg/m2 2 Advising the patient to exercise daily 3 Advising the patient to maintain a waist circumference of less than 45 inches 4 Administering an antiplatelet agent 5 Administering an angiotensin-converting enzyme (ACE) inhibitor

Answer 1,2,4,5

A patient is diagnosed with chronic venous insufficiency (CVI), a venous ulcer, peripheral artery disease (PAD), and an arterial stasis ulcer. The nurse determines that compression stockings should not be placed on the patient based on what assessment finding? 1 Rest pain 2 High blood pressure 3 Elevated blood sugar 4 Dry, itchy, flaky skin

Answer: 1

A patient who has undergone peripheral artery bypass surgery reports increased pain and tingling in the extremities. The nurse notes the loss of a previously palpable pulse, cyanosis, and a decreased ankle-brachial index. The nurse identifies that the assessment findings are related to what condition? 1 Blockage of the graft 2 Compartment syndrome 3 Thoracic aortic aneurysms 4 Superficial vein thrombosis

Answer: 1

A patient with peripheral arterial disease (PAD) underwent atherectomy. During the immediate postoperative period, the patient's neurovascular checks were normal. The nurse assesses the patient 2 hours after the surgery and notes that the peripheral pulses are absent. What action should the nurse take? 1 Notify the surgeon immediately. 2 Recognize that it is the result of arterial spasm and continue to monitor. 3 Perform ankle-brachial index measurement. 4 Place the patient in a sitting position with legs dangling

Answer: 1

A patient's assessment findings include a waist circumference of 42 inches, current tobacco use, hypertension, and a sedentary lifestyle. The nurse recognizes that which finding is the most important risk factor for peripheral artery disease (PAD)? 1 Tobacco use 2 Excess weight 3 Sedentary lifestyle 4 High blood pressure

Answer: 1

A patient who presents with claudication is diagnosed with peripheral arterial disease (PAD). The nurse expects that what will be included in the patient's treatment plan? Select all that apply. 1 Antiplatelet therapy 2 Exercise therapy 3 Nutritional therapy 4 Sympathectomy 5 Calcium channel blockers

Answer: 1,2,3

The nurse reviews the treatment plan for a patient with symptomatic peripheral artery disease (PAD). The nurse expects to find which medications listed on the plan? Select all that apply. 1 Ramipril 2 Iloprost 3 Simvastatin 4 Nifedipine 5 Warfarin 6 Argatroban

Answer: 1,3

A patient reports fingers and toes that change in color from pallor to cyanotic to rubor, especially when being exposed to cold temperatures. The patient states that, after the color changes, the digits are throbbing, achy, and tingly. The nurse suspects what diagnosis? 1 Aortic aneurysm 2 Raynaud's phenomenon 3 Post-thrombotic syndrome 4 Superficial vein thrombosis

Answer: 2

A patient reports leg pain that awakens the patient at night. The patient reports that the same pain develops in the legs when they are elevated and disappears when the legs are dangled. The nurse assesses a lesion on the inner aspect of the ankle. The nurse suspects what diagnosis? 1 Lymphatic obstruction 2 Arterial insufficiency 3 Venous insufficiency 4 Musculoskeletal abnormalities

Answer: 2

A patient with lower extremity peripheral artery disease (PAD) undergoes a balloon angioplasty with stent placement. The nurse recalls that the balloon and the stent may be coated with what medication to reduce restenosis? 1 Bosentan 2 Paclitaxel 3 Doxycycline 4 Amphetamine

Answer: 2

The nurse teaches dietary measures to a patient who underwent peripheral artery bypass surgery. Which patient actions indicate effective learning? Select all that apply. 1 Limiting kale intake 2 Increasing fresh fruit intake 3 Increasing foods high in Vitamin A 4 Limiting foods high in zinc 5 Limiting the intake of broccoli and carrots

Answer: 2, 3

The nurse provides discharge instructions to a patient who underwent femoral artery bypass surgery with synthetic graft replacement. The nurse instructs the patient to monitor for what indications of acute arterial ischemia? Select all that apply. 1 Pulse rate of 110 2 Pale and white leg 3 Severe pain in the lower leg 4 Oral temperature of 38.2º C 5 No hair growth on lower legs 6 Redness along the surgical incision

Answer: 2,3

A patient with diabetes undergoes an ankle-brachial index (ABI) test. The result of the test is 1.10. How should the nurse interpret the test result? 1 The patient will be diagnosed with peripheral arterial disease (PAD). 2 The patient has an abnormal ABI. 3 The patient may have a falsely elevated ABI. 4 The patient has borderline ABI

Answer: 3

A patient with intermittent claudication experiences pain in the leg muscles while exercising that resolves within 10 minutes after stopping. The nurse recognizes that the ischemic pain is a result of the buildup of what? 1 Blood viscosity 2 Triglycerides 3 Lactic acid 4 Homocysteine

Answer: 3

A patient has loss of hair on the legs and the feet, extremities cold to the touch, and brittle nails. The ankle-brachial index (ABI) is 0.41 and the laboratory report indicates decreased Doppler pressures. What should the nurse interpret from the assessment findings? 1 The patient is experiencing side effects of heparin. 2 The patient has Raynaud's phenomenon. 3 The patient has venous disease. 4 The patient has peripheral artery disease (PAD)

Answer: 4

A patient takes ibuprofen and aspirin for management of peripheral artery disease (PAD). The nurse should instruct the patient to notify the health care provider (HCP) before taking which herbal supplement? 1 Milk thistle 2 St. John's wort 3 Flaxseed 4 Goldenseal

Answer: 4

After assessing a patient, the nurse identifies that the patient is in the initial stage of Raynaud's disorder. The determination was made based on what assessment finding? 1 Throbbing, tingling, and swelling of the limbs 2 Chronic ischemic pain and ulcers on both feet 3 Hypertension, hyperglycemia, and inflamed arteries 4 Color changes of fingers and toes from white to blue to red

Answer: 4

What is the rationale for the use of ramipril in a symptomatic patient with peripheral artery disease (PAD)? 1 Reduces hypertension 2 Reduces vasospastic attack 3 Lowers low-density lipoproteins 4 Slows growth rate of aneurysm

Reduces hypertension

The nurse anticipates that which medication will be prescribed to a patient with intermittent claudication? 1 Ramipril 2 Warfarin 3 Simvastatin 4 Pentoxifylline

Answer: 4

A patient is diagnosed with peripheral artery disease (PAD). The nurse anticipates that which medication will be prescribed?

Simvastatin

Which ankle-brachial index (ABI) value indicates noncompressible arteries?

1.50

Which ankle-brachial index (ABI) value indicates noncompressible arteries? 1 0.92 2 0.96 3 1.20 4 1.50

1.50

A patient who is diagnosed with critical limb ischemia is not a candidate for bypass surgery or percutaneous transluminal angioplasty (PTA). The nurse anticipates that what medication will be prescribed to decrease rest pain and improve ulcer healing? 1 Aspirin 2 Iloprost 3 Propranolol 4 Hydralazine

2

The nurse anticipates a prescription for which treatment for a patient who has undergone distal peripheral bypass surgery using synthetic graft material? 1 Furosemide therapy for 3 days 2 Propranolol therapy for 1 week 3 Nitroprusside therapy for 1 month 4 Clopidogrel plus aspirin therapy for 1 year

Answer: 4

What is the rationale behind recommending gene and stem cell therapy to a patient who has critical limb ischemia? 1 To reduce pain 2 To increase perfusion 3 To prevent maceration 4 To increase angiogenesis

Answer: 4

A patient with diabetes is being discharged after distal peripheral bypass surgery below the knee. What should the nurse include in the patient's discharge instructions? Select all that apply. 1 Participate in supervised exercise training. 2 It is important to practice meticulous foot care. 3 Increase daily walking to 60 min/day. 4 Visit the health care provider for treatment of thick or overgrown toenails. 5 Wear pointed shoes with soft insoles.

Answer 1,2,4

A patient is diagnosed with intermittent claudication. The nurse expects the patient's treatment plan to include what medication? 1 Iloprost 2 Cilostazol 3 Ibuprofen 4 Omeprazole

Answer : 2

Which statement made by the student nurse indicates the need for additional teaching about appropriate postoperative interventions for a patient who has undergone peripheral artery bypass surgery? 1 "I should turn and position the patient frequently with pillows." 2 "I should measure the ankle-brachial index 10 minutes after surgery." 3 "I should instruct the patient to use elastic compression stockings daily." 4 "I should instruct the patient to refrain from sitting with the legs dangling."

Answer:2

A patient reports leg pain that awakens the patient at night. The patient reports that the same pain develops in the legs when they are elevated and disappears when the legs are dangled. The nurse assesses a lesion on the inner aspect of the ankle. The nurse suspects what diagnosis?

Arterial insufficiency

The nurse provides care for a patient 1 day after the patient underwent peripheral artery bypass surgery. What is an appropriate nursing intervention?

Assist the patient with walking several times

The nurse reviews the assessment findings of a patient with atherosclerosis and notes an ankle brachial index (ABI) of 0.8, decreased Doppler pressures, aspirin intolerance, and arterial stenosis. What is the best treatment choice?

Clopidogrel

The nurse reviews the assessment findings of a patient with atherosclerosis and notes an ankle brachial index (ABI) of 0.8, decreased Doppler pressures, aspirin intolerance, and arterial stenosis. What is the best treatment choice? 1 Nifedipine 2 Clopidogrel 3 Furosemide 4 Doxycycline

Clopidogrel

The nurse provides care to a patient diagnosed with thromboangiitis obliterans (Buerger's disease). What is the primary treatment for the disease?

Complete cessation of tobacco and marijuana use

The nurse provides postoperative care to a patient who underwent peripheral artery bypass surgery. Thirty minutes after the initial assessment, the nurse reassesses the patient and detects a change in the Doppler sound over a pulse. What action should the nurse take?

Contact the health care provider

The nurse provides postoperative care to a patient who underwent peripheral artery bypass surgery. Thirty minutes after the initial assessment, the nurse reassesses the patient and detects a change in the Doppler sound over a pulse. What action should the nurse take? 1 Administer an oral anticoagulant 2 Measure the ankle-brachial index 3 Prepare for surgical revascularization 4 Contact the health care provider

Contact the health care provider

The nurse reviews the care options for patients with lower extremity peripheral artery disease (PAD). Which treatment is used to stimulate blood vessel growth?

Gene and stem cell therapy

Which condition should the nurse check in the patient's history before administering cilostazol?

Heart failure

A patient who is diagnosed with critical limb ischemia is not a candidate for bypass surgery or percutaneous transluminal angioplasty (PTA). The nurse anticipates that what medication will be prescribed to decrease rest pain and improve ulcer healing?

Iloprost

A patient is diagnosed with critical limb ischemia, which resulted from severe chronic peripheral vascular disease. The nurse places the patient's bed in the reverse Trendelenberg position to achieve what desired effect?

Increase tissue perfusion by gravity

The nurse teaches dietary measures to a patient who underwent peripheral artery bypass surgery. Which patient actions indicate effective learning? Select all that apply.

Increasing fresh fruit intake Increasing foods high in Vitamin A

A patient reports a recent onset of pain in the calf when climbing stairs. The pain is relieved when the patient sits and rests for about 2 minutes. The patient is then able to resume activities. The nurse suspects what condition?

Intermittent claudication

A patient experiences pain in the calf while exercising and reports that the pain disappears after a few minutes of resting. The nurse recognizes the finding as consistent with what condition?

Ischemia resulting from partial blockage of an artery

The nurse is assessing a patient with lower-extremity peripheral artery disease (PAD). The nurse expects to find what clinical manifestation?

Loss of hair on legs, feet, and toes

A patient has undergone peripheral artery bypass surgery. The patient is diabetic, has a history of chronic ischemic rest pain, and has been taking opioids for more than a year. Which postoperative nursing interventions are appropriate for the patient? Select all that apply.

Monitor perfusion to the extremities Encourage the patient to practice meticulous foot care Teach the patient or caregiver about wound management Report any potential complications, such as bleeding or thrombosis

The nurse observes leakage of pus, increased redness and hardness, and wound separation along the incision of a patient who has undergone peripheral artery bypass surgery. What action should the nurse take?

Notify the primary health care provider

The nurse assesses a patient who is diagnosed with acute arterial ischemia in the leg. Which early clinical manifestation requires immediate intervention?

Paresthesia

A patient who underwent percutaneous transluminal angioplasty (PTA) to treat lower leg peripheral artery disease is prescribed 75 mg of aspirin daily. What is the desired effect of this medication?

Prevent platelet agglutination

The nurse teaches self-care instructions to a patient who has undergone peripheral artery bypass surgery. Which patient action indicates the need for further teaching?

Sits cross-legged

A male Hispanic patient is diagnosed with peripheral artery disease (PAD). The nurse notes a history of smoking and a history of depression. The nurse identifies that the patient has what PAD risk factor?

Smoking

The nurse observes another health care provider caring for a patient with critical limb ischemia. Which action needs correction?

Soaking the patient's feet to allow for thorough cleaning

The nurse recognizes that which interventions may benefit a patient with Buerger's disease? Select all that apply.

Stopping all use of marijuana Administering a calcium channel blocker Administering an analgesic

A patient develops edema following peripheral artery bypass surgery. The nurse should place the patient in what position?

Supine position

A patient has loss of hair on the legs and the feet, extremities cold to the touch, and brittle nails. The ankle-brachial index (ABI) is 0.41 and the laboratory report indicates decreased Doppler pressures. What should the nurse interpret from the assessment findings?

The patient has peripheral artery disease (PAD).

What is the reason behind placing the bed in the reverse Trendelenburg position while the nurse cares for a patient with critical limb ischemia?

To increase perfusion to the lower extremities

The nurse is assessing a patient who has peripheral artery disease (PAD). Which assessment finding is considered to be a classic symptom of lower extremity PAD? 1 Rest pain 2 Skin ulcerations 3 Intermittent claudication 4 Paresthesia in the feet and toes

answer: Intermittent claudication

The nurse is assessing the ankle-brachial index (ABI) of four patients. Which patient is at moderate risk for peripheral artery disease (PAD)?

patient 1