Chapter 26

The nurse is assessing a client with severe hypertension. Which symptom indicates to the nurse that the client is experiencing dissection of the aorta? a. Pain when flexing the neck forward b. Numbness and pain of the left arm c. A ripping sensation in the chest d. Gradual onset of a frontal headache

A ripping sensation in the chest

What should the nurse do to manage the persistent swelling in a client with severe lymphangitis and lymphadenitis? a. Offer cold applications to promote comfort and to enhance circulation b. Inform the physician if the client's temperature remains low c. Avoid elevating the area d. Teach the client how to apply an elastic sleeve

Teach the client how to apply an elastic sleeve

The nurse is assisting a patient with peripheral arterial disease to ambulate in the hallway. What should the nurse include in the education of the patient during ambulation? a. "If you feel pain during the walk, keep walking until the end of the hallway is reached." b. "As soon as you feel pain, we will go back and elevate your legs." c. "Walk to the point of pain, rest until the pain subsides, then resume ambulation." d. "If you feel any discomfort, stop and we will use a wheelchair to take you back to your room."

"Walk to the point of pain, rest until the pain subsides, then resume ambulation."

The nurse is preparing discharge teaching for a client with venous insufficiency. Which information will the nurse include in the instructions? Select all that apply. a. Avoid wearing socks that are tight only at the top of the leg. b. Elevate the legs 15 to 20 minutes 4 times a day. c. Sleep with the foot of the bed elevated 6 inches. d. Decrease the amount of time spent walking. e. Wear graduated compression socks only at night.

-Avoid wearing socks that are tight only at the top of the leg. -Elevate the legs 15 to 20 minutes 4 times a day. -Sleep with the foot of the bed elevated 6 inches.

A client is recovering from sclerotherapy to treat varicose veins. Which information will the nurse provide to the client after the procedure? Select all that apply. a. Increase the amount of time walking at home. b. Wear graduated compression stockings for a week after the procedure. c. Change the dressings once a day. d. Take acetaminophen as prescribed for pain. e. Expect a burning sensation in the injected areas for 1 to 2 days.

-Increase the amount of time walking at home. -Wear graduated compression stockings for a week after the procedure. -Take acetaminophen as prescribed for pain. -Expect a burning sensation in the injected areas for 1 to 2 days.

Heparin therapy is usually considered therapeutic when the activated partial thromboplastin time (aPTT) is how many times higher than a normal value? a. 0.5 to 1.5 b. 1.5 to 2.5 c. 2.5 to 3.5 d. 3.5 to 4.5

1.5 to 2.5

When administering heparin anticoagulant therapy, the nurse needs to make certain that the activated partial thromboplastin time (aPTT) is within the therapeutic range of: a. 4.5 times the baseline control. b. 2.5 to 3.0 times the baseline control. c. 1.5 to 2.5 times the baseline control. d. 3.5 times the baseline control.

1.5 to 2.5 times the baseline control.

When administering heparin anticoagulant therapy, the nurse needs to make certain that the activated partial thromboplastin time (aPTT) is within the therapeutic range of: a. 4.5 times the baseline control. b. 3.5 times the baseline control. c. 1.5 to 2.5 times the baseline control. d. 2.5 to 3.0 times the baseline control.

1.5 to 2.5 times the baseline control.

A patient is admitted to a special critical care unit for the treatment of an arterial thrombus. The nurse is aware that the preferred drug of choice for clot removal, unless contraindicated, would be: a. Urokinase. b. Alteplase. c. Reteplase. d. Streptokinase

Alteplase.

A nurse is changing a dressing on an arterial suture site. The site is red, with foul-smelling drainage. Based on these symptoms, the nurse is aware to monitor for which type of aneurysm? a. False b. Saccular c. Anastomotic d. Dissecting

Anastomotic

You are presenting a workshop at the senior citizens center about how the changes of aging predisposes clients to vascular occlusive disorders. What would you name as the most common cause of peripheral arterial problems in the older adult? a. Aneurysm b. Coronary thrombosis c. Atherosclerosis d. Raynaud's disease

Atherosclerosis

Which of the following is a diagnostic test that involves injection of a contrast media into the venous system through a dorsal vein in the foot? a. Contrast phlebography b. Air plethysmography c. Lymphangiography d. Lymphoscintigraphy

Contrast phlebography

As the clinic nurse caring for a client with varicose veins, what is an appropriate nursing action for this client? a. Assess for the sites of bleeding. b. Demonstrate how to self-administer IV infusions. c. Assess for skin integrity. d. Demonstrate how to apply and remove elastic support stockings.

Demonstrate how to apply and remove elastic support stockings.

Which is a characteristic of arterial insufficiency? a. Superficial ulcer b. Diminished or absent pulses c. Aching, cramping pain d. Pulses are present but may be difficult to palpate

Diminished or absent pulses

Which aneurysm results in bleeding into the layers of the arterial wall? a. False b. Anastomotic c. Dissecting d. Saccular

Dissecting

A patient is having an angiography to detect the presence of an aneurysm. After the contrast is administered by the interventionist, the patient begins to complain of nausea and difficulty breathing. What medication is a priority to administer at this time? a. Cimetidine (Tagamet) b. Epinephrine c. Hydrocortisone (Solu-Cortef) d. Metoprolol (Lopressor)

Epinephrine

Which statement is accurate regarding Raynaud disease? a. Episodes may be triggered by unusual sensitivity to cold. b. The disease generally affects the client trilaterally. c. It is most common in men 16 to 40 years of age. d. It affects more than two digits on each hand or foot.

Episodes may be triggered by unusual sensitivity to cold.

Which class of medication lyses and dissolves thrombi? a. Platelet inhibitors b. Anticoagulant c. Fibrinolytic d. Factor XA inhibitors

Fibrinolytic

A client with lower extremity edema is diagnosed with lymphedema. For which medication will the nurse prepare teaching for this client? a. Heparin b. Amoxicillin c. Furosemide d. Oxycodone

Furosemide

Providing postoperative care to a patient who has percutaneous transluminal angioplasty (PTA), with insertion of a stent, for a femoral artery lesion, includes assessment for the most serious complication of: a. Decreased motor function. b. Stent dislodgement. c. Thrombosis of the graft. d. Hemorrhage.

Hemorrhage.

The nurse is caring for a patient who has started anticoagulant therapy with warfarin (Coumadin). When does the nurse understand that therapeutic benefits will begin? a. Within 12 hours b. Within the first 24 hours c. In 3 to 5 days d. In 2 days

In 3 to 5 days

A client is receiving enoxaparin and warfarin therapy for a venous thromboembolism (VTE). Which laboratory value indicates that anticoagulation is adequate and enoxaparin can be discontinued? a. Prothrombin time (PT) is 0.5 times normal. b. Activated partial thromboplastin time (aPPT) is half of the control value c. K+ level is 3.5. d. International normalized ratio (INR) is 2.5.

International normalized ratio (INR) is 2.5.

Aortic dissection may be mistaken for which of the following disease processes? a. Stroke b. Pneumothorax c. Angina d. Myocardial infarction (MI)

Myocardial infarction (MI)

A nurse is assessing a client's right lower leg, which is wrapped with an elastic bandage. Which signs and symptoms suggest circulatory impairment? a. Numbness, warm skin temperature, and redness b. Redness, cool skin temperature, and swelling c. Numbness, cool skin temperature, and pallor d. Swelling, warm skin temperature, and drainage

Numbness, cool skin temperature, and pallor

A nurse is caring for a client following an arterial vascular bypass graft in the leg. What should the nurse plan to assess over the next 24 hours? a. Color of the leg every 4 hours b. Peripheral pulses every 15 minutes after surgery c. Ankle-arm indices every 12 hours d. Blood pressure every 2 hours

Peripheral pulses every 15 minutes after surgery

A female client is readmitted to the facility with a warm, tender, reddened area on her right calf. Which contributing factor should the nurse recognize as most important? a. A history of diabetes mellitus b. An active daily walking program c. Recent pelvic surgery d. History of increased aspirin use

Recent pelvic surgery

A physician admits a client to the health care facility for treatment of an abdominal aortic aneurysm. When planning this client's care, which goal should the nurse keep in mind as she formulates interventions? a. Increasing blood pressure and reducing mobility b. Decreasing blood pressure and increasing mobility c. Increasing blood pressure and monitoring fluid intake and output d. Stabilizing heart rate and blood pressure and easing anxiety

Stabilizing heart rate and blood pressure and easing anxiety

A client with a diagnosed abdominal aortic aneurysm (AAA) develops severe lower back pain. Which is the most likely cause? a. The client is experiencing normal sensations associated with this condition. b. The client is experiencing inflammation of the aneurysm. c. The aneurysm may be preparing to rupture. d. The aneurysm has become obstructed.

The aneurysm may be preparing to rupture.

A nurse and physician are preparing to visit a hospitalized client with peripheral arterial disease. As you approach the client's room, the physician asks if the client has reported any intermittent claudication. The client has reported this symptom. The nurse explains to the physician which of the following details? a. The client experiences shortness of breath after walking about 50 feet. b. The client can walk about 50 feet before getting pain in the right lower leg. c. The client's legs awaken him during the night with itching. d. The client's fingers tingle when left in one position for too long.

The client can walk about 50 feet before getting pain in the right lower leg.

Which of the following is the most common site for a dissecting aneurysm? a. Lumbar area b. Sacral area c. Thoracic area d. Cervical area

Thoracic area

The nurse is caring for a patient with venous insufficiency. For what should the nurse assess the patient's lower extremities? a. Rubor b. Cellulitis c. Ulceration d. Dermatitis

Ulceration

A home health nurse is seeing an elderly male client for the first time. During the physical assessment of the skin on the lower legs, the nurse notes edema, brown pigmentation in the gaiter area, pedal pulses, and a few irregularly shaped ulcers around the ankles. From these findings, the nurse knows that the client has a problem with peripheral circulation. Which of the following does the nurse suspect? a. Neither venous nor arterial insufficiency b. Trauma c. Arterial insufficiency d. Venous insufficiency

Venous insufficiency

A client reports pain and cramping in the thigh when climbing stairs and numbness in the legs after exertion. Which diagnostic test with the physician likely perform right in the office to determine PAD? a. electron beam computed tomography b. exercise electrocardiography c. ankle-brachial index d. photoplethysmography

ankle-brachial index

The term for a diagnostic test that involves injection of a contrast media into the venous system through a dorsal vein in the foot is a. contrast phlebography. b. lymphoscintigraphy. c. lymphangiography. d. air plethysmography.

contrast phlebography.

The most important reason for a nurse to encourage a client with peripheral vascular disease to initiate a walking program is that this form of exercise: a. decreases venous congestion. b. increases high-density lipoprotein (HDL) level. c. aids in weight reduction. d. reduces stress.

decreases venous congestion.

A nurse is instructing a client about using antiembolism stockings. Antiembolism stockings help prevent deep vein thrombosis (DVT) by: a. forcing blood into the deep venous system. b. providing warmth to the extremity. c. encouraging ambulation to prevent pooling of blood. d. elevating the extremity to prevent pooling of blood.

forcing blood into the deep venous system.