Master quizlet for Perfusion
T/F- patients with low-density lipoprotein (LDL) values of 130-159 are advised to follow a fat-modified diet
True
A nurse is caring for a group of clients on a medical-surgical unit. Which client has the highest risk for developing a pulmonary embolism? a. An obese client with leg trauma b. A pregnant client with acute asthma c. A client with diabetes who has cholecystitis d. A client with pneumonia who is immunocompromised
Answer: A
A nurse is providing dietary instruction to a client with cardiovascular disease. Which dietary selection by the client indicates that the nurse needs to follow up? a. Whole milk with oatmeal b. Garden salad with olive oil c. Tuna fish with a small apple d. Soluble fiber cereal with yogurt
Answer: A
Which diagnostic test would the nurse consider to be the gold standard for diagnosis of pulmonary embolism? a. Pulmonary angiography b. Helical computed tomography (CT) c. Ventilation-perfusion (V/Q) scans d. Computed tomography pulmonary angiography (CT-PA)
Answer: A Pulmonary angiography is considered the gold standard for diagnosis of pulmonary embolism. Helical CT, also known as CT-PA, may also be used as a diagnostic test for pulmonary embolism. This has the added advantage of diagnosing other pulmonary abnormalities. V/Q scans are not as widely used currently, but may be considered in certain circumstances when the client has an allergy to contrast dyes
Select all that apply Atherosclerosis affects which larger arteries: a) renal b) femoral c) coronary d) brachial cephalic e) aorta
Answer: A, B, C, E
What should the nurse do to prevent thrombus formation after most surgeries? a. Keep the client's bed gatched to elevate the knees. b. Have the client dangle the legs off the side of the bed. c. Have the client use an incentive spirometer every hour. d. Encourage the client to ambulate with assistance every few hours
Answer: D
Which complications does the nurse anticipate in the client who has blue-colored nail beds? a. Thrombocytopenia b. Polycythemia vera c. Methemoglobinemia d. Cardiopulmonary disease
Answer: D
Intravenous heparin therapy is ordered for a client. While implementing this order, a nurse ensures that which of the following medications is available on the nursing unit? A. Vitamin K B. Aminocaproic acid C. Potassium chloride D. Protamine sulfate
Answer: D The antidote to heparin is protamine sulfate and should be readily available for use if excessive bleeding or hemorrhage should occur
For woman which of the following is a normal triglyceride level? a) over 150 mg/dL b) under 135 mg/dL c) over 100 mg/dL d) under 70 mg/dL
Answer: B
T/F- medications for hyperlipidemia should be taken with meals
True
A client is receiving warfarin. Which test result should the nurse use to determine whether the daily dose of this anticoagulant is therapeutic? a. International normalized ratio (INR) b. Accelerated partial thromboplastin time (APTT) c. Bleeding time d. Sedimentation rate
Answer: A
A pt is on heparin therapy in the hospital. What lab would a nurse expect to see done daily? A. PTT B. PT/INR C. CBC D. Sed Rate
Answer: A
This is an examination using sound waves, thich go through tissue and strike the RBCs and bounce back. It evaluates blood flow and can locate a thrombus. A. Photoelectric B. Xray C. Radionuclide Study D. Ultrasound
Answer: D
After surgery, a client reports sudden severe chest pain and begins coughing. The nurse suspects the client has a thromboembolism. What characteristic of the sputum supports the nurse's suspicion that the client has a pulmonary embolus? a. Pink b. Clear c. Green d. Yellow
Answer: A
Before discharging a client who had an inguinal herniorrhaphy, the nurse teaches the client about exercising to prevent venous stasis. How can the nurse achieve the best results? a. Demonstrate specific exercises. b. Suggest frequent moving of the legs. c. Advise against sitting for prolonged periods. d. Suggest that the client change positions frequently
Answer: A
Mike, a 43-year old construction worker, has a history of hypertension. He smokes two packs of cigarettes a day, is nervous about the possibility of being unemployed, and has difficulty coping with stress. His current concern is calf pain during minimal exercise that decreased with rest. The nurse assesses Mike's symptoms as being associated with peripheral arterial occlusive disease. The nursing diagnosis is probably: A. Alteration in tissue perfusion related to compromised circulation B. Dysfunctional use of extremities related to muscle spasms C. Impaired mobility related to stress associated with pain D. Impairment in muscle use associated with pain on exertion
Answer: A
The nurse is reviewing a client's current medication therapy and suspects hematuria. Which medication is responsible for the client's condition? a. Warfarin b. Cimetidine c. Phenazopyridine d. Nitrofurantoin
Answer: A
Which medication is used to inactivate thromboplastin? A. Heparin B. Warfarin C. Diazepam D. Streptokinase
Answer: A
Women who use oral contraceptives should be educated about: A. Venous insufficiency B. Arterial insufficiency
Answer: A
a patient is prescribed niacin (Niaspan) to lower low-density lipoprotein cholesterol (LDL-C) and very low density lipoprotein (VLDL). Why are lower doses prescribed to the patient? a) to prevent an elevation of hepatic enzymes b) to prevent muscle myopathies c) to prevent elevation of BP d) to prevent undesirable hypokalemia
Answer: A
A nurse has an order to begin administering warfarin sodium (coumadin) to a client. While implementing this order, the nurse ensures that which of the following medications is available on the nursing unit as the antidote for Coumadin? A. Vitamin K B. Aminocaproic acid C. Potassium chloride D. Protamine sulfate
Answer: A The antidote to warfarin (Coumadin) is Vitamin K and should be readily available for use if excessive bleeding or hemorrhage should occur.
A client admitted to the hospital has edematous ankles. What should the nurse do to best reduce edema of the lower extremities? a. Restrict fluids. b. Elevate the legs. c. Apply elastic bandages. d. Do range-of-motion exercises
Answer: B
A client's serum lipids are cholesterol 197 mg/dl, low-density lipoprotein (LDL) 110 mg/dl, and high-density lipoprotein (HDL) 35 mg/dl. The nurse knows what about these values? a. Serum lipids are within desirable values. b. Cholesterol is within desirable value, but LDL and HDL are not. c. Cholesterol is not within desirable value, though LDL and HDL are. d. Cholesterol, LDL, and HDL are not within desirable values.
Answer: B
A nurse receives a shift report on four adult clients who are between the ages of 25 and 55. Which client should the nurse assess first? a. Male client with a hemoglobin of 15.9 (160 mmol/L) b. Female client on warfarin (Coumadin) with an international normalized ratio (INR) of 7.5 c. Female client taking daily calcium supplements with a serum calcium level of 9.4 (2.35 mmol/L) d. Male client with a blood urea nitrogen (BUN) of 20 (7.1 mmol/L) and a creatinine of 1 (96 mcmol/L)
Answer: B
A pt has arterial insufficiency. What should the nurse not do? A. Apply warm compresses B. Apply cold compresses C. Instruct the use of loose fitting clothing D. Educate of the potential for burns
Answer: B
Amy is being assessed for PVD. Upon her assessment, the nurse finds that Amy has ulceration around her hips, he legs show no edema, she has severe pain, and has no pedal pulse. What would the nurse take away from this assessment? A. Venous PVD B. Arterial PVD
Answer: B
Warfarin is used commonly in pts. How does Warfarin work? A. Inactivates thromboplastin B. Inhibits activity of Vit K and prolongs clotting C. Relaxation and stress reductioin D. Moves free water to the kidney
Answer: B
What should the nurse monitor when a client is receiving a platelet aggregation inhibitor such as clopidogrel? a. Nausea b. Epistaxis c. Chest pain d. Elevated temperature
Answer: B
Which condition may cause the gradual occlusion of the internal or common carotid arteries, manifested by transient ischemic attacks? a. Acquired valvular heart disease b. Atherosclerosis of the vascular system c. Emboli associated with atrial fibrillation d. Developmental defects of the arterial wall
Answer: B
Which technique is considered the gold standard for diagnosing DVT? A. Ultrasound imaging B. Venography C. MRI D. Doppler flow study
Answer: B
With peripheral arterial insufficiency, leg pain during rest can be reduced by: A. Elevating the limb above heart level B. Lowering the limb so it is dependent C. Massaging the limb after application of cold compresses D. Placing the limb in a plane horizontal to the body
Answer: B
a patient gets a new prescription for Pravigar for treatment of high cholesterol. Because this is a combination drug, the nurse alerts the physician when the patient discloses an allergy to which drug? a) sulfa b) aspirin c) some calcium channel blockers d) some diuretics
Answer: B
A nurse is caring for a client who had a percutaneous insertion of an inferior vena cava filter and was on heparin therapy before surgery. The nurse would inspect the surgical site most closely for signs of: A. Thrombosis and infection B. Bleeding and infection C. Bleeding and wound dehiscence D. Wound dehiscence and evisceration
Answer: B After inferior vena cava insertion, the nurse inspects the surgical site for bleeding and signs and symptoms of infection. Otherwise, care is the same as for any post-op client.
A client comes to the outpatient clinic and tells the nurse that he has had legs pains that began when he walks but cease when he stops walking. Which of the following conditions would the nurse assess for? A. An acute obstruction in the vessels of the legs B. Peripheral vascular problems in both legs C. Diabetes D. Calcium deficiency
Answer: B Intermittent claudication is a condition that indicates vascular deficiencies in the peripheral vascular system. If an obstruction were present, the leg pain would persist when the client stops walking. Low calcium levels may cause leg cramps but would not necessarily be related to walking.
A 24-year old man seeks medical attention for complaints of claudication in the arch of the foot. A nurse also notes superficial thrombophlebitis of the lower leg. The nurse would next assess the client for: A. Familial tendency toward peripheral vascular disease B. Smoking history C. Recent exposures to allergens D. History of insect bites
Answer: B The mixture of arterial and venous manifestations (claudication and phlebitis, respectively) in the young male client suggests Buerger's disease. This is an uncommon disorder characterized by inflammation and thrombosis of smaller arteries and veins. This disorder typically is found in young adult males who smoke. The cause is not known precisely but is suspected to have an autoimmune component.
A client who has been receiving heparin therapy also is started on warfarin sodium (coumadin). The client asks the nurse why both medications are being administered. In formulating a response, the nurse incorporates the understanding that warfarin sodium: A. Stimulates the breakdown of specific clotting factors by the liver, and it takes 2-3 days for this is exhibit an anticoagulant effect. B. Inhibits synthesis of specific clotting factors in the liver, and it takes 3 to 4 days for this medication to exert an anticoagulation effect. C. Stimulates production of the body's own thrombolytic substances, but it takes 2-4 days for it to begin. D. Has the same mechanism action of heparin, and the crossover time is needed for the serum level of warfarin sodium to be therapeutic.
Answer: B Warfarin sodium works in the liver and inhibits synthesis of four vitamin K-dependent clotting factors (X, IX, VII, and II), but it takes 3 to 4 days before the therapeutic effect of warfarin is exhibited.
Matt has PVD. The nurse shows an understanding of PVD when the nurse states: (select all that apply) A. In PVD, skin temperature is not important. B. Do not elevate lower limb positioning for arterial PVD C. No hair on lower legs with venous PVD D. Elevate lower limb positioning for venous PVD
Answer: B and D
the nurse is performing blood pressure screening at a community center. Which patients are referred for evaluation of their blood pressure? (select all that apply) a) diabetic patient with blood pressure of 118/78 mmHg b) Patient with heart disease with a high blood pressure of 134/90 mm Hg. c) patient with no known health problems who has a blood pressure of 125/86 mm Hg. d) diabetic patient with a blood pressure of 180/80 mm Hg. e) patient with no known health problems and a blood pressure of 106/70 mmHg
Answer: B, C, D
Which factors can increase systemic arterial pressure (select all that apply) a) decreased cardiac output b) increased HR c) increased peripheral vascular resistance d) increased stroke volume e) decreased BP
Answer: B,C,D
A client has delivered her infant via cesarean birth. What is the most important nursing intervention to prevent thromboembolism on the client's first postpartum day? a. Providing oxygen therapy b. Administering pain medication c. Encouraging frequent ambulation d. Recommending an increase in oral fluids
Answer: C
A client who had a femoropopliteal bypass graft is receiving clopidogrel postoperatively. What should the nurse teach the client related to the medication? a. Eliminate grapefruit from the diet b. Eat more roughage if constipation occurs c. Report any occurrence of multiple bruises d. Take the medication on an empty stomach
Answer: C
A patient's cholesterol screening shows an HDL value >40 and a total serum cholesterol level of 188. The patient has no other cardiac or vascular risk factors. What does the nurse advise the patient to do? a) modify the diet to exclude fats and increase fiber, then repeat tests b) contact the physician for a prescription of antilipemic medication c) repeat total and HDL cholesterol testing in 6-12 weeks d) repeat total and HDL testing during the next routine exam
Answer: C
To prevent thrombophlebitis in the immediate postoperative period, which action is most important for a nurse to include in the client's plan of care? a. Increase fluid intake. b. Restrict fluids. c. Encourage early mobility. d. Elevate the knee gatch of the bed.
Answer: C
When caring for a patient who has started anticoagulant therapy with warfarin (Coumadin), the nurse knows not to expect therapeutic benefits for: A. At least 12 hours B. The first 24 hours C. 2-3 days D. 1 week
Answer: C
Which of the following characteristics is typical of the pain associated with DVT? A. Dull ache B. No pain C. Sudden onset D. Tingling
Answer: C DVT is associated with deep leg pain of sudden onset, which occurs secondary to the occlusion. A dull ache is more commonly associated with varicose veins. A tingling sensation is associated with an alteration in arterial blood flow. If the thrombus is large enough, it will cause pain.
A nurse understands they key symptom areas of PVD when the nurse includes: Tissue death, skin appearance and temperature, pulse changes, and: A. Increase of BP B. Vericose Veins C. Increased WBC D. Pain
Answer: D
A significant cause of venous thrombosis is: A. Altered blood coagulation B. Stasis of blood C. Vessel wall injury D. All of the above
Answer: D
Examples of venous insufficiency would be: A. DVT B. Thrombophlebitis C. Varicose veins D. All the above E. None of the above
Answer: D
The most important factor in regulating the caliber of blood vessels, which determines resistance to flow, is: A. Hormonal secretion B. Independent arterial wall activity C. The influence of circulating chemicals D. The sympathetic nervous system
Answer: D
The nurse is conducting dietary teaching with a patient. Which statement by the patient indicates an understanding of fat sources and the need to limit saturated fats. a) coconut oil has a rich flavor and is a good cooking oil b) sunflower oil is high in saturated fats, so i should avoid it c) meat and eggs mostly contain unsaturated fats d) canola oil has monounsaturated fat and is recommended
Answer: D
A client is admitted with a venous stasis leg ulcer. A nurse assesses the ulcer, expecting to note that the ulcer: A. Has a pale colored base B. Is deep, with even edges C. Has little granulation tissue D. Has brown pigmentation around it
Answer: D Venous leg ulcers, also called stasis ulcers, tend to be more superficial than arterial ulcers, and the ulcer bed is pink. The edges of the ulcer are uneven, and granulation tissue is evident. The skin has a brown pigmentation from accumulation of metabolic waste products resulting from venous stasis. The client also exhibits peripheral edema. (options 1, 2, and 3 are due to tissue malnutrition; and thus us an arterial problem)
A pt has a thrombus in their calf. What would you expect to see in the pt? A. No pain B. Pallor C. Absent pulsation beyond embolus D. Polikilothermia E. B,C, D
Answer: E