Perfusion

a client begins therapy with a new medication. one month later the client notices blood in the urine. which medication would the nurse anticipate is the cause? 1. warfarin 2. nifedipine 3. nitrofurantoin 4. phenazophyridine

1

after the nurse has finished teaching a postoperative client about prevention of pulmonary embolism, which client statement indicates that the teaching has been effective? 1. "I will avoid crossing my legs" 2. "pillows placed under my knees will help avoid clots" 3. "stain on bed rest as long as possible is best for me" 4. "three times every day I will massage my lower legs to get blood moving"

1

which action will the nurse take when caring for a client with chronic arterial insufficiency of the legs who refuses the prescribed does of aspirin (ASA) and states "my legs are not painful"? 1. explain the reason for the medication and encourage the client to take it 2. withhold the medication at this time and return to check with the client again in 30 minute s 3. withhold the medication and tell the client to ask for it if the legs become uncomfortable 4. request that the client take the medication and explain that is prevents the client from being uncomfortable in the next few hours

1

which client action indicates that the teaching has been effective after the nurse provides discharge teaching for a client who had a femoropopliteal bypass graft? 1. walking fro 10 minutes twice a day 2. elevating the legs when sitting or lying 3. taking a hot bath before going to bed 4. discontinuing prescribed daily aspirin

1

which clinal finding will help the nurse determine that the ulcer is arterial when client is seen in the outpatient clinic with a large leg ulcer? 1. dry-appearing and light pink ulcer 2. serasanguineous drainage from the ulcer 3. dependent edema of the extremities 4. stasis dermatitis on the affected extremity

1

which response would the nurse make to a. 30 yo client diagnosed with hyperlipidemia and hypertension who asks the nurse to explain why treatment is important, stating "I feel fine, so I don't really see the need to make any changes"? 1. "both high BP and high cholesterol contribute to development of heart disease" 2. "lifestyle adaptations alone will be adequate as long as you continue to be asymptomatic" 3. "usually someone with these diagnoses will have symptoms of heart disease already" 4. "you should discuss your questions about medical problems with the health care provider"

1

which statement by a client with hypertension who has been prescribed furosemide indicates a need for medication education? 1. "this can decrease my vitamin k level" 2. "I will take the medication in the morning" 3. "I will contact my health care provider if I notice muscle weakness" 4. "I plan to take the medication even when my blood pressure is normal"

1

which statement indicates to the nurse providing discharge medication education to a client prescribed warfarin that teaching was effective? 1. "I will avoid taking aspirin and non steroidal anti-inflammatory drugs" 2. "I will need to develop a more sedentary routine" 3. "I will need to have regular complete blood counts to guide warfarin dosage" 4. "before going to the dentist, I will ask my healthcare provider for antibiotics"

1

which is the best action for the nurse to take when a client with hypertension tells the nurse, "I took the blood pressure pills for a few weeks, but I didn't feel any different, so I decided id only take them when I feel sick" ? 1. educate the client about the complications associated with high BP 2. ask the client questions to determine the current understanding of high BP 3. emphasize the importance of taking BP medications now to continue to feel well 4. show the client the current BP and compare that with normal BP levels

2

which mechanism would the nurse attempt to increase to prevent postoperative deep vein thrombosis? 1. coaguability of the blood 2. velocity of the venous return 3. effectiveness of internal respiration 4. oxygen-carrying capacity of the blood

2

which nursing intervention will be implemented when the health care provider prescribes verapamil to be administered intravenously to a 70 yo client with hypertension? 1. monitor the electrocardiogram for reflex tachycardia 2. keep the client in bed for an hour after giving the medication 3. dilute the does in 50 mL of normal saline and administer it over 15 minutes 4. assess the client for wheezes and history of asthma before administering the mediation

2

which risk factor is the highest priority when teaching a 68 yo client who has multiple risk factors for peripheral arterial disease, including client age, siblings with diabetes, a sedentary lifestyle, and family history of heart disease? 1. older age 2. low activity level 3. blood glucose control 4. family history of cardiac disease

2

which topic would the nurse include when doing discharge teaching about ways to avoid another venous thrombosis when caring for a client hospitalized with deep vein thrombosis? 1. daily aspirin use 2. frequent ambulation 3. warm soaks to legs 4. avoidance of cold

2

which finding in a client with right calf venous thrombosis is most important to communicate to the health care provider? 1. sever right calf pain 2. right calf redness and swelling 3. oxygen saturation 89% 4. heart rate of 136 breaths/min

3

which finding would indicate a need to refer a client to a health care provider when the nurse is screening clients for hypertension? 1. report of pain as the blood pressure cuff is inflated 2. systolic blood pressure result higher than 120 mm Hg 3. diastolic blood pressure reading greater than 89 mm Hg 4. loud Korotkoff sounds as the blood pressure cuff is deflated

3

which laboratory result will ebimportant fort he nurse to review when a client is admitted to the hospital with a long history of uncontrolled hypertension? 1. blood glucose level 2. white blood cell count 3. blood urea nitrogen 4. lactic dehydrogenase

3

which prescribed action would the nurse take first when a client who is admitted to the emergency department with a blood pressure of. 240/150 mm Hg reports severe headache, blurred vision, and swelling of the ankles 1. obtain a glucose blood sample 2. collect urine and blood samples 3. assess the client's pulse and respirations 4. determine the amount of ankle edema

3

for which purpose would enoxaparin 40 mg subcutaneously daily be prescribed for a client who had abdominal surgery? 1. to control postoperative fever 2. to provide a constant source of mild analgesia 3. to limit the post surgical inflammatory response 4. to provide prophylaxis against postoperative throbs formation

4

after consistently obtaining a blood pressure of 140/76 mm Hg for a client, which stage of hypertension will the nurse document? 1. normal 2. elevated 3. stage 1 4. stage 2

4

which clinical finding would the nurse expect to identify when caring for a client with a left leg venous thrombosis? select all that apply 1. pain in the left calf 2. intermittent claudication 3. redness in the affected area 4. swelling of the lower leg tleg 5. ecchymotic areas at the left ankle 6. localized warmth in the lower left leg

1, 3, 4, 6

which dietary choice would the nurse teach for the client with peripheral arterial disease? 1. limit salt intake 2. choose foods high in calcium 3. eat whole-grain breads 4. use liquid vegetable oils 5. reduce fresh fruits and vegetables 6. avoid processed meats

1, 3, 4, 6

which finding in a client seen at the outpatient clinic supports a diagnosis of an arterial ulcer? select all that apply 1. lack of hair 2. thickened toenails 3. copious ulcer drainage 4. diminished pedal pulse 5. brown skin discoloration

1, 2, 4

which finding in a client who has had major abdominal surgery indicates a possible venous thrombosis of the leg? select all that apply 1. edema of the ankle 2. skin breakdown over the shin 3. pruritis on the side of the calf 4. tender area in the posterior lower leg 5. warmth along the course of the involved vessel

1, 4, 5

a client is hospitalized for treatment of severe hypertension. shortly after admission, the client says, "I don't think any of you know what you are doing, you are just guessing what I need." which factor does the nurse know is a portable cause of this statement? 1. denial of illness 2. fear of the health problem 3. response to cerebral anorexia 4. reaction to an antihypertensive medication

2

based upon the provided data, which client would the nurse suspect of having hypertension? 1. decreased cardiac output, normal peripheral resistance, and decreased hematocrit 2. increased cardiac output, increased peripheral resistance, and increased hematocrit 3. decreased cardiac output, normal peripheral resistance, normal hematocrit 4. normal cardiac output, increased peripheral resistance, and normal hematocrit

2

the health care provider has prescribed enoxaparin 1mg/kg for a client who had a total knee replacement. the client weighs 187 lbs. this medication is available in a concentration 30mg/0.3mL. which dose will the nurse administer in milliliters? 1. 0.8 mL 2. 0.85 mL 3. 0.9 mL 4. 0.95 mL

2

when teaching a health awareness class, which situation would the nurse teach as being the highest risk factor for the development of a deep vein thrombosis (DVT)? 1. pregnancy 2. inactivity 3. aerobic exercise 4. tight clothing

2

Which information will the nurse include when teaching a client who has a new diagnosis of Raynaud disease? select all that apply 1. medication will be needed to control the symptoms 2. stop cigarette smoking and other tobacco use 3. wear gloves when getting food from the freezer 4. plan to take a daily low-dose aspirin tablet 5. avoid going quickly from a warm to cold environment

2, 3, 5

which topic would the nurse include in teaching for a client with a new diagnosis of hypertension? select all that apply 1. reason for daily low-dose aspirin use 2. use of a home blood pressure monitor 3. adverse effects of tobacco on blood pressure 4. avoidance of any alcohol consumption 5. benefits of moderate daily exercise

2, 3, 5

which information obtained by the nurse about a client would represent a risk factor for the client's admission diagnosis of hypertension? select all that apply 1. daily use of 1 aspirin 2. occasional cocaine use 3. reduced hemoglobin level 4. African american/black heritage 5. increased high-density lipoprotein (HDL)

2, 4

which findings occur with orthostatic hypotension? select all that apply 1. reflex tachycardia 2. felling of faintness 3. increased cardiac output 4. increased diastolic pressure 5. decreased systolic pressure

2, 5

which clinical finding can the nurse expect to identify when assessing a client with varicose veins? select all that apply 1. discolored toenails 2. reports of leg fatigue 3. localized heat in a calf 4. reddened areas on a calf 5. tortuous veins in the legs 6. pain in lower extremities when standing

2, 5, 6

Which term will the nurse use to document when a client with peripheral arterial disease tells the nurse about having leg pain and weakness after walking a short distance? 1. rest pain 2. Raynaud phenomenon 3. intermittent claudication 4. phantom limb sensation

3

which action would the home health nurse take when caring for a client with a pink and moist left leg venous stasis ulcer? 1. teach the client to keep the left leg in a dependent position to improve blood flow 2. monitor for increases in bruising or bleeding caused by use of anticoagulant medications 3. clean the wound with normal saline and apply prescribed hydrocolloid dressings weekly 4. educate the client about the need for vascular surgery to improve blood flow to the wound

3

which action would the nurse prioritize after applying pressure to the nose of a client who is being treated for uncontrolled hypertension and develops a nosebleed? 1. add humidity to the client's oxygen 2. teach the client how to avoid nosebleeds 3. assess the client's blood pressure 4. obtain the client's pulse rate

3

which action would the nurse take after obtaining client blood pressures of 172/104 mm Hg and 164/98 mm Hg during a blood pressure screening? 1. provide health teaching about a low-sodium diet 2. call the paramedics for transport to the hospital 3. suggest ways to decrease the client's stress level 4. refer the client to a primary health care provider

4

which action would the nurse take when the high-high anti embolism stockings that have been prescribed for a client with varicose veins fit on the lower legs but are too small to fit over the thighs? 1. slightly slit the top of the stockings to relieve pressure 2. leave the anti embolism stockings off to prevent tissue damage 3. roll the top of the stockings to below the knees to limit popliteal presser 4. ask the health care provider if an elastic bandage can be used in place of the stockings

4

which antihypertensive medication class would the nurse identify as the likely cause of the ought in a client taking multiple medications for hypertension who develops a persistent, hacking cough? 1. thiazide diuretics 2. calcium channel blockers 3. direct renin inhibitors 4. angiotensin-converting enzyme (ACE) inhibitor

4

which finding will be most important to communicate to the health care provider when the clinics nurse is assessing a client with thromboangiitis obliterates (Buerger disease)? 1. age 41 years 2. burning leg pain 3. taking daily nifedipine 4. continues tobacco use

4

which information will the nurse include when providing instructions to a client with the diagnosis of primary hypertension who is started on a regimen of hydrochlorothiazide? 1. a common side effect is decreased sexual ibido 2. one does should be omitted if dizziness occurs when standing up 3. the client should adjust the dosage daily based on the client's blood pressure 4. an antihypertensive medication will likely be required for the remainder of life

4

which information will the nurse include when teaching a client with venous insufficiency about prevention of venous thrombosis? 1. wear snug-fitting pants 2. sit with the knees flexed 3. apply warm soak to the legs tail 4.put on compression stockings before arising

4

which medication will the nurse be prepares to administer to a client admitted to the hospital with a diagnosis of deep vein thrombosis who is prescribed IV heparin sodium if the client experiences excessive bleeding? 1. vitamin k 2. oprelvekin 3. warfarin sodium 4. protamine sulfate

4

which finding would the nurse expect when assessing a client with peripheral arterial disease? select all that apply 1. pallor of feet 2. warm extremities 3. ulcers on the toes 4. thick, hardnedskin 5. delayed capillary refill

1, 3, 5

which adverse effect of valsartan, an angiotensin II receptor antagonist, will a nurse monitor for when prescribed for a client? 1. constipatino 2. hyperkalemia 3. hypertension 4. change in visual acuity

2

which adverse effect would a nurse monitor for a in a client taking clopidrogel? 1. nasuea 2. epixtaxis 3. chest pain 4. elevated temperature

2

which adverse effect would a nurse monitor for when caring for a client with hypertension who is prescribed metoprolol? 1. hirsutism 2. bradycardia 3. restlessness 4. angina

2

which client between the ages of 25 and 55 years would the nurse assess first? 1. male client with a hemoglobin of 15.9 2. female client on warfarin with an international normalized ratio (INR) pf 7.5 3. female client taking daily calcium supplements with a serum calcium level of 9.4 4. male client with a blood urea nitrogen (BUN) of 20 and a creatinine of 1

2

which clinical finding would the nurse expect for a client with hypertensive emergency? 1. increased urine output 2. severe pounding headache 3. heart rate 110 beats/minute 4. weak and thready radial pulses

2

which assessment finding indicates a need for the nurse to consult with the health care provider before administering the prescribed metoprolol to a client with stable angina? 1. blood pressure 142/90 mm Hg 2. report of chest pain when walking 3. sinus bradycardia, rate 54 on monitor 4. large Q waves on the electrocardiogram

3

which diagnostic study is used to detect deep vein thrombosis in the client's lower extremities? 1. thermography 2. plethysmography 3. duplex venous doppler 4. somatosensory evoked potential

3