MS Quiz 15 Review | Vascular Disorders and Hypertension

35. A nurse is caring for a client who is receiving IV dextrose 5% in 0.0% sodium chloride at 75 mL/hr. When the nurse checks the client's IV bag at 0700, 300 mL remains in the bag. At what time should the nurse hang a new bag of IV fluid?

1100

11. A nurse is preparing to administer 400 mL of 0.9% sodium chloride IV over 8 hr. The drop factor of the manual IV tubing is 60 gtt/ mL. The nurse should set the manual IV infusion to deliver how many gtt/ min?

50 gtt/min

23. A nurse is reinforcing teaching about a heart healthy diet with a group of clients who have hypertension. Which of the following statements by the client indicates a need for further teaching? a. "I can have a cola drink twice a day." b. "Fresh fruits are good to include with meals." c. "I will replace table salt with dried herbs." d. "I can eat frozen juice bars for a snack."

a. "I can have a cola drink twice a day."

2. The nurse provides education to a patient about the Dietary Approaches to Stop Hypertension (DASH) diet. Which statement made by the patient indicates understanding of the teaching? a. "I should include four to five servings of fruits and vegetables daily." b. "I should include lean red meat." c. "I should include whole grains." d. "I should include sugar."

a. "I should include four to five servings of fruits and vegetables daily."

25. A nurse is reinforcing teaching with a client about how to prevent the onset of manifestations of Raynaud's phenomenon. Which of the following statements should the nurse identify as an indication that the client needs further teaching? a. "I will keep my house at a cool temperature." b. "I will try to anticipate and avoid stressful situations." c. "I will complete the smoking cessation program I started." d. "I will wear gloves when removing food from the freezer."

a. "I will keep my house at a cool temperature."

1. What is a characteristic of a venous stasis ulcer? a. Painlessness b. Poikilothermy c. Pale color d. Location near the groin

a. Painlessness

7. What patient teaching should be included for a patient with varicose veins? a. Weight reduction b. Decreasing exercise c. Wearing a panty girdle d. Standing rather than sitting

a. Weight reduction

20. A nurse is reinforcing teaching with a client who has peripheral vascular disease. Which of the following instructions should the nurse include in the teaching? a. "Elevate your legs while in bed." b. "Incorporate walking into your daily routine." c. "Wear knee length stockings." d. "Shop for new shoes during the morning hours."

b. "Incorporate walking into your daily routine."

29. A nurse is providing discharge teaching to a client who has peripheral arterial disease (PAD). Which of the following instructions should the nurse include in the teaching? a. Apply a heating pad on a low setting to help relieve leg pain b. Adjust the thermostat so that the environment is warm c. Wear anti-embolic stockings during the day d. Rest with the legs above heart level

b. Adjust the thermostat so that the environment is warm

16. An obese postsurgical patient complains of sudden discomfort in her leg. The nurse assesses the leg and finds it cold and pale with no pedal or popliteal pulse. What should the nurse suspect? a. Venous thrombosis b. Arterial occlusion c. Vascular spasm d. Paresthesia

b. Arterial occlusion

30. A 69-year-old patient reports a burning, aching pain in the legs when walking to the mailbox. These symptoms are relieved with rest. What should the nurse suspect? a. Venous insufficiency b. Claudication c. Phlebitis d. Rest pain

b. Claudication

24. A nurse is giving a presentation to a community group about preventing atherosclerosis. Which of the following should the nurse include as a modifiable risk factor for this disorder? (Select all that apply.) a. Genetic predisposition b. Hypercholesterolemia c. Hypertension d. Obesity e. Smoking

b. Hypercholesterolemia c. Hypertension d. Obesity e. Smoking

19. Following admission, a client with a vascular occlusion of the RLE calls the nurse and reports difficulty sleeping because of cold feet. Which of the following nursing actions should the nurse take to promote the client's comfort? a. Rub the client's feet briskly for several minutes. b. Obtain a pair of slipper socks for the client. c. Increase the client's oral fluid intake. d. Place a moist heating pad under the client's feet.

b. Obtain a pair of slipper socks for the client.

28. A nurse is caring for a patient who has had an angiogram. What should the nurse make a point of care to assess and document on this patient? a. Fluid intake b. Peripheral pulses in the affected leg c. Inquiring about an allergy to iodine d. Decreased blood pressure

b. Peripheral pulses in the affected leg

10. A nurse is reinforcing teaching with a client who has a family history of hypertension. The nurse should inform the client that his blood pressure reading of 124/ 84 mmHg places him in which of the following categories? a. Normal b. Prehypertension c. Stage 1 d. Stage 2

b. Prehypertension

26. A patient with Raynaud disease has a nursing diagnosis of Ineffective tissue perfusion, related to vasoconstriction and is being given discharge instructions. What should the nurse include when providing this information? a. Avoid sun exposure. b. Wear gloves and warm socks when outdoors. c. Chafe hands frequently to warm them. d. Wash dishes in warm water.

b. Wear gloves and warm socks when outdoors.

9. A nurse is performing an intake examination on a patient with peripheral vascular disease (PVD). Which lifestyle information identified by the patient aggravates vascular disease? a. Riding a bicycle to work b. Drinking red wine every day c. Being employed as an air traffic controller d. Eating chocolate candy every day

c. Being employed as an air traffic controller

33. A nurse is assisting with the plan of care for a client who has a new DVT in his leg. Which of the following interventions should the nurse include in the plan? a. Apply cool compresses to the client's affected leg. b. Rub the client's affected leg every 4 hr. c. Keep the client's affected leg elevated. d. Ambulate the client every shift.

c. Keep the client's affected leg elevated.

6. A nurse is collecting data from a child who has sickle disease and is experiencing a vaso-occlusive crisis. Which of the following findings should the nurse expect? a. Vomiting b. Bradycardia c. Pain d. Constipation

c. Pain

32. What does treatment for essential hypertension focus on? a. Daily medication with mild diuretics b. Low-dose vasodilators c. Reduction of modifiable risks d. Combination of vasodilators and diuretics

c. Reduction of modifiable risks

4. What is a normal age-related change in older adults that makes them susceptible to cardiovascular disease? a. Increase in cardiac output b. Increase in stroke volume c. Stiff peripheral vessels d. Oxygen capacity improvement

c. Stiff peripheral vessels

13. A patient has returned from a vein ligation and stripping. What are the appropriate instructions for a nurse to provide? a. Dangle the legs to prevent edema. b. Cross the legs to apply pressure. c. Wear compression stockings to promote circulation. d. Remove the drain after 24 hours.

c. Wear compression stockings to promote circulation.

15. A nurse is reinforcing teaching with a client who has peripheral vascular disease (PVD). the nurse should recognize that which of the following statements by the client indicates a need for further teaching? a. "I will avoid crossing my legs at the knees." b. "I will use a thermometer to check the temperature of my bath water." c. "I will not go barefoot." d. "I will wear stockings with elastic tops."

d. "I will wear stockings with elastic tops."

12. What should a nurse include when developing a teaching plan for a patient with hypertension? a. Stop medications if side effects occur. b. Maintain a diet high in unsaturated fat. c. Advise no further visits if no other symptoms occur. d. Encourage relaxation techniques.

d. Encourage relaxation techniques.

17. A patient inquires if his blood pressure is normal. What is the nurses most accurate response regarding the definition of normal blood pressure? a. Less than 144/90 mmHg b. Less than 138/86 mmHg c. Less than 126/82 mmHg d. Less than 120/80 mmHg

d. Less than 120/80 mmHg

34. A nurse is collecting data from a client who has venous insufficiency. Which of the following findings should the nurse expect? a. Dusky, red color of the feet when dangling b. Shiny, thin skin on the lower extremities c. Thickened toenails d. Pitting edema

d. Pitting edema

21. What is the focus of treatment for secondary hypertension? a. Smoking cessation program b. Strenuous exercise program c. Weight-loss program designed to reduce weight rapidly d. Specific etiologic disease

d. Specific etiologic disease

14. Which lifestyle change has the greatest effect on reducing hypertension? a. Sodium restriction b. Reduction in alcohol consumption c. Daily aerobic exercise d. Weight reduction

d. Weight reduction

3. A nurse is caring for a patient who has deep vein thrombosis who received IV heparin for the past 5 days and now has a new prescription for oral warfarin in addition to the heparin. The client asked the nurse if both medications are necessary. Which of the following is an appropriate response by the nurse? a. "The Coumadin (warfarin) takes several days to work, so the IV heparin will be used until the Coumadin (warfarin) reaches a therapeutic level." b. "I will call the provider to get a prescription for discontinuing the IV heparin today." c. "Both heparin and Coumadin (warfarin) work together to dissolve the clots." d. "IV heparin increases the effects of Coumadin (warfarin) and decreases the length of your hospital stay."

a. "The Coumadin (warfarin) takes several days to work, so the IV heparin will be used until the Coumadin (warfarin) reaches a therapeutic level."

18. A nurse records the assessment of stasis dermatitis on an intake assessment for a patient with peripheral vascular disease (PVD). What is the best way to describe this finding? a. Brownish skin discoloration on the lower legs b. Ulceration on medial surface of the lower legs c. Edema in the lower legs d. Purple rash on medial surface of the lower legs

a. Brownish skin discoloration on the lower legs

27. A nurse is caring for a client immediately following a cardiac catheterization with a femoral artery approach. Which of the following actions should the nurse take? a. Check pedal pulses every 15 min b. Perform passive ROM for the affected extremity c. Remind the client not to turn from side to side d. Keep the client in High-Fowler's position for 6 hours

a. Check pedal pulses every 15 min

31. A nurse suspects a circulatory disorder in one leg. Which assessments should the nurse include when comparing both legs? (Select all that apply.) a. Color b. Warmth c. Muscle strength d. Pulse quality e. Hair loss on extremity

a. Color b. Warmth d. Pulse quality e. Hair loss on extremity

5. A nurse is caring for a client who has unilateral edema with associated pain and low-grade temperature. Which of the following should the nurse take? a. Elevate the affected leg b. Raising legs for 2 minutes until they blanch c. Lowering the legs until the color returns d. Keeping legs flat for 5 minutes and then repeat the exercise

a. Elevate the affected leg

8. Which instruction is most appropriate for a patient with arterial insufficiency? a. Frequently allow the legs to dangle dependently. b. Rub the legs vigorously. c. Stand often to keep blood flow in the legs. d. Walk barefoot.

a. Frequently allow the legs to dangle dependently.

22. A patient with hypertension comes to the emergency department and is experiencing nausea and vomiting and is restless and confused. Vital signs are assessed at blood pressure, 220/130 mm Hg; pulse, 120 beats/min; and respirations, 32 breaths/min. What should the nurse conclude the patient is experiencing based on these assessments? a. Hypertension crisis from the cessation of a drug b. Stroke from increased blood pressure c. Adverse drug reaction d. Onset of diabetes

a. Hypertension crisis from the cessation of a drug