Chapter 33 Exam 2

During which timeframe is it most important for the nurse to monitor a client for graft occlusion after receiving revascularization with graft placement? A. First 2 hours B. First 24 hours C. Days 1 and 2 postoperative D. During the first week

B

For which client would the nurse question the prescription of hydrochlorothiazide? A. Client with asthma B. Client with hypokalemia C. Client with hyperkalemia D. Client with chronic airway limitation

B

Which relatively newtherapy would be tried for clients with familial hypercholesterolemia or for those who are unable to reduce LDLs with existing therapies? A. PCSK9 inhibitors B. Nicotinic acid C. Lovaza (omega-3 ethyl esters) D. Combination drugs (e.g., Caduet)

D

Which symptom causes most clients to seek medical attention for peripheral arterial disease (PAD)? A. Pain at rest B. Rubor in the extremity C. Muscle atrophy D. Intermittent claudication

D

Which nonsurgical management techniques would the nurse expect when caring for a client with DVT? Select all that apply. A. Gradual increase in ambulation as tolerated by the client B. Elevation of legs when in bed or sitting in a chair C. Knee- or thigh-high compression stockings D. Massage to ease the client's calf pain E. Anticoagulant drugs as prescribed F. Complete bedrest for up to 4 weeks

A,B,C,E

Which are complications that the nurse would monitor for after a client receives an endovascular stent graft for emergent repair of an abdominal aortic aneurysm? Select all that apply. A. Bleeding B. Misplacement of stent graft C. Dissecting aneurysm D. Peripheral embolization E. Endoleak F. Aneurysm rupture

A,B,D,E,F

What drug would the nurse expect to be prescribed for a client with hypertension and for whom lifestyle modifications have failed to control blood pressure? A. Thiazide diuretic B. Calcium channel blocker C. Angiotensin-converting enzyme inhibitor D. Beta blocker

A

What is the nurse's priority action when a client with AAA suddenly exhibits decreased level of consciousness, blood pressure 82/48 mm Hg, irregular apical pulse, and perfuse diaphoresis? A. Alert the Rapid Response Team. B. Establish IV access. C. Place the client on a cardiac monitor. D. Auscultate for bruit and palpate for a mass.

A

What is the priority action for the nurse when a client is to have unfractionated heparin (UFH) discontinued and to start receiving subcutaneous low-molecular-weight heparin (LMWH)? A. Discontinue the UFH at least 30 minutes before giving the first LMWH injection. B. Check the aPTT and INR laboratory results before giving the first LMWH injection. C. Assess the client's IV site and convert it to a saline lock before starting LMWH. D. Instruct the client about the need for frequent laboratory test to ensure the LMWH is working.

A

Which action increases the effectiveness of angiotensin II receptor blockers (ARBs) and angiotensin-converting enzyme inhibitors (ACEIs) in controlling hypertension for African-American clients?A. The ARB or ACEI is given with a diuretic, beta blocker, or a calcium channel blocker. B. A much higher dose of ARB or ACEI is prescribed for an African-American client. C. The ARB or ACEI is combined with rigorous lifestyle modifications. D. Clients take the ARB or ACEI around the clock on an individualized schedule.

A

Which drug would the nurse expect to administer to a client with Raynaud's or Buerger's disease? A. Captopril B. Nifedipine C. Warfarin D. Atorvastatin

A

Which piece of equipment would the nurse recommend for a client to manage hypertension at home? A. Blood pressure monitoring device B. Stationary exercise bicycle C. Blood glucose monitoring device D. Kitchen food scale

A

Which lifestyle changes would the nurse teach a client to help control hypertension? Select all that apply. A.Weight reduction if overweight or obese B. Implement a healthy diet such as the DASH diet C. Decrease smoking and nicotine use D. Use relaxation techniques to decrease stress E. Restrict sodium by not adding salt at the tables F. Increase activity by use of a structured exercise program

A, D, E, F

Which features would the nurse recognize as indicated that a client had a venous ulcer? Select all that apply A. No claudication or rest pain B. Ulcer located in the ankle area C. Brown pigmentation D. Very little granulation tissue present E. Ulcer bed is pink F. Pulses are present

A, B, C, E, F

Which information would the nurse be sure to include when teaching a client with peripheral arterial disease about methods to promote vasodilation? Select all that apply. A. Maintain a warm environment at home B. Wear socks or insulated shoes at all times C. Prevent cold exposure to the affected limb D. Apple direct heat to the involved limb with a heating pad E. Completely abstain from smoking or chewing tobacco F. Avoid emotional stress and excessive caffeine

A, B, C, E, F

Which statement about percutaneous vascular interventions are accurate? Select all that apply? A. One or more arteries are dilated with a balloon catheter to open the vessel(s) B. Stents are often placed to ensure adequate blood flow C. Placement of stents results in longer hospitalization D. Some clients are occlusion free for 3-5 years E. Clients who are candidates must have occlusion or stenoses that accessible to the catheter F. A percutaneous vascular intervention is considered to be a minor surgical procedure

A, B, D, E

What nursing actions are included in the routine post-op care for a client after percutaneous vascular intervention? Select all that apply A. Observe for bleeding at the puncture site B. Perform frequent distal pulse checks on both limbs C. Provide supplemental oxygen at 5L per nasal cannula D. Administer antiplatelet therapy as prescribed E. Monitory for signs of shock F. Check vital signs frequently as ordered

A, B, D, E, F

Which drugs are useful in promoting circulation for clients with chronic peripheral arterial disease? Select all that apply. A. Aspirin B. Ezetimibe C. Pentoxifylline D. Clopidogrel E. Cilostazol F. Propranolol

A, C, D, E

Which nursing interventions promote a client's compliance with antihypertensive therapy? Select all that apply. A. Provide oral and written instructions related to all prescribed medications B. Give the client a list of resources for finding additional information on prescribed medications C. Stress that suddenly stopping beta blockers can cause angina or heart attack D. Suggest that the client have a home scale for weight monitoring E. Advocate for medications that are taken three times a day for better BP control F. Teach clients to report unpleasant side effects to the primary health care provider

A, C, D, F

Which assessment findings indicate to the nurse that a client has stage III peripheral arterial disease? Select all that apply. A. Pain is described as numbness, burning, toothache-type pain B. Muscle pain, cramping, or burning occurs with exercise and is relieved with rest C. Pain is relieved by placing the extremity in a dependent position D. Ulcers and blackened tissue occur on the toes, forefoot, and heel E. Pain usually occurs in the distal part of the extremity F. Pain while resting comfortably awakens the client at night

A, C, E, F

Which control systems play an important role in maintaining a clients blood pressure? Select all that apply. A. The arterial baroreceptor system B. Elevated lipid levels C. Regulation of body fluid volume D. Dietary saturated fats and sodium E. Vascular auto regulation F. The renin-angiotensin-aldosterone system

A, C, E, F

Which symptoms would indicate to the nurse that a client's aneurysm had ruptured? Select all that apply. A. Hypotension B. Diaphoresis C. Decreased level of consciousness D. Loss of pulses distal to rupture E. Bradypnea F. Scant urine output

A,B,C,D,F

Which essential teaching would the nurse provide for a client being discharged with chronic venous insufficiency? Select all that apply. A. Elevate your legs at least 20 minutes four to five times a day. B. Avoid crossing legs at all times. C. Wear compression stocking at night during sleep. D. Avoid standing still for any length of time. E. Keep legs and feet positioned below the heart for better perfusion. F. Avoid tight restrictive pants, girdles, or garters.

A,B,D,F

Which factors would the nurse notes as an increasing risk for arthrerosclerosis with an older African American client? Select all that apply. A. 20yr history of type 2 diabetes B. Nutrition includes three-four diet sodas per day C. Sedentary lifestyle D. 25 lbs overweight E. Father with history of colon cancer F. Grandmother died after heart attack

A,C,D,F

Which are characteristics a nurse would expect in clients with Raynaud's disease? Select all that apply. A. Occurs more often in young women B. Claudication in feet and lower extremities is present C. Clients experience cold intolerance D. Occurs only in upper extremities E. Causes red-white-blue skin color changes on exposure to cold or stress F. Occurs often in smokers especially young men

A,C,E

Which are conservative management measures for a client's varicose veins? Select all that apply. A. Graduated compression stockings (GCSs) B. Surgical ligation and removal of veins C. Exercise to increase venous return D. Sclerotherapy E. Elevating the extremities F. Endovenous ablation

A,C,E

The nurse is evaluating a 3-day diet history with a client who has an elevated lipid panel. What mealselection indicates the client is managing this condition well with diet? a. A 4-ounce steak, French fries, iceberg lettuce b. Baked chicken breast, broccoli, tomatoes c. Fried catfish, cornbread, peas d. Spaghetti with meat sauce, garlic bread

ANS: B The diet recommended for this client would be low in saturated fats and red meat, high in vegetables andwhole grains (fiber), low in salt, and low in trans fat. The best choice is the chicken with broccoli andtomatoes. The French fries have too much fat and the iceberg lettuce has little fiber. The catfish is fried. Thespaghetti dinner has too much red meat and no vegetables.

1. A student nurse is assessing the peripheral vascular system of an older adult. What action by the studentwould cause the faculty member to intervene? a. Assessing blood pressure in both upper extremities b. Auscultating the carotid arteries for any bruits c. Classifying capillary refill of 4 seconds as normal d. Palpating both carotid arteries at the same time

ANS: D The student should not compress both carotid arteries at the same time to avoid brain ischemia. Blood pressureshould be taken and compared in both arms. Prolonged capillary refill is considered to be greater than 5seconds in an older adult, so classifying refill of 4 seconds as normal would not require intervention. Bruitsshould be auscultated.

2. The nurse is reviewing the lipid panel of a male client who has atherosclerosis. Which finding is mostconcerning? a. Cholesterol: 126 mg/dL b. High-density lipoprotein cholesterol (HDL-C): 48 mg/dL c. Low-density lipoprotein cholesterol (LDL-C): 122 mg/dL d. Triglycerides: 198 mg/dL

ANS: D Triglycerides in men should be below 160 mg/dL. The other values are appropriate for adult males.

What is the bestnonsurgical intervention for a client with a 3-cm abdominal aortic aneurysm to decrease the risk of rupture? A. Bedrest with bathroom privileges until the aneurysm shrinks B. Maintenance of normal blood pressure and avoidance of hypertension C. Heparin followed by warfarin therapy to prevent clotting D. Intraarterial thrombolytic therapy to dissolve any existing clots

B

What is the nurse's bestinterpretation when reviewing a client's abdominal CT scan and noting that there is an outpouched segment coming off the abdominal aorta? A. Dissecting aneurysm B. Saccular aneurysm C. Fusiform aneurysm D. False aneurysm

B

What is the nurse's bestresponse when a client asks about the difference between arteriosclerosis and atherosclerosis? A. Arteriosclerosis is the sudden blockage of an artery while atherosclerosis is formation of plaque in arteries. B. Atherosclerosis is forming plaques in arteries but arteriosclerosis is thickening of arterial walls associated with aging. C. Arteriosclerosis is hardening of arterial walls while atherosclerosis involves permanent localized dilation of arteries

B

What is the recommended therapeutic range for the international normalized ratio (INR) for a client receiving warfarin sodium to prevent DVT and decrease the risk for stroke? A. 2.0-2.5 B. 1.5-2.0 C. 1.0-1.5 D. 0.5-1.0

B

What would the nurse expect to find in the history of a client admitted with acute arterial occlusion? A. History of chronic venous stasis disease treated with debridement B. Acute myocardial infarction or atrial fibrillation within the previous weeks C. Episode of blunt trauma that occurred several months ago D. Family history of coronary artery disease

B

Which drug would the nurse expect the primary health care provider to prescribe for a client to decrease blood pressure, decrease triglycerides, increase high-density lipoprotein cholesterol (HDL-C), and lower low-density lipoprotein cholesterol (LDL-C)? A. Advicor B. Caduet C. Vytorin D. Ezetimibe

B

Which clients are at increased risk for peripheral arterial disease? Select all that apply A. Client with anemia B. Client with hypertension C. Client with diabetes mellitus D. Client who smokes cigarettes E. Client who is African American F. Client who is extremely thin

B, C, D, E

Which techniques would the nurse use when performing an initial cardiovascular assessment on a middle aged client? Select all that apply. A. Check BP on the dominant side B. Palpate all of the major pulse sites C. Auscultate bruits in the radial and brachial arteries D. Palpate and compare temp differences in the lower extremities E. Check the client for orthostatic hypotension F. Perform bilateral but separate palpations on the carotid arteries

B, C, D, E, F,

Which instruction would the nurse give a client for following dietary recommendations of the American College of Cardiology and the American Heart Association? Select all that apply A. Consume a dietary pattern that emphasizes intake of lean protein B. Consume low-fat dairy products, poultry and fish C. Lower sodium intake to no more than 2,400 mg/day D. Engage in aerobic physical activity 6-7 times a week E. Limit intake of sweets and red meats F. Eat legumes, tropical vegetable oils (Canola oil) and nuts

B, C, E, F

What would the nurse assess for when a client is suspected of having an abdominal aortic aneurysm? Select all that apply. A. Chest pain and shortness of breath B. Abdominal, flank, or back pain C. Gnawing pain unaffected by movement D. Pulsation in the upper abdomen E. Auscultation of a bruit in the upper abdomen F. Palpation of a mass in the upper abdomen

B,C,D,E

Which statements pertaining to the use of an Unna boot for a client are accurate? Select all that apply. A. It is used to heal peripheral arterial ulcers. B. It is constructed from gauze and zinc oxide. C. It promotes venous return and prevents stasis. D. It is changed by the health care provider every 3 to 4 days. E. It forms a sterile environment for the ulcer. F. The client is instructed to report any increase in pain.

B,C,E

When the nurse performs blood pressure screenings, which client would be referred for further evaluation? select all that apply. A. Diabetic client in BP 118/77 B. Client with heart disease and blood pressure 248/90 C. Renal failure client with blood pressure of 180/90 D. Client with no known health problems and blood pressure of 106/70 E. Client with muscle cramping taking a statin drug with BP 124/82 F. COPD client with BP 158/88

B,C,E,F

Which findings would the nurse expect to assess when a client presents with a thoracic aortic aneurysm? Select all that apply. A. Tachycardia B. Hoarseness C. Shortness of breath D. Paralytic ileus E. Difficulty swallowing F. Visible mass above the suprasternal notch

B,C,E,F

What are the purposes for a client with a venous stasis ulcer to be prescribed the topical drug Accuzyme? Select all that apply. A. Improve circulation B. Promote healing C. Eliminate infection D. Chemically debride the ulcer E. Eliminate necrotic tissue F. Prevent stasis

B,D,E

Which diagnostic tests would the health care provider prescribe to confirm a diagnosis of abdominal aortic aneurysm (AAA) suspected in a client? Select all that apply. A. Chest x-ray B. Ultrasound C. Electrocardiogram D. Magnetic resonance imaging E. Computed tomography scan F. Cardiac catheterization

B,E

How does the nurse bestinterpret a client's low-density lipoprotein cholesterol (LDL-C) value which is greater than 190 mg/dL and does not respond to dietary intervention? A. The client should have total cholesterol and LDL-C testing repeated during the next routine examination. B. The client should be instructed to exercise 6 to 7 days per week to help bring the LDL-C level over time. C. The client should be evaluated for secondary causes of hyperlipidemia and treated with statin therapy because of the high LDL-C level. D. The client should be followed every 6 months routinely to check lipid profiles and detect trends in the values.

C

What is the mostimportant teaching point for the nurse to emphasize with a client who has Buerger's disease? A. Decrease intake of fats and reduce cholesterol to reverse the disease process. B. Limit exposure to extreme warm temperatures because of vasodilation. C. Cease cigarette smoking and all exposure to tobacco to arrest the disease process. D. Perform exercises of fingers and toes at least twice a day to slow the disease process.

C

What is the nurse's bestexplanation to a client for use of low-dose niacin to decrease LDL-C and very-low-density lipoprotein (VLDL) cholesterol levels? A. It will prevent muscle myopathies. B. It works well to prevent elevated blood pressure. C. It helps reduce side effects of flushing and feeling too warm. D. It will help prevent the undesirable side effect of hypokalemia.

C

What is the nurse's bestresponse when a client with peripheral arterial disease asks why he or she should exercise when walking causes pain? A. "This type of therapy is free and you can do it by yourself to improve the muscle tone in your legs." B. "The cramping will eventually stop if you continue the exercise routine. When you have too much pain, just rest a little while." C. "Exercise can improve blood flow to your legs because small blood vessels will compensate for the blood vessels that are blocked off." D. "Exercise is a nonsurgical, noninvasive technique used to increase arterial blood flow to your affected leg."

C

What would be the nurse's best action when a client reports dizziness when changing position from sitting tostanding and a sudden dry cough after starting a prescription of captopril? A. Instruct the client to change positions slowly and take an over-the-counter cough syrup. B. Tell the client to take the drug at bedtime and use over-the-counter throat lozenges. C. Notify the primary health care provider immediately about these side effects. D. Teach the client to increase fluid intake to at least 3 L/day.

C

What would the nurse teach a client with peripheral arterial disease about positioning and position changes? A. Change positions slowly when getting out of bed. B. Sleep with legs elevated above the heart if legs are swollen. C. Avoid crossing legs at all times. D. Sit upright in a chair if legs are not swollen.

C

Which drug would the nurse prepare to administer when a client enters the emergency department with chest pain described as a "tearing" sensation, diaphoresis, blood pressure of 200/130 mm Hg, weak pulses, and a sense of apprehension? A. Oral beta blocker such as atenolol B. Calcium channel blocker such as amlodipine C. IV beta blocker such as esmolol D. Antianginal drug such as nitroglycerin

C

1. What are the prioritynursing care concepts for clients with vascular problems? A. Perfusion and fluid balance B. Clotting and immunity C. Inflammation and perfusion D. Perfusion and clotting

D

For prevention of DVT, which drug would the nurse expect the health care provider to prescribe? A. Thrombolytic therapy B. IV unfractionated heparin C. Novel oral anticoagulants (NOACs) D. Subcutaneous low-molecular-weight heparin (LMWH)

D

What does the nurse suspect when assessing a client on bedrest and finding that he or she has a left calf that is swollen, warm to touch, reddened, and moderately painful? A. Raynaud's syndrome B. Cellulitis C. Arterial occlusion D. Deep vein thrombosis

D

What frequency of drug dosage therapy would the nurse advocate for an older client with hypertension who lives alone and is able to manage his or her self-care? A. Four times a day B. Three times a day C. Twice a day D. Once a day

D

What is the nurse's bestadvice for a client, who is an avid golfer, but has been recently diagnosed with thoracic outlet syndrome? A. Check your blood pressure in both arms daily. B. Rest whenever shortness of breath occurs. C. Avoid walking for long distances. D. Don't elevate your arms above your head.

D

What priority teaching would the nurse provide for a client who will be discharged with a prescription for atorvastatin? A. "Take over-the-counter ranitidine when you experience nausea or vomiting." B. "Go to the emergency department if you experience a nagging, nonproductive cough." C. "You can use acetaminophen if the drug causes mild to moderate headaches." D. "Immediately report any muscle cramping to your primary health care provider."

D

What symptom would the nurse expect on assessment of a client with inflow peripheral arterial disease? A. Frequent episodes of rest pain B. Burning or cramping in the calves, ankles, feet, or toes after walking C. Waking often at night for pain relieved by hanging feet off the bed D. Discomfort in the lower back, buttocks, or thighs after walking

D

What would the nurse suspect when assessing a client's lower extremities and finding decreased pedal pulses, skin that is cool to touch, loss of hair, and thickened toenails? A. Peripheral venous disease B. Raynaud's syndrome C. Deep vein thrombosis D. Peripheral

D

Which activity would the nurse advise during the recovery period for a client returning home after AAA repair? A. Climbing a flight of stairs B. Driving a car C. Playing golf D. Gradually increased walking

D

Which condition would the nurse suspect when a client has these findings (BP 200/130 mm Hg; sudden headache, blurred vision, and dyspnea)? A. Sustained hypertension B. Primary hypertension C. Secondary hypertension D. Malignant hypertension

D

Which location would the nurse expect to be the most common for a client to form an aneurysm? A. Femoral artery B. Radial artery C. Thoracic aorta D. Abdominal aorta

D

Which method would the postanesthesia care unit (PACU) nurse use to assess the patency of the graft after a client's arterial revascularization with graft placement? A. Gently palpate the site every 15 minutes for the first hour and assess for warmth, redness, and swelling. B. Ask the client if there is any pain or loss of sensation anywhere in the extremity. C. Check the dorsalis pedis and post tibial pulses for the first hour, then every 2 hours. D. Check the affected extremity, comparing it to the unaffected, for changes in color, temperature, and pulse intensity every 15 minutes for the first hour, then hourly.

D

The nurse is assessing a client on admission to the hospital. The client's leg appears as shown below: What action by the nurse is best? a. Assess the client's ankle-brachial index. b. Elevate the client's leg above the heart. c. Obtain an ice pack to provide comfort. d. Prepare to teach about heparin sodium

a. Assess the client's ankle-brachial index.

A client with a history of heart failure and hypertension is in the clinic for a follow-up visit. The client is on lisinopril and warfarin. The client reports new-onset cough. What action by the nurse is most appropriate? a. Assess the client's lung sounds and oxygenation. b. Instruct the client on another antihypertensive. c. Obtain a set of vital signs and document them. d. Remind the client that cough is a side effect of lisinopril.

a. Assess the client's lung sounds and oxygenation.

A nurse is assessing a client with peripheral artery disease (PAD). The client states that walking five blocks is possible without pain. What question asked next by the nurse will give the best information? a. "Could you walk further than that a few months ago?" b. "Do you walk mostly uphill, downhill, or on flat surfaces?" c. "Have you ever considered swimming instead of walking?" d. "How much pain medication do you take each day?"

a. "Could you walk further than that a few months ago?"

A client has peripheral arterial disease (PAD). What statement by the client indicates misunderstanding about self-management activities? a. "I can use a heating pad on my legs if it's set on low." b. "I should not cross my legs when sitting or lying down." c. "I will go out and buy some warm, heavy socks to wear." d. "It's going to be really hard but I will stop smoking."

a. "I can use a heating pad on my legs if it's set on low."

A client is taking warfarin and asks the nurse if taking St. John's wort is acceptable. What response by the nurse is best? a. "No, it may interfere with the warfarin." b. "There isn't any information about that." c. "Why would you want to take that?" d. "Yes, it is a good supplement for you."

a. "No, it may interfere with the warfarin.

A nurse is teaching a female client about alcohol intake and how it affects hypertension. The client asks if drinking two beers a night is an acceptable intake. What answer by the nurse is best? a. "No, women should only have one beer a day as a general rule." b. "No, you should not drink any alcohol with hypertension." c. "Yes, since you are larger, you can have more alcohol." d. "Yes, two beers per day is an acceptable amount of alcohol."

a. "No, women should only have one beer a day as a general rule."

A nurse is interested in providing community education and screening on hypertension. In order to reach a priority population, to what target audience would the nurse provide this service? a. African-American churches b. Asian-American groceries c. High school sports camps d. Women's health clinics

a. African-American churches

A client has been bedridden for several days after major abdominal surgery. What action does the nurse delegate to the assistive personnel (AP) for deep vein thrombosis (DVT) prevention? (Select all that apply.) a. Apply compression stockings. b. Assist with ambulation. c. Encourage coughing and deep breathing. d. Offer fluids frequently. e. Teach leg exercises.

a. Apply compression stockings. b. Assist with ambulation. d. Offer fluids frequently.

A client had a femoral-popliteal bypass graft with a synthetic graft. What action by the nurse is most important to prevent wound infection? a. Appropriate hand hygiene before giving care b. Assessing the client's temperature every 4 hours c. Clean technique when changing dressings d. Monitoring the client's daily white blood cell count

a. Appropriate hand hygiene before giving care

A nurse is working with a client who takes clopidogrel. The client's recent laboratory results include a blood urea nitrogen (BUN) of 33 mg/dL and creatinine of 2.8 mg/dL. What action by the nurse is best? a. Ask if the client eats grapefruit. b. Assess the client for dehydration. c. Facilitate admission to the hospital. d. Obtain a random urinalysis.

a. Ask if the client eats grapefruit.

nurse is caring for a client with a nonhealing arterial ulcer. The primary health care provider has informed the client about possibly needing to amputate the client's leg. The client is crying and upset. What actions by the nurse are best? (Select all that apply.) a. Ask the client to describe his or her current emotions. b. Assess the client for support systems and family. c. Offer to stay with the client if he or she desires. d. Relate how smoking contributed to this situation. e. Tell the client that many people have amputations. f. Arrange for an amputee to come visit the client.

a. Ask the client to describe his or her current emotions. b. Assess the client for support systems and family. c. Offer to stay with the client if he or she desires.

A nurse is caring for a client on IV infusion of heparin. What actions does this nurse include in the client's plan of care? (Select all that apply.) a. Assess the client for bleeding. b. Monitor the daily activated partial thromboplastin time (aPTT) results. c. Stop the IV for aPTT above baseline. d. Use an IV pump for the infusion. e. Weigh the client daily on the same scale.

a. Assess the client for bleeding. b. Monitor the daily activated partial thromboplastin time (aPTT) results. d. Use an IV pump for the infusion.

A client has been diagnosed with a deep vein thrombosis and is to be discharged on warfarin. The client is adamant about refusing the drug because "it's dangerous." What action by the nurse is best? a. Assess the reason behind the client's fear. b. Remind the client about laboratory monitoring. c. Tell the client that drugs are safer today than before. d. Warn the client about consequences of noncompliance

a. Assess the reason behind the client's fear.

The nurse working in the emergency department knows that which factors are commonly related to aneurysm formation? (Select all that apply.) a. Atherosclerosis b. Down syndrome c. Frequent heartburn d. History of hypertension e. History of smoking f. Hyperlipidemia

a. Atherosclerosis d. History of hypertension e. History of smoking f. Hyperlipidemia

A client had a percutaneous angioplasty for renovascular hypertension 3 months ago. What assessment finding by the nurse indicates that an important outcome for this client has been met? a. Client is able to decrease blood pressure medications. b. Insertion site has healed without redness or tenderness. c. Most recent lab data show BUN: 19 mg/dL and creatinine 1.1 mg/dL. d. Verbalizes understanding of postprocedure lifestyle changes.

a. Client is able to decrease blood pressure medications.

A nurse is caring for a client with a nonhealing arterial lower leg ulcer. What action by the nurse is best? a. Consult with the wound care nurse. b. Give pain medication prior to dressing changes. c. Maintain sterile technique for dressing changes. d. Prepare the client for eventual amputation.

a. Consult with the wound care nurse.

A client is being discharged on warfarin therapy. What discharge instruction is the nurse required to provide? (Select all that apply.) a. Dietary restrictions b. Driving restrictions c. Follow-up laboratory monitoring d. Possible drug-drug interactions e. Reason to take medication f. Wearing a Medic Alert bracelet

a. Dietary restrictions c. Follow-up laboratory monitoring d. Possible drug-drug interactions e. Reason to take medication

The nurse is reviewing risk factors in a client who has atherosclerosis. Which findings are most concerning? (Select all that apply.) a. Elevated low-density lipoprotein (LDL-C) b. Decreased levels of high-density lipoprotein cholesterol (HDL-C) c. Asian ethnicity d. History of smoking e. Blood pressure: 142/92 mm Hg on one occasion

a. Elevated low-density lipoprotein (LDL-C) b. Decreased levels of high-density lipoprotein cholesterol (HDL-C)d. History of smoking

The nurse is caring for four hypertensive clients. Which drug-laboratory value combination would the nurse report immediately to the health care provider? a. Furosemide/potassium: 2.1 mEq/L b. Hydrochlorothiazide/potassium: 4.2 mEq/L c. Spironolactone/potassium: 5.1 mEq/L d. Torsemide/sodium: 142 mEq/L

a. Furosemide/potassium: 2.1 mEq/L

A client is 4 hours postoperative after a femoral-popliteal bypass. The client reports throbbing leg pain on the affected side, rated as 7/10. What action by the nurse is most important? a. Administer pain medication as ordered. b. Assess distal pulses and skin color. c. Document the findings in the client's chart. d. Notify the surgeon immediately.

b. Assess distal pulses and skin color.

A client has been diagnosed with hypertension but does not take the antihypertensive medications because of a lack of symptoms. What response by the nurse is best? a. "Do you have trouble affording your medications?" b. "Most people with hypertension do not have symptoms." c. "You are lucky; most people get severe morning headaches." d. "You need to take your medicine or you will get kidney failure."

b. "Most people with hypertension do not have symptoms."

A client has a deep vein thrombosis (DVT). What comfort measure does the nurse delegate to the assistive personnel (AP)? a. Ambulate the client. b. Apply a warm moist pack. c. Massage the client's leg. d. Provide an ice pack.

b. Apply a warm moist pack.

What nonpharmacologic comfort measures would the nurse include in the plan of care for a client with severe varicose veins? (Select all that apply.) a. Administering mild analgesics for pain b. Applying elastic compression stockings c. Elevating the legs when sitting or lying d. Reminding the client to do leg exercises e. Teaching the client about surgical options f. Encouraging participation in high impact aerobic activity

b. Applying elastic compression stockings c. Elevating the legs when sitting or lying d. Reminding the client to do leg exercises

A client with a known abdominal aortic aneurysm reports dizziness and severe abdominal pain. The nurse assesses the client's blood pressure at 82/40 mm Hg. What actions by the nurse are most important? (Select all that apply.) a. Administer pain medication. b. Assess distal pulses every 10 minutes. c. Have the client sign a surgical consent. d. Notify the Rapid Response Team. e. Take vital signs every 10 minutes.

b. Assess distal pulses every 10 minutes. d. Notify the Rapid Response Team. e. Take vital signs every 10 minutes.

A client has hypertension and high risk factors for cardiovascular disease. The client is overwhelmed with the recommended lifestyle changes. What action by the nurse is best? a. Assess the client's support system. b. Assist in finding one change the client can control. c. Determine what stressors the client faces in daily life. d. Inquire about delegating some of the client's obligations.

b. Assist in finding one change the client can control.

The nurse is evaluating a 3-day diet history with a client who has an elevated lipid panel. What meal selection indicates that the client is managing this condition well with diet? a. A 4-ounce steak, French fries, iceberg lettuce b. Baked chicken breast, broccoli, tomatoes c. Fried catfish, cornbread, peas d. Spaghetti with meat sauce, garlic bread

b. Baked chicken breast, broccoli, tomatoes

A nurse is caring for four clients. Which one would the nurse see first? a. Client who needs a beta blocker, and has a blood pressure of 98/58 mm Hg. b. Client who had a first dose of captopril and needs to use the bathroom. c. Hypertensive client with a blood pressure of 188/92 mm Hg. d. Client who needs pain medication prior to a dressing change of a surgical wound.

b. Client who had a first dose of captopril and needs to use the bathroom.

A client presents to the emergency department with a thoracic aortic aneurysm. Which findings are most consistent with this condition? (Select all that apply.) a. Abdominal tenderness b. Difficulty swallowing c. Changes in bowel habits d. Shortness of breath e. Hoarseness

b. Difficulty swallowing e. Hoarseness

A client is receiving an infusion of alteplase for an intra-arterial clot. The client begins to mumble and is disoriented. What action by the nurse is most important? a. Assess the client's neurologic status. b. Notify the Rapid Response Team. c. Prepare to administer vitamin K. d. Turn down the infusion rate.

b. Notify the Rapid Response Team.

A nurse is caring for a client with a deep vein thrombosis (DVT). What nursing assessment indicates that an important outcome has been met? a. Ambulates with assistance b. Oxygen saturation of 98% c. Pain of 2/10 after medication d. Verbalizing risk factors

b. Oxygen saturation of 98%

A nurse wants to provide community service that helps meet the goals of Healthy People 2020 (HP2020) related to cardiovascular disease and stroke. What activity would best meet this goal? a. Teach high school students heart-healthy living. b. Participate in blood pressure screenings at the mall. c. Provide pamphlets on heart disease at the grocery store. d. Set up an "Ask the nurse" booth at the pet store.

b. Participate in blood pressure screenings at the mall.

Which statements by the client indicate good understanding of foot care in peripheral vascular disease? (Select all that apply.) a. "A good abrasive pumice stone will keep my feet soft." b. "I'll always wear shoes if I can buy cheap flip-flops." c. "I will keep my feet dry, especially between the toes." d. "Lotion is important to keep my feet smooth and soft." e. "Washing my feet in room-temperature water is best." f. "I will inspect my feet daily."

c. "I will keep my feet dry, especially between the toes." d. "Lotion is important to keep my feet smooth and soft." e. "Washing my feet in room-temperature water is best."

A client asks what "essential hypertension" is. What response by the registered nurse is best? a. "It means it is caused by another disease." b. "It means it is 'essential' that it be treated." c. "It is hypertension with no specific cause." d. "It refers to severe and life-threatening hypertension."

c. "It is hypertension with no specific cause."

A nurse is assessing an obese client in the clinic for follow-up after an episode of deep vein thrombosis. The client has lost 20 lb (9.09 Kg) since the last visit. What action by the nurse is best? a. Ask if the weight loss was intended. b. Encourage a high-protein, high-fiber diet. c. Measure for new compression stockings. d. Review a 3-day food recall diary.

c. Measure for new compression stockings.

An older client with peripheral vascular disease (PVD) is explaining the daily foot care regimen to the family practice clinic nurse. What statement by the client may indicate a barrier to proper foot care? a. "I nearly always wear comfy sweatpants and house shoes." b. "I'm glad I get energy assistance so my house isn't so cold."c. "My daughter makes sure I have plenty of lotion for my feet." d. "My hands shake when I try to do things requiring coordination."

d. "My hands shake when I try to do things requiring coordination."

A new nurse is caring for a client with an abdominal aneurysm. What action by the new nurse requires the nurse's mentor to intervene? a. Assesses the client for back pain. b. Auscultates over abdominal bruit. c. Measures the abdominal girth. d. Palpates the abdomen in four quadrants.

d. Palpates the abdomen in four quadrants.

A nurse is assessing the peripheral vascular system of an older adult. What action by the nurse would cause the supervising nurse to intervene? a. Assessing blood pressure in both upper extremities b. Auscultating the carotid arteries for any bruits c. Classifying capillary filling of 4 seconds as normal d. Palpating both carotid arteries at the same time

d. Palpating both carotid arteries at the same time