Exam 3 question errors
3 rules of the dash diet
Lifestyle modifications can stop the progression of prehypertension into primary hypertension. Good modifications include stopping smoking and getting regular exercise at least 5 days a week. Also, dietary modifications are recommended, such as following the DASH diet, which includes 4/5 servings of fruit a day, limiting fats and oils to 2/3 servings per day, including grain intake of 6/8 servings per day.
unable to assess pedal pulse what should they do next 1. neuro assessment 2. doppler 3. have pt hang feet over the bed 4. wrap legs in blanket
1. first do neuro-- should assess if the feet are warm to make sure they are getting perfused 2. then do doppler
The nurse is teaching a client about lifestyle modifications to promote vasodilation in a client with peripheral vascular disease (PVD). Which intervention should the nurse suggest? A. Stop smoking. B. Wash extremities in cool water. C. Take an aspirin daily. D. Walk daily.
A Smoking causes vasoconstriction, so stopping smoking will improve vasodilation. Increasing activity such as walking may lead to collateral circulation but does not cause vasodilation. The use of aspirin may impede platelet clumping but does not cause vasodilation. Cool water may cause vasoconstriction to occur.
The nurse is teaching a client with atrial fibrillation about deep venous thrombosis prevention. Which should the nurse instruct the client to avoid? (Select all that apply.) A. Crossing the legs B. Tight-fitting clothing C. Extreme exercise D. Prolonged standing E. Prolonged sitting
A, B, D
The nurse is teaching a client about glaucoma. Which information should the nurse include? (Select all that apply.) A. "It can eventually lead to blindness." B. "There are two types of glaucoma: angle-closure and open-angle glaucoma." C. "It is caused by the loss of lens clarity, which results in cloudy vision." D. "It is a painless, gradual loss of peripheral vision." E. "Persons with this condition are required to maintain a medication regimen to manage pain symptoms associated with pupillary accommodation."
A, B, D There are two types of glaucoma, open-angle and angle-closure glaucoma. Open-angle glaucoma is a painless, gradual loss of peripheral vision resulting from increased intraocular pressure and destruction of optic fibers, and it is the most common form. Glaucoma causes progressive narrowing of the visual field and eventual blindness. Cataracts cause the loss of lens clarity, which leads to cloudy vision. Clients with glaucoma take medications to manage intraocular pressure, not to manage pain symptoms.
The nurse is caring for a client recently diagnosed with peripheral vascular disease (PVD). Which intervention should the nurse teach the client? (Select all that apply.) A. Avoid crossing the legs when in a sitting position. B. Put on above-the-knee elastic hose with the legs elevated. C. Encourage wearing knee-high compression stockings. D. Avoid walking or standing to allow the legs to rest. E. Elevate the legs when asleep or resting.
A, B, E Nursing interventions for PVD include elevating the legs when resting or asleep, avoiding crossing the legs or putting pressure on the back of the knees, and putting on hose after the legs have been elevated. The client should be encouraged to walk as much as possible. Compression hose should be above the knee and tighter over the feet than the top of the leg.
A client presents with tenderness, edema, and erythema of a lower extremity. Which diagnostic test should the nurse anticipate being ordered for this client? (Select all that apply.) A. Plethysmography B. Color-flow Doppler ultrasound C. Duplex venous ultrasonography D. Magnetic resonance angiography E. Magnetic resonance imaging
A, C, E
A home health nurse is caring for a client with peripheral vascular disease (PVD). When teaching the client regarding foot and leg care, which statement should the nurse include? (Select all that apply.) A. "Apply moisturizing cream to feet and legs daily." B. "Buy shoes in the morning, when feet are largest." C. "When swimming, ensure the water is cool, not warm." D. "Dry between your toes after showering." E. "Avoid using powder on your feet."
A, D Foot and leg care for clients with PVD includes applying moisturizing cream to feet and legs daily as well as drying between the toes after showering. The client should use powder on the feet to keep feet dry. When swimming, water should be warm because cool water causes vasospasm, worsening the client's condition. The client should buy shoes in the afternoon, when feet are largest.
The nurse should assess which client for possible deep venous thrombosis? (Select all that apply.) A. The client with capillary refill less than 3 seconds in one lower extremity and 4 seconds in the other B. The client with cyanosis of the right lower extremity C. The client who recently had surgery but has no reports of pain or swelling in the lower extremities D. The client with sharp, stabbing pain in the right lower extremity only when walking E. The client with bilateral lower extremity edema but slightly greater in the left lower extremity
A,B,C,E Signs and symptoms of DVT include cyanosis, dull aching pain when walking, edema greater in one leg, and capillary refill greater in one leg. DVT is often asymptomatic. The client who has had surgery is at risk for DVT and should be assessed.
A client recently diagnosed with hypertension has a family history of hyperaldosteronism. Which diagnostic test should the nurse expect to be ordered? A. Creatinine clearance B. Serum potassium C. Renal function panel D. Serum creatinine
B The serum potassium level will be decreased with hyperaldosteronism. Serum creatinine is elevated and creatinine clearance is reduced if there is an underlying renal cause to the hypertension. A renal function panel is used to detect alterations in kidney function that may be causing the hypertension.
The nurse is performing a nursing assessment for a client with peripheral vascular disease (PVD). Which data should the nurse collect during the health history? (Select all that apply.) A. Presence of skin discoloration B. Presence of pain C. History of coronary artery disease D. Current medications E. Current diet
B, C, D, E
A nurse is evaluating teaching for a client who recently experienced a hypertensive crisis. Which statement by the client indicates an understanding of the instructions? (Select all that apply.) A. "I will exercise 3 days a week." B. "I must stop smoking." C. "I will increase fruits and vegetables in my diet." D. "I will set a schedule to remind me to take my medications each day." E. "I need to restrict my alcohol intake to no more than 20 oz of beer a day."
B, C, D, E Smoking is closely associated with cardiovascular disease, which is a complication of hypertension. In addition, smoking interferes with some antihypertensive medications. Clients with hypertension should drink only in moderation. The recommended alcohol intake is one alcoholic beverage per day. A diet that is high in fruits and vegetables will help maintain a normal weight and lower blood pressure. The client will also benefit from a diet that is low in fat. This client has experienced a hypertensive crisis. Failure to take medications as prescribed can cause hypertensive crisis. A routine that includes taking medications at a set time each day will help the client remember to take medications as prescribed. Exercise 5 days a week lasting 30dash45 minutes per day is recommended. Exercise helps with stress reduction, weight loss, and general feelings of well-being.
The nurse is talking to a client with peripheral vascular disease (PVD) who reports using biofeedback as a complementary therapy. The nurse knows this serves which purpose for PVD? A. Decreasing arterial plaque buildup B. Reducing stress C. Lowering overall cholesterol D. Improving peripheral circulation
D Biofeedback is used to improve peripheral circulation; biofeedback does not reduce plaque buildup. Exercise and a change in diet can reduce overall cholesterol and slow the progress of PVD. Many alternative therapies are used to reduce stress, but that is not a main function of biofeedback.
what causes atherosclerosis in ppl with DM
DM speeds up athero by thickening basement mebrane of both large and small vessels
An older adult client is being screened for hearing loss. Which signs should alert the nurse to hearing loss? (Select all that apply.) A. Difficulty understanding speech B. Increased mobility C. Unsociable behavior D. Depression in the client E. Increased forgetfulness
a, c, d, e The older adult client with a hearing impairment may be described as unsociable, increasingly forgetful, and depressed. Functional problems such as reduced mobility are also associated with hearing loss. Nurses need to be alert for signs of impaired hearing, such as difficulty understanding verbal communication.
The nurse is preparing a class about risk factors for glaucoma. Which factor should the nurse include? (Select all that apply.) A. Race B. Age .C. Heredity .D. Smoking E. Long-term steroid use
a,b,c,e Not smoking smoking is for AMD and Cat
A client who exercises for 30 minutes every day and maintains a normal body weight develops primary hypertension. The client asks how this could have happened. Which finding in the client's health history should the nurse include in the response to the client? (Select all that apply.) A. Age: 62 years B. High magnesium intake C. Insulin resistance D. Working as an air traffic controller E. Family history of hypertension
a,c,d,e
The nurse is caring for a client with peripheral vascular disease (PVD). Which nursing intervention should the nurse implement? (Select all that apply.) A. Keep lower extremities warm. B. Encourage frequent position change. C. Keep legs in dependent position during sleep. D. Encourage exercise. E. Assess peripheral pulses.
ans ABDE To evaluate and promote tissue perfusion in the client with PVD, the nurse should assess peripheral pulses to ensure adequate perfusion, keep lower extremities warm to prevent vasoconstriction associated with cold temperatures, encourage exercise to increase circulation to lower extremities, and encourage frequent position changes to avoid a decrease in circulation to the lower extremities. The nurse should elevate the legs during sleep and rest. Elevation promotes venous return from the extremity, increasing circulation and relieving pain.
A client is complaining of difficulty hearing. Which medications on the client's home medication list would alert the nurse of the potential risk for hearing impairment? (Select all that apply.) A. Angiotensin-converting enzyme inhibitor B. Salicylate C. Aminoglycoside D. Loop diuretic E. Alkylating agent
ans b,c,d,e
which otoxoic medication should be used cautiously 1.oral CCB 2. iV aminoglycoside antibiotic 3. IV glucocorticoid 4. oral loop diuretic
ans 2 4. IV push loop diuretic can cause auditory nerve damage PO is safe for ears 2. overdose can cause client to go deaf
Interventions for PAD 1. encourage pt to use heating pads 2. teach how to apply stockings 3. tell pt to walk 30 mins qday 4. check both feet for red areas 1/week
ans 3: helps promote circulation and prevent ischemic tissue
after femoral angiogram for pt with AOD which intervention 1. explan this procedure will be done at bedside 2.bed rest with bathroom priv 3. no IV access neccessary 4.fluids will be INC
ans 4 to help expel the contrast and help prevent kidney damage
The nurse is assessing a client diagnosed with chronic vascular insufficiency (CVI). Which assessment finding should the nurse expect? (Select all that apply.) A. Cyanosis of lower legs B. Lower extremity edema C. Pale skin on lower legs D. Excessive hair growth on the legs E. Soft subcutaneous tissue on affected areas on leg
ans A, B CVI include lower extremity edema that worsens with standing; itching, dull leg discomfort or pain that increases with standing; thin, shiny, atrophic skin; cyanosis and brown skin pigmentation of lower leg and foot; possible weeping dermatitis; thick, fibrous (hard) subcutaneous tissue; and recurrent ulcerations of medial or anterior ankles
A nurse is teaching a client about aspirin for peripheral vascular disease (PVD). Which client statement indicates that teaching has been successful? A. "This medication will help decrease the plaque in my arteries." B. "This medication will prevent me from developing a blood clot." C. "This medication will open my arteries and increase blood flow to my legs." D. "This medication will thin out my blood so it flows easier."
ans B Aspirin, an antiplatelet, is prescribed in PVD to prevent clot formation. Aspirin does not vasodilate, decrease viscosity, or help decrease plaque in the arteries. Pentoxifylline (Trental) decreases blood viscosity and Cilostazol (Pletal) decreases blood viscosity in addition to preventing further clots.
The nurse is preparing to teach a client with a venous stasis ulcer on the left lower leg. Which intervention should the nurse include in the teaching plan? A. How to keep the wound bed clean and dry B. Purpose of antibiotic therapy C. Application of elastic compression stockings D. Increased carbohydrate intake to promote wound healing
ans C Use of elastic compression stockings is essential to healing of venous stasis ulcers. High dietary intake of protein, rather than carbohydrates, is needed for wound healing. Antibiotics are not routinely used for venous ulcers. Moist dressings are used for venous stasis ulcers, not dry dressings.
The nurse is assessing a patient diagnosed with open-angle glaucoma. Which clinical manifestation should the nurse expect to find? a.Gradual loss of peripheral vision b Intermittent stabbing eye pain c Progressive reduction of color brightness d Rapid change in visual acuity
ans a The increased intraocular pressure noted in open-angle glaucoma leads to a gradual loss of peripheral vision. Intermittent stabbing eye pain, change in color brightness, and rapid change in visual acuity are associated with angle-closure glaucoma.
The nurse is assessing a patient with macular degeneration. Which clinical manifestation should the nurse expect to find? a Halos around lights b Distorted straight lines c Central vision distortion d Blurriness of printed words
ans a Visualization of halos around lights is a symptom of glaucoma. Distorted straight lines, central vision distortion, and blurriness of printed words are common clinical manifestations of macular degeneration.
A patient who reports having a headache in the back of the head and neck every morning that subsides during the day, visual disturbances, and nocturia has a blood pressure of 156/100 mmHg. Which condition should the nurse expect to find in this patient? Correct answer a Hypertensive crisis b Primary hypertension c Pheochromocytoma d Secondary hypertension
ans b WHAT YOU NEED TO KNOW The patient's symptoms of elevated blood pressure, headache, nocturia, and visual disturbances are manifestations of primary hypertension. The symptoms of nocturia and visual disturbances are associated with target organ damage caused by primary hypertension. The elevated blood pressure reading of 156/100 mmHg is not indicative of a hypertensive crisis. The patient's symptoms are not associated with a pheochromocytoma, which can be a cause of secondary hypertension.
The nurse is caring for a patient who reports decreased hearing and ear fullness during an upper respiratory infection. Which medication should the nurse expect to be prescribed for this patient? a Corticosteroid b Loop diuretic c Adrenergic d Macrolide antibiotic
ans c The use of an adrenergic drug, such as pseudoepedrine, can be helpful in treating hearing loss due to an upper respiratory infection or seasonal allergies. Adrenergic drugs improve norepinephrine and epinephrine activity by stimulating alpha-adrenergic receptors. This causes vasoconstriction and reduces inflammation. Corticosteroids, such as prednisone, can be used for treatment initially in patients with sudden sensorineural loss. Corticosteroids mimic hormones produced by the adrenal gland and reduce inflammation and the immune response system. Loop diuretics, such as furosemide, inhibit the ascending limb of the loop of Henle in the kidneys, causing diuresis. Macrolide antibiotics are used to treat infection caused by bacteria.
A client with sudden sensorineural hearing loss comes to the clinic. Which medication should the nurse expect to be prescribed? A. Aminoglycoside B. Alkylating agent C. Corticosteroid D. Loop diuretic
ans c Corticosteroids are used to reduce inflammation and can help with temporary hearing loss. Medications such as aminoglycosides, alkylating agents, and loop diuretics can all cause hearing impairment.
The nurse suspects that a patient may have macular degeneration. Which manifestation supports this diagnosis? a Poor peripheral vision b Intact central vision c Difficulty adjusting to low-light areas after being in bright areas d Colored halos around lights
ans c Difficulty adjusting to low-light areas after being in bright areas is a manifestation of macular degeneration. Intact, not poor, peripheral vision is a manifestation of macular degeneration. Blurred, not intact, central vision is a manifestation of macular degeneration. Colored halos around lights are not a manifestation of macular degeneration.
The nurse suspects a patient has hypertension. Which patient statement further confirms the nurse's suspicion? ANSWER Correct answer a "I have trouble driving at night due to my vision." b "I sometimes have a headache at night." c "I have to get up almost every night to urinate." d "I have neck pain in the afternoon after work."
ans c The patient's symptoms of consistently elevated blood pressure and nocturia are manifestations of primary hypertension. The nocturia is associated with target organ damage caused by primary hypertension. Vision issues limited to trouble driving at night are not specifically related to hypertension. A headache in the back of the head and neck is a strong indication of primary hypertension; neck pain associated with the work day would not be.
The nurse is caring for a patient who has been diagnosed with renal failure and is receiving a loop diuretic. The nurse knows that which other medication, when used with loop diuretics in renal failure patients, can cause ototoxicity? a Beta blocker b Nitrate c Antiviral d Aminoglycoside
ans d Hearing loss is most common in patients with renal failure who have received both loop diuretics and aminoglycosides. Beta blockers, nitrates, and antivirals are not known to cause hearing loss when used with loop diuretics.
The nurse taught a client about the treatment for nonexudative macular degeneration. Which client statement indicates an understanding of the teaching? A. "I will add iron to my diet." B. "I may need laser surgery." C. "It is important that I use the eyedrops prescribed daily." D. "I will need to follow up with my eye doctor annually."
ans d Treatment for macular degeneration requires frequent monitoring of the condition, which includes yearly appointments with the eye doctor. Zinc, copper, and antioxidants, but not iron, are used to treat nonexudative macular degeneration. Clients with nonexudative macular degeneration are not candidates for surgery or use of prescribed eyedrops.
which med is for AOD 1.anticoagulant 2.antihypertensive 3.antiplatelet 4.muscle relaxant
ans. 3-- asprin or plavix-- inhibit platelet formation in the arterial blood 1: px for venous problems
The nurse is planning to teach a client about a pulmonary angiogram. Which statement should the nurse include in the teaching? (Select all that apply.) A. "This procedure involves inhaling a gas that measures ventilation." B. "This procedure involves contrast injected into the pulmonary arteries." C. "This procedure involves the use of x-ray." D. "This procedure involves the placement of an IV." E. "This procedure uses radioisotopes to help diagnose pulmonary embolism."
b,c,d
A client had a vena cava filter inserted. Which condition most likely indicates a complication? A. Productive cough B. Chest pain C. Shortness of breath D. Edema in bilateral lower extremities
d may indicate the filter is stuck with emboli the rest are normal for this sx
The nurse plans care for a client diagnosed with macular degeneration. Which nursing diagnosis should the nurse include in the client's plan of care? (Select all that apply.) A. Impaired Visual Perception B. Ineffective Self-Care Management, Risk of C. Pain, Chronic D. Social Interaction, Impaired E. Fear
e,d,b,a The client with macular degeneration may have diagnoses of Fear; Ineffective Self-Care Management, Risk of; Impaired Visual Perception; and Reduced Social Interaction. Pain is not associated with this condition.