Deck 31: Coordinating Care for Patients With Vascular Disorders

Question 1

A patient is diagnosed with carotid artery disease. The nurse monitors the patient for which potential complication of this disease process?
1)Stroke
2)Diabetes mellitus
3)Hypertension
4)Dyslipidemia

Answer 1

1

Question 2

The nurse is preparing teaching material to help a patient with atherosclerosis manage lifestyle changes. What should the nurse emphasize in this teaching?
1)"You need to limit cigarette smoking."
2)"You need to follow a low-fat, low-cholesterol diet."
3)"You should consider adopting an active lifestyle."
4)"You may have dizziness at times which is expected."

Answer 2

2

Question 3

A patient recovering from a carotid endarterectomy (CEA) has a blood pressure of 90/48 mm Hg. What should the nurse do first?
1)Raise the head of the bed
2)Lower the head of the bed
3)Assess cranial nerve function
4)Place the head in neutral position

Answer 3

2

Question 4

In completing an admission assessment on a patient admitted for evaluation of peripheral arterial disease (PAD), which statement by the patient correlates with stage III PAD?
1)"The pain usually goes away when I lie down."
2)"The pain frequently awakens me at night."
3)"I do not feel sharp objects when I step on them."
4)"The pain is the same when I take long walk."

Question 5

The nurse provides education to a patient who is prescribed the DASH diet. Which patient statement indicates a need for additional teaching?
1)"I will eat four servings of fruit each day."
2)"I will eat one serving of nonfat dairy each day."
3)"I will eat five servings of vegetables each day."
4)"I will eat at least three whole-grain foods each day."

Question 6

Which assessment finding in patient with Raynaud's phenomena requires an immediate intervention by the nurse?
1)Pitting edema in the lower extremities
2)Leg pain when ambulating
3)Numbness and tingling in the lower extremities
4)Weak distal pulses audible by Doppler only

Question 7

Based on an auscultated bruit over a patient's carotid artery, the nurse explains to the patient which test as the most commonly ordered noninvasive diagnostic test to evaluate atherosclerotic plaque?
1)Carotid angiography
2)Carotid duplex ultrasound
3)Magnetic resonance angiography
4)Computed tomography angiography

Question 8

The nurse is monitoring a patient with peripheral arterial disease (PAD). Which clinical manifestations does the nurse correlate to stage III PAD?
1)Decreased pedal pulses
2)Pain, burning, and leg cramping relieved by rest
3)Pain, numbness and burning in the legs/feet at rest
4)Ulcers and blackened tissue on the toes

Question 9

The nurse provides education to a patient who is diagnosed with atherosclerosis. Which patient statement indicates a need for additional teaching?
1)"I will decrease my intake of folic acid."
2)"I will eat a low-fat, low-cholesterol diet."
3)"I will increase by daily activity to decrease by blood pressure."
4)"I will quit smoking because nicotine increases the buildup of plaque."

Question 10

The nurse is monitoring a patient with peripheral arterial disease (PAD). Which clinical manifestations does the nurse correlate to stage IV PAD?
1)Pedal pulses are decreased.
2)Muscle pain experienced with exercise.
3)Numbness and tingling of the extremity.
4)Tissue that is blackened on the great toe.

Question 11

The nurse monitors for which complication in the patient with carotid atheroembolization?
1)Shortness of breath
2)Tachycardia
3)Change in level of consciousness
4)Upper extremity edema

Question 12

A patient with atherosclerosis asks why smoking cessation is important. What should the nurse respond to this patient?
1)"Tobacco toxins increase your HDL-C."
2)"Tobacco reduces the effects of cholesterol in the body."
3)"Tobacco causes the blood pressure to drop and changes the cells within the arteries."
4)"Tobacco smoke speeds the growth of atherosclerosis in coronary arteries, aorta, and the legs."

Question 13

In administering hemorheological agents to a patient with peripheral arterial disease, the nurse correlates this treatment to which mechanism of action?
1)Anticoagulation
2)Diuretic
3)Platelet aggregation inhibitor
4)Vasodilator

Question 14

In administering a calcium channel blocker to patient diagnosed with primary hypertension, the nurse correlates a decrease to which mechanism of action of this medication?
1)Blocks formation of angiotensin II, a potent vasoconstrictor
2)Blocks the action, not the formation, of angiotensin II
3)Decreases blood vessels' ability to contract and cause vasoconstriction
4)Relaxes the muscles of the blood vessels

Question 15

The nurse formulates the following diagnosis: "Impaired Tissue Perfusion related to Acute inflammation and thrombosis in arteries and veins in the hands and feet." This nursing diagnosis is most relevant to which disease process?
1)Buerger's disease
2)Raynaud's disease
3)Secondary hypertension
4)Deep vein thrombosis

Question 16

In monitoring a patient immediately after a carotid endarterectomy (CEA), the patient demonstrates impaired swallowing. The nurse correlates this finding to compression of which cranial nerve (CN)?
1)CN VII, Facial
2)CN X, Vagus
3)CN XI, Spinal accessory
4)CN XII, Hypoglossal

Question 17

Which statement by the patient with Raynaud's disease indicates that teaching was effective?
1)"Mittens are better than gloves to prevent episodes."
2)"I need to decrease cigarette smoking."
3)"I will need to take blood thinners for life."
4)"I will need to limit fluid intake."

Question 18

A patient's blood pressure is 140/86 mm Hg; however, previous measurements have been within normal limits. The patient denies any other complaints. Which intervention would be appropriate for this patient?
1)Refer the patient to the emergency department for treatment.
2)Prepare teaching on antihypertensive medications.
3)Schedule an additional measurement in a few weeks.
4)Instruct on the effects of hypertension on major body organs.

Question 19

The nurse monitors for which early clinical manifestation in the patient admitted with Buerger's disease?
1)Bounding pulses
2)Claudication
3)Gangrene in affected extremity
4)Pitting edema in the lower extremities

Question 20

The nurse reviews the ankle-brachial index for a patient admitted for treatment of peripheral arterial disease (PAD). What is the significance of a value of 0.50?
1)Normal
2)Borderline PAD
3)Mild to moderate PAD
4)Severe PAD

Question 21

In providing care to a patient who is diagnosed with hypertension, which assessment data are risk factors for this disease process? Select all that apply.
1)Current age 45 years
2)Body mass index 28 kg/m³
3)A history of cigarette smoking
4)Glomerular filtration rate 58 mL/min
5)Concurrent diagnosis of diabetes mellitus

Question 22

In reviewing healthcare provider admission orders for a patient admitted for treatment of a deep vein thrombosis of the left lower leg, which order should the nurse question?
1)Compression stockings on both legs
2)Sequential compression devices on both legs
3)Elevate the left leg 10 to 20 degrees above the heart
4)Encourage fluid intake

Question 23

In providing care to a patient with a deep vein thrombosis (DVT), which findings in the patient's history are contraindications for tissue plasminogen activator (tPA)? Select all that apply.
1)History of osteoarthritis
2)Being treated for hemophilia
3)Previous surgery for spinal stenosis
4)Symptoms of a DVT present for a week
5)Diagnosis of DVT made upon symptoms

Question 24

In reviewing diagnostic results for a patient, which values are consistent with a diagnosis of atherosclerosis? Select all that apply.
1)Decreased homocysteine levels
2)HDL-C 30 mg/dL
3)LDL-C 120 mg/dL
4)Triglycerides 175 mg/dL
5)HgbA1c 5%

Question 25

In admitting a patient with a vascular disorder, the nurse correlates which clinical manifestation to femoral vein thrombosis?
1)Calf pain
2)Tenderness in the foot
3)Thigh swelling to the knee
4)Entire leg swollen and painful

Question 26

Which statements by a 70-year-old patient about elective surgery for repair of an abdominal aortic aneurysm indicate that teaching was effective? Select all that apply.
1)"The size of my aneurysm is not a factor."
2)"I have a greater risk of rupture because I have hypertension."
3)"Because my aneurysm is 7 cm, the risk of rupture is greater that the risk of dying during surgery."
4)"My risk of rupture is greater because my aneurysm is 7 cm wide."
5)"My age is really not a consideration at this time."

Question 27

Which statement by the patient discharge on warfarin (Coumadin) indicates the need for further teaching?
1)"I can take acetaminophen for pain."
2)"I need to limit intake of green leafy vegetables."
3)"It is okay if I see a little blood in my stool."
4)"I need to take the medications at the same time every day."

Question 28

The nurse monitors for which clinical manifestations in the patient with carotid artery disease. Select all that apply.
1)Dizziness
2)Difficulty talking
3)Sudden vision changes
4)Upper extremity edema
5)Sudden weakness on one side of the body

Question 29

The nurse is preparing material about peripheral artery disease (PAD) for a community fair. What should the nurse include about modifiable risk factors for the disease? Select all that apply.
1)History of chronic obstructive pulmonary disease
2)Smoking
3)Hypertension
4)Family history of cardiovascular disease
5)Sedentary lifestyle

Question 30

The nurse correlates which pathophysiological processes to Virchow's triad? Select all that apply.
1)Vasodilation
2)Stasis of blood flow
3)Hypercoagulability
4)Leukocytosis
5)Endothelial injury

Question 31

A patient's ankle systolic blood pressure is 148 mm Hg and brachial systolic pressure is 118 mm Hg. What is this patient's ankle-brachial index? Record your answer as a whole number. ______