Deck 19: Disorders of the Venous System

Question 1

A nurse is reviewing the prescription records of four clients being treated for deep vein thromboembolism (DVT). Which client needs a prothrombin time laboratory test to monitor the therapeutic effects of the drug?
1)The client receiving low-molecular-weight heparin (Enoxaparin)
2)The client receiving warfarin (Coumadin)
3)The client receiving bivalirudin (Angiomax)
4)The client receiving rivaroxaban (Xarelto)

Answer 1

2

Question 2

The nurse is interviewing a client diagnosed with varicose veins. Which cause of the condition does the nurse share with the client?
1)Valvular incompetence in the legs
2)Sluggish circulation
3)Poor tissue oxygenation
4)Impaired removal of fluid and waste products

Answer 2

1

Question 3

Which specific sign or symptom indicates that a client is experiencing varicose veins?
1)Itching and aching in the lower leg muscles
2)Ropiness over a vein in the leg
3)Tenderness in the location of a vein
4)Irregular margins in the medial ankle region

Answer 3

1

Question 4

Which drug administered to clients with deep venous thromboembolism (DVT) requires international normalized ratio monitoring?
1)Low-molecular-weight heparin
2)Factor Xa inhibitor
3)Warfarin
4)Direct thrombin inhibitors

Question 5

Which diagnostic test is used to identify the pattern of collateral blood flow?
1)Venography
2)Ultrasonography
3)Photoplethysmography
4)Ventilation-profusion scan

Question 6

A client with left lower extremity swelling and tenderness along a vein has to be assessed to rule out deep vein thrombosis (DVT). Which criteria would rule out DVT?
1)A negative D-dimer assay and Wells criteria score of 3
2)A positive D-dimer assay and Wells criteria score of less than 1
3)A negative D-dimer assay and Wells criteria score of less than 2
4)A positive D-dimer assay and Wells criteria score of 0

Question 7

The nurse is performing a medical and physical assessment on a new client. The client is overweight and admits to a sedentary lifestyle. The nurse palpates pulses on the lower leg, the legs are warm to touch, and a normal capillary refill is present. In addition, there is an open wound medially on the ankle of one leg. Which condition does the nurse identify?
1)Skin breakdown related to poor hygiene
2)Pressure injury related to low activity
3)Arterial obstruction related to weight
4)An ulcer from venous insufficiency

Question 8

A client presents with a painful, swollen mass at the ankle of the right leg. Physical examination revealed that the edema is dark red in color, with drainage just above the medial malleolus of the leg. Which condition has the client developed?
1)Deep venous thromboembolism
2)Pulmonary embolism
3)Venous ulcer
4)Varicose vein

Question 9

Which test is most commonly used to diagnose varicose veins?
1)D-dimer test
2)Duplex ultrasound
3)Wells criteria
4)Magnetic resonance imaging

Question 10

The nurse is assessing four clients for deep vein thromboembolism (DVT). Which client does the nurse identify as being at a risk of developing DVT?
1)The client with an elevated D-dimer level and a Well's criteria score of 2
2)The client with a normal D-dimer level and a Well's criteria score of 1
3)The client with a low D-dimer level and a Well's criteria score of 0
4)The client with an elevated D-dimer level and a Well's criteria score of 1

Question 11

The nurse is preparing to explain the anatomical cause of venous insufficiency to a client. Which factor does the nurse include about the tunica media?
1)It is an endothelial cell lining where damage causes clots to form.
2)It is the smooth muscle layer that moves blood toward the heart.
3)It is made up of connective tissue that gives the vein strength.
4)It is also called the tunica adventitia because it is elastic.

Question 12

The nurse is administering an anticoagulant to a client after lower extremity surgery. The client states, "I have never had a clotting problem before." Which reason does the nurse provide to the client about the prescribed drug?
1)Up to 30% of orthopedic surgery clients form clots.
2)The percentage of clots becoming emboli is unknown.
3)Deep vein thrombus (DVT) is an expected side effect of surgery.
4)Pulmonary emboli are lethal but are asymptomatic.

Question 13

What is the purpose of a Greenfield filter?
1)To prevent the formation of a blood clot
2)To help burst a blood clot
3)To prevent a blood clot from traveling
4)To detect a blood clot

Question 14

The nurse is providing care to a client diagnosed with a deep vein thrombosis (DVT) who is prescribed anticoagulant therapy. The client asks the nurse about the reason for the medication. Which condition does the nurse address as being a risk if the DVT is not treated appropriately?
1)Necrosis
2)Skin breakdown
3)Tissue damage
4)Pulmonary embolism

Question 15

The nurse is caring for a client with chronic venous insufficiency. Which instruction is appropriate to include in the client's care plan?
1)Limit walking throughout the day.
2)Wear knee-high stockings or socks.
3)Apply cold compresses for pain.
4)Elevate legs periodically during the day.

Question 16

A client works as a sales associate in a garment outlet and stands for the duration of each work shift. Clinical examination reveals a presence of a dusky discoloration around the ankle, instep, and lower leg. What condition do these findings indicate?
1)Deep venous thromboembolism
2)Pulmonary embolism
3)Chronic venous insufficiency
4)Varicose vein

Question 17

An older adult client is seen at the clinic with skin inflammation. There is dusky discoloration around the ankle and in the lower leg of the client. What might be the cause of this condition?
1)Reduced blood pressure in the veins
2)Insufficient oxygenation to the tissues
3)Buildup of hemosiderin
4)Blockage of sweat glands

Question 18

A client reports to the hospital with a swollen mass on the left leg. Physical examination reveals that the swollen mass is red, tender, and is textured like a rope. A review of the client's records show that the client has recently undergone an orthopedic surgery on the right leg. Which condition has the client developed?
1)Deep venous thromboembolism (DVT)
2)Pulmonary embolism
3)Chronic venous insufficiency
4)Varicose vein

Question 19

A client comes to the clinic with dark red edema on the lower leg, with irregular margins of skin breakdown especially in the medial ankle region. The primary health-care provider diagnoses necrosis and tissue damage surrounding the affected area. Which treatment does the nurse expect to be prescribed for this client?
1)Sclerotherapy
2)Antiplatelet drugs
3)Topical medications
4)Pneumatic compression device

Question 20

The nurse is providing care for an older adult client after a left knee joint replacement. The client is resisting offers for frequent assisted ambulation. Which manifestation during assessment causes the nurse to suspect the formation of a deep venous thrombus?
1)Reports of pain in the left leg
2)Palpable warmth over a leg vein
3)Pain when the left ankle is flexed
4)Severe pain during ambulation

Question 21

Arrange the symptoms in the proper order to describe the pathophysiology of varicose veins. (Enter the number of each step in the proper sequence; do not use commas or spaces.)
1) Damaged valves occur from pressure
2) Increased pressure on the lower extremity valves
3) Blood stagnation and pooling in the lower extremities
4) Compromised venous return

Question 22

Arrange the pathophysiological changes involved in a pulmonary embolism. (Enter the number of each step in the proper sequence; do not use commas or spaces.)
1) The thrombus becomes an embolus and travels into the inferior vena cava.
2) The thrombus travels into the right side of the heart.
3) Inflammation occurs and a thrombus forms in the vein.
4) The thrombus then enters the pulmonary artery.

Question 23

Which diagnostic tests are used for peripheral venous disorders? Select all that apply.
1)Magnetic resonance imaging (MRI)
2)Photoplethysmography
3)Computerized tomography (CT)
4)Doppler ultrasonography
5)Venography

Question 24

Which risk factors form Virchow's triad? Select all that apply.
1)Venous stasis
2)Smoking
3)Vascular damage
4)Obesity
5)Hypercoagulability

Question 25

The nurse is responsible for caring for a variety of clients in a hospital setting. Using Virchow's triad, which clients does the nurse recognize as being at most risk for developing venous insufficiency? Select all that apply.
1)An obese client
2)A client with pulmonary embolism
3)A pregnant client at 30 weeks' gestation
4)A client who is recovering from a shoulder surgery
5)A client who uses a walker for support