Chp 38

Question 0

A 23-year-old patient tells the health care provider about experiencing cold, numb fingers when running during
the winter and Raynaud’s phenomenon is suspected. The nurse will anticipate teaching the patient about tests for

Answer 0

autoimmune disorders.

Question 1

46-year-old is diagnosed with thromboangiitis obliterans (Buerger’s disease). When the nurse is
developing a discharge teaching plan for the patient, which outcome has the highest priority for this patient?

Answer 1

Cessation of all tobacco use

Question 2

A 46-year-old service-counter worker undergoes sclerotherapy for treatment of superficial varicose
veins at an outpatient center. Which instructions should the nurse provide to the patient before discharge?

Answer 2

Elastic compression stockings should be applied before getting out of bed.

Question 3

A 67-year-old patient is admitted to the hospital with a diagnosis of venous insufficiency. Which patient
statement is most supportive of the diagnosis?

Answer 3

“I can’t get my shoes on at the end of the day.”

Question 4

A 73-year-old patient with chronic atrial fibrillation develops sudden severe pain, pulselessness, pallor, and
coolness in the right leg. The nurse should notify the health care provider and immediately

Answer 4

keep the patient in bed in the supine position.

Question 5

An 80-year-old patient with a history of an abdominal aortic aneurysm arrives at the emergency department
(ED) with severe back pain and absent pedal pulses. Which actions should the nurse take first?

Answer 5

Obtain the blood pressure.

Question 6

After receiving report, which patient admitted to the emergency department should the nurse assess first?

Answer 6

50-year-old who is complaining of sudden “sharp” and “worst ever” upper back pain

Question 7

After teaching a patient with newly diagnosed Raynaud’s phenomenon about how to manage the condition, which action by the patient demonstrates that the teaching has been effective?

Answer 7

The patient exercises indoors during the winter months.

Question 8

The health care provider has prescribed bed rest with the feet elevated for a patient admitted to the hospital
with venous thromboembolism. Which action by the nurse to elevate the patient’s feet is best?

Answer 8

One pillow is placed under the thighs and two pillows are placed under the lower legs

Question 9

The health care provider prescribes an infusion of heparin (Hep-Lock) and daily partial thromboplastin
time (PTT) testing for a patient with venous thromboembolism (VTE). The nurse will plan to

Answer 9

avoid giving any IM medications to prevent localized bleeding.

Question 10

The nurse has started discharge teaching for a patient who is to continue warfarin (Coumadin) following
hospitalization for venous thromboembolism (VTE). The nurse determines that additional teaching is needed when the patient says which of the following?

Answer 10

I should reduce the amount of green, leafy vegetables that I eat.”

Question 11

The nurse is caring for a patient immediately after repair of an abdominal aortic aneurysm. On
assessment, the patient has absent popliteal, posterior tibial, and dorsalis pedis pulses. The legs are cool and mottled. Which action should the nurse take first?

Answer 11

Notify the surgeon and anesthesiologist.

Question 12

The nurse is caring for a patient with a descending aortic dissection. Which assessment finding is most
important to report to the health care provider?

Answer 12

Blood pressure 137/88 mm Hg

Question 13

The nurse is caring for a patient with critical limb ischemia who has just arrived on the nursing unit after having percutaneous transluminal balloon angioplasty. Which action should the nurse perform first?

Answer 13

Obtain vital signs.

Question 14

The nurse performing an assessment with a patient who has chronic peripheral artery disease (PAD) of the legs
and an ulcer on the right second toe would expect to find

Answer 14

prolonged capillary refill in all the toes.

Question 15

The nurse reviews the admission orders shown in the accompanying figure for a patient newly diagnosed with
peripheral artery disease. Which admission order should the nurse question?

Answer 15

Combined clopidogrel and omeprazole therapy

Question 16

The nurse who works in the vascular clinic has several patients with venous insufficiency scheduled today.
Which patient should the nurse assign to an experienced licensed practical/vocational nurse (LPN/LVN)?

Answer 16

Patient who needs wound care for a chronic venous stasis ulcer on the right lower leg

Question 17

A patient at the clinic says, “I have always taken a walk after dinner, but lately my leg cramps and hurts after
just a few minutes of starting. The pain goes away after I stop walking, though.” The nurse shout

Answer 17

assess for the presence of the dorsalis pedis and posterior tibial pulses

Question 18

A patient has a 6-cm thoracic aortic aneurysm that was discovered during a routine chest x-ray. When
obtaining an admission history from the patient, it will be most important for the nurse to ask about

Answer 18

trouble swallowing.

Question 19

A patient in the outpatient clinic has a new diagnosis of peripheral artery disease (PAD). Which group of
medications will the nurse plan to include when providing patient teaching about PAD management?

Answer 19

Statins

Question 20

A patient is being evaluated for post-thrombotic syndrome. Which assessment will the nurse perform?

Answer 20

Check for presence of lipodermatosclerosis.

Question 21

A patient who is 2 days post-femoral-popliteal bypass graft to the right leg is being cared for on the vascular unit. Which action by a licensed practical/vocational nurse (LPN/LVN) caring for the patient requires the registered nurse (RN) to intervene?

Answer 21

The LPN/LVN has the patient sit in a chair for 90 minutes.

Question 22

A patient with a venous thromboembolism (VTE) is started on enoxaparin (Lovenox) and warfarin
(Coumadin). The patient asks the nurse why two medications are necessary. Which response by the nurse is most appropriate?

Answer 22

“Lovenox will work right away, but Coumadin takes several days to have an effect on preventing clots.”

Question 23

Several hours after an open surgical repair of an abdominal aortic aneurysm, the UAP reports to the nurse that urinary output for the past 2 hours has been 40 mL. The nurse notifies the health care provider and anticipates an order for a(n)

Answer 23

Lblood urea nitrogen (BUN) level.:

Question 24

When assessing a patient with possible peripheral artery disease (PAD), the nurse obtains a brachial BP of
147/82 and an ankle pressure of 112/74. The nurse calculates the patient’s ankle-brachial index (ABI) as ________ (round up to the nearest hundredth)

Answer 24

0.76

Question 25

When caring for a patient on the first postoperative day after an abdominal aortic aneurysm repair, which
assessment finding is most important for the nurse to communicate to the health care provider?

Answer 25

Loose, bloody stools

Question 26

When developing a teaching plan for a 76-year-old patient newly diagnosed with peripheral artery disease
(PAD), which instructions should the nurse include?

Answer 26

It is very important that you stop smoking cigarettes.

Question 27

When discussing risk factor modification for a 63-year- old patient who has a 5-cm abdominal aortic aneurysm,
the nurse will focus discharge teaching on which patient risk factor?

Answer 27

Uncontrolled hypertension:

Question 28

When evaluating the discharge teaching for a patient with chronic peripheral artery disease (PAD), the nurse
determines a need for further instruction when the patient says, “I will

Answer 28

use a heating pad on my feet at night to increase the circulation and warmth in my feet.”

Question 29

Which action by a nurse who is giving fondaparinux (Arixtra) to a patient with a lower leg venous
thromboembolism (VTE) indicates that more education about the drug is needed?

Answer 29

The nurse ejects the air bubble in the syringe before giving the drug.

Question 30

Which actions could the nurse delegate to unlicensed assistive personnel (UAP) who are providing care for a
patient who is at risk for venous thromboembolism?

Answer 30

Apply sequential compression device whenever the patient is in bed.

Question 31

Which assessment finding for a patient who has been admitted with a right calf venous thromboembolism
(VTE) requires immediate action by the nurse?

Answer 31

New onset shortness of breath

Question 32

Which nursing action should be included in the plan of care after endovascular repair of an abdominal aortic
aneurysm?

Answer 32

Monitor fluid intake and urine output.

Question 33

Which nursing intervention for a patient who had an open repair of an abdominal aortic aneurysm 2 days previously is appropriate for the nurse to delegate to unlicensed assistive personnel (UAP)?

Answer 33

Help the patient to use a pillow to splint while coughing.

Question 34

Which topic should the nurse include in patient teaching for a patient with a venous stasis ulcer on the
left lower leg?

Answer 34

Application of elastic compression stockings

Question 35

While working in the outpatient clinic, the nurse notes that a patient has a history of intermittent claudication.
Which statement by the patient would support this information?

Answer 35

My legs cramp whenever I walk more than a block.”