LEWIS MEDICALSURGICAL NURSING
CHAPTER 31 ASSESSMENT
CARDIOVASCULAR SYSTEM EXAM SCRIPT
2026 FULL QUESTIONS AND SOLUTIONS
⩥ An older 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
a. apply a compression stocking to the leg.
b. elevate the leg above the level of the heart.
c. assist the patient in gently exercising the leg.
d. keep the patient in bed in the supine position. Answer: ANS: D
The patient's history and clinical manifestations are consistent with acute
arterial occlusion, and resting the leg will decrease the O2 demand of the
tissues and minimize ischemic damage until circulation can be restored.
Elevating the leg or applying an elastic wrap will further compromise
blood flow to the leg. Exercise will increase oxygen demand for the
tissues of the
⩥ A patient at the clinic says, "I always 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 should
a. look for the presence of tortuous veins bilaterally on the legs.
b. ask about any skin color changes that occur in response to cold.
, c. assess for unilateral swelling, redness, and tenderness of either leg.
d. palpate for the presence of dorsalis pedis and posterior tibial pulses.
Answer: ANS: D
The nurse should assess for other clinical manifestations of peripheral
arterial disease in a patient who describes intermittent claudication.
Changes in skin color that occur in response to cold are consistent with
Raynaud's phenomenon. Tortuous veins on the legs suggest venous
insufficiency. Unilateral leg swelling, redness, and tenderness indicate
venous thromboembolism.
⩥ The nurse performing an assessment of a patient who has chronic
peripheral artery disease (PAD) of the legs and an ulcer on the right
second toe would expect to find
a. dilated superficial veins.
b. swollen, dry, scaly ankles.
c. prolonged capillary refill in all the toes.
d. serosanguineous drainage from the ulcer. Answer: ANS: C
Capillary refill is prolonged in PAD because of the slower and decreased
blood flow to the periphery. The other listed clinical manifestations are
consistent with chronic venous disease
⩥ 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
a. use a heating pad on my feet at night to increase the circulation."
CHAPTER 31 ASSESSMENT
CARDIOVASCULAR SYSTEM EXAM SCRIPT
2026 FULL QUESTIONS AND SOLUTIONS
⩥ An older 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
a. apply a compression stocking to the leg.
b. elevate the leg above the level of the heart.
c. assist the patient in gently exercising the leg.
d. keep the patient in bed in the supine position. Answer: ANS: D
The patient's history and clinical manifestations are consistent with acute
arterial occlusion, and resting the leg will decrease the O2 demand of the
tissues and minimize ischemic damage until circulation can be restored.
Elevating the leg or applying an elastic wrap will further compromise
blood flow to the leg. Exercise will increase oxygen demand for the
tissues of the
⩥ A patient at the clinic says, "I always 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 should
a. look for the presence of tortuous veins bilaterally on the legs.
b. ask about any skin color changes that occur in response to cold.
, c. assess for unilateral swelling, redness, and tenderness of either leg.
d. palpate for the presence of dorsalis pedis and posterior tibial pulses.
Answer: ANS: D
The nurse should assess for other clinical manifestations of peripheral
arterial disease in a patient who describes intermittent claudication.
Changes in skin color that occur in response to cold are consistent with
Raynaud's phenomenon. Tortuous veins on the legs suggest venous
insufficiency. Unilateral leg swelling, redness, and tenderness indicate
venous thromboembolism.
⩥ The nurse performing an assessment of a patient who has chronic
peripheral artery disease (PAD) of the legs and an ulcer on the right
second toe would expect to find
a. dilated superficial veins.
b. swollen, dry, scaly ankles.
c. prolonged capillary refill in all the toes.
d. serosanguineous drainage from the ulcer. Answer: ANS: C
Capillary refill is prolonged in PAD because of the slower and decreased
blood flow to the periphery. The other listed clinical manifestations are
consistent with chronic venous disease
⩥ 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
a. use a heating pad on my feet at night to increase the circulation."
