MEDICAL-SURGICAL NURSING
CONCEPTS FOR
INTERPROFESSIONAL
COLLABORATIVE CARE
EXAM
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1
,The nurse is assessing a 48-year-old client with a history of smoking during a
routine clinic visit. The client, who exercises regularly, reports having pain in
the calf during exercise that disappears at rest. Which of the following findings
requires further evaluation?
1. Heart rate 57 bpm.
2. SpO2 of 94% on room air.
3. Blood pressure 134/82.
4. Ankle-brachial index of 0.65. - CORRECT ANSWER -4
An Ankle-Brachial Index of 0.65 suggests moderate arterial vascular disease in
a client who is experiencing intermittent claudication. A Doppler ultrasound is
indicated for further evaluation. The bradycardic heart rate is acceptable in an
athletic client with a normal blood pressure. The SpO2 is acceptable; the client
has a smoking history.
An overweight client taking warfarin (Coumadin) has dry skin due to decreased
arterial blood flow. What should the nurse instruct the client to do? Select all
that apply.
1. Apply lanolin or petroleum jelly to intact skin.
2. Follow a reduced-calorie, reduced-fat diet.
3. Inspect the involved areas daily for new ulcerations.
4. Instruct the client to limit activities of daily living (ADLs).
5.Use an electric razor to shave - CORRECT ANSWER -1,2,3,5 Maintaining skin
integrity is important in preventing chronic ulcers and infections. The client
should be taught to inspect the skin on a daily basis. The client should reduce
weight to promote circulation; a diet lower in calories and fat is appropriate.
Because the client is receiving Coumadin, the client is at risk for bleeding from
cuts. To decrease the risk of cuts, the nurse should suggest that the client use
an electric razor. The client with decreased arterial blood flow should be
2
,encouraged to participate in ADLs. In fact, the client should be encouraged to
consult an exercise physiologist for an exercise program that enhances the
aerobic capacity of the body.
A client with peripheral vascular disease has undergone a right femoral-
popliteal bypass graft. The blood pressure has decreased from 124/80 to
94/62. What should the nurse assess first?
1. IV fluid solution.
2. Pedal pulses.
3. Nasal cannula flow rate.
4. Capillary refill - CORRECT ANSWER -2
With each set of vital signs, the nurse should assess the dorsalis pedis and
posterior tibial pulses. The nurse needs to ensure adequate perfusion to the lower
extremity with the drop in blood pressure. IV fluids, nasal cannula setting, and
capillary refill are important to assess; however, priority is to determine the
cause of drop in blood pressure and that adequate perfusion through the new
graft is maintained.
The nurse is caring for a client with peripheral artery disease who has
recently been prescribed clopidogrel (Plavix). The nurse understands that
more teaching is necessary when the client states which of the following:
1. "I should not be surprised if I bruise easier or if my gums bleed a little
when brushing my teeth."
2. "It doesn't really matter if I take this medicine with or without food,
whatever works best for my stomach."
3. "I should stop taking Plavix if it makes me feel weak and dizzy."
4. "The doctor prescribed this medicine to make my platelets less likely to
stick together and help prevent clots from forming." - CORRECT
ANSWER -3
3
, Weakness, dizziness, and headache are common adverse effects of Plavix and the
client should report these to the physician if they are problematic; in order to
decrease risk of clot formation, Plavix must be taken regularly and should not be
stopped or taken intermittently. The main adverse effect of Plavix is bleeding,
which often occurs as increased bruising or bleeding when brushing teeth.
Plavix is well absorbed, and while food may help decrease potential
gastrointestinal upset, Plavix may be taken with or without food. Plavix is an
antiplatelet agent used to prevent clot formation in clients who have
experienced or are at risk for myocardial infarction, ischemic stroke, peripheral
artery disease, or acute coronary syndrome.
A client is receiving Cilostazol (Pletal) for peripheral arterial disease causing
intermittent claudication. The nurse determines this medication is effective
when the client reports which of the following?
1. "I am having fewer aches and pains."
2. "I do not have headaches anymore."
3. "I am able to walk further without leg pain."
4. "My toes are turning grayish black in color." - CORRECT ANSWER -3
Cilostazol is indicated for management of intermittent claudication. Symptoms
usually improve within 2 to 4 weeks of therapy. Intermittent claudication
prevents clients from walking for long periods of time. Cilostazol inhibits platelet
aggregation induced by various stimuli and improving blood flow to the muscles
and allowing the client to walk long distances without pain. Peripheral arterial
disease causes pain mainly of the leg muscles. "Aches and pains" does not specify
exactly where the pain is occurring. Headaches may occur as a side effect of this
drug, and the client should report this information to the health care provider.
Peripheral arterial disease causes decreased blood supply to the peripheral
4
CONCEPTS FOR
INTERPROFESSIONAL
COLLABORATIVE CARE
EXAM
High-Yield Qs & Answers with Feedback
This Exam Description:
High-Yield Qs
Answers with Feedback
Multiple Choices
100% Guaranteed Pass
1
,The nurse is assessing a 48-year-old client with a history of smoking during a
routine clinic visit. The client, who exercises regularly, reports having pain in
the calf during exercise that disappears at rest. Which of the following findings
requires further evaluation?
1. Heart rate 57 bpm.
2. SpO2 of 94% on room air.
3. Blood pressure 134/82.
4. Ankle-brachial index of 0.65. - CORRECT ANSWER -4
An Ankle-Brachial Index of 0.65 suggests moderate arterial vascular disease in
a client who is experiencing intermittent claudication. A Doppler ultrasound is
indicated for further evaluation. The bradycardic heart rate is acceptable in an
athletic client with a normal blood pressure. The SpO2 is acceptable; the client
has a smoking history.
An overweight client taking warfarin (Coumadin) has dry skin due to decreased
arterial blood flow. What should the nurse instruct the client to do? Select all
that apply.
1. Apply lanolin or petroleum jelly to intact skin.
2. Follow a reduced-calorie, reduced-fat diet.
3. Inspect the involved areas daily for new ulcerations.
4. Instruct the client to limit activities of daily living (ADLs).
5.Use an electric razor to shave - CORRECT ANSWER -1,2,3,5 Maintaining skin
integrity is important in preventing chronic ulcers and infections. The client
should be taught to inspect the skin on a daily basis. The client should reduce
weight to promote circulation; a diet lower in calories and fat is appropriate.
Because the client is receiving Coumadin, the client is at risk for bleeding from
cuts. To decrease the risk of cuts, the nurse should suggest that the client use
an electric razor. The client with decreased arterial blood flow should be
2
,encouraged to participate in ADLs. In fact, the client should be encouraged to
consult an exercise physiologist for an exercise program that enhances the
aerobic capacity of the body.
A client with peripheral vascular disease has undergone a right femoral-
popliteal bypass graft. The blood pressure has decreased from 124/80 to
94/62. What should the nurse assess first?
1. IV fluid solution.
2. Pedal pulses.
3. Nasal cannula flow rate.
4. Capillary refill - CORRECT ANSWER -2
With each set of vital signs, the nurse should assess the dorsalis pedis and
posterior tibial pulses. The nurse needs to ensure adequate perfusion to the lower
extremity with the drop in blood pressure. IV fluids, nasal cannula setting, and
capillary refill are important to assess; however, priority is to determine the
cause of drop in blood pressure and that adequate perfusion through the new
graft is maintained.
The nurse is caring for a client with peripheral artery disease who has
recently been prescribed clopidogrel (Plavix). The nurse understands that
more teaching is necessary when the client states which of the following:
1. "I should not be surprised if I bruise easier or if my gums bleed a little
when brushing my teeth."
2. "It doesn't really matter if I take this medicine with or without food,
whatever works best for my stomach."
3. "I should stop taking Plavix if it makes me feel weak and dizzy."
4. "The doctor prescribed this medicine to make my platelets less likely to
stick together and help prevent clots from forming." - CORRECT
ANSWER -3
3
, Weakness, dizziness, and headache are common adverse effects of Plavix and the
client should report these to the physician if they are problematic; in order to
decrease risk of clot formation, Plavix must be taken regularly and should not be
stopped or taken intermittently. The main adverse effect of Plavix is bleeding,
which often occurs as increased bruising or bleeding when brushing teeth.
Plavix is well absorbed, and while food may help decrease potential
gastrointestinal upset, Plavix may be taken with or without food. Plavix is an
antiplatelet agent used to prevent clot formation in clients who have
experienced or are at risk for myocardial infarction, ischemic stroke, peripheral
artery disease, or acute coronary syndrome.
A client is receiving Cilostazol (Pletal) for peripheral arterial disease causing
intermittent claudication. The nurse determines this medication is effective
when the client reports which of the following?
1. "I am having fewer aches and pains."
2. "I do not have headaches anymore."
3. "I am able to walk further without leg pain."
4. "My toes are turning grayish black in color." - CORRECT ANSWER -3
Cilostazol is indicated for management of intermittent claudication. Symptoms
usually improve within 2 to 4 weeks of therapy. Intermittent claudication
prevents clients from walking for long periods of time. Cilostazol inhibits platelet
aggregation induced by various stimuli and improving blood flow to the muscles
and allowing the client to walk long distances without pain. Peripheral arterial
disease causes pain mainly of the leg muscles. "Aches and pains" does not specify
exactly where the pain is occurring. Headaches may occur as a side effect of this
drug, and the client should report this information to the health care provider.
Peripheral arterial disease causes decreased blood supply to the peripheral
4
