NUR 1020 EXAM 3 REVIEW | QUESTIONS AND ANSWERS | 2026
UPDATE | WITH COMPLETE SOLUTIONS.
,SECTION 1: PERFUSION & VASCULAR DISORDERS
1. A nurse is assessing a client with peripheral arterial disease (PAD). Which
finding is most consistent with this diagnosis?
A) Warm, pink skin on the lower extremities
B) Thick, hardened nails and hair loss on the lower legs
C) Edema and brownish discoloration around the ankles
D) Full, bounding pedal pulses
Answer: B
Rationale: PAD is characterized by reduced arterial blood flow, leading to poor
tissue perfusion. Classic signs include hair loss on the lower extremities, thick and
hardened nails, dry and shiny skin, and diminished or absent pedal pulses. The skin
is typically pale and cool to the touch .
2. A client on continuous heparin infusion for a deep vein thrombosis (DVT) has
an aPTT of 98 seconds. What is the nurse's priority action?
A) Document the finding as normal
B) Notify the provider to increase the infusion rate
C) Notify the provider to decrease the infusion rate
D) Administer protamine sulfate as ordered
Answer: C
Rationale: The therapeutic aPTT for heparin therapy is typically 1.5 to 2.5 times
the normal control value (about 60-80 seconds). An aPTT of 98 seconds is elevated
and indicates the client is at a significantly increased risk for bleeding. The nurse
should notify the provider to decrease the infusion rate to bring the aPTT back into
the therapeutic range .
,3. Which instruction is most important to include in the teaching plan for a client
prescribed warfarin (Coumadin)?
A) "Take the medication with a full glass of milk."
B) "Increase your intake of leafy green vegetables."
C) "Report any unusual bleeding or bruising to your healthcare provider."
D) "Avoid using an electric razor for shaving."
Answer: C
Rationale: Warfarin is an anticoagulant that increases the risk of bleeding. The
most critical patient education is to report any signs of abnormal bleeding (e.g.,
bruising, bleeding gums, dark or tarry stools, blood in urine). Clients should be
educated to maintain a consistent intake of Vitamin K-rich foods (like leafy green
vegetables), not increase it, as this can affect the INR .
4. A client with a pulmonary embolism (PE) is receiving enoxaparin (Lovenox)
injections. Which statement by the client indicates a need for further teaching?
A) "I should not take this medication if I have any bleeding."
B) "I will rub the injection site gently to help the medicine absorb."
C) "I may feel some mild bruising at the injection site."
D) "I need to watch for signs of unusual bleeding."
Answer: B
Rationale: Enoxaparin is a low-molecular-weight heparin given subcutaneously. It
should be administered in the abdomen, and the injection site should not be
rubbed after administration, as this can cause bruising and tissue damage. The
site should be pressed gently with a gauze pad, but not rubbed .
5. A nurse is caring for a client who had an angioplasty with a stent placed.
Which assessment finding is the highest priority to report to the provider?
A) Slight oozing of blood at the catheter insertion site
B) Pain rated as 2 on a scale of 0-10 at the insertion site
, C) A palpable, pulsatile mass in the groin area
D) The client reports being tired after the procedure
Answer: C
Rationale: A palpable, pulsatile mass in the groin area after a catheterization
procedure is a sign of a pseudoaneurysm. This is a serious complication that occurs
when the arterial puncture site does not seal properly, allowing blood to collect in
the surrounding tissue. It requires immediate intervention, such as ultrasound-
guided compression or surgical repair .
6. The nurse is performing an assessment on a client with chronic venous
insufficiency. Which finding is characteristic of this condition?
A) Pain that is relieved by elevation of the legs
B) Pale, cool skin with decreased hair growth
C) Diminished or absent pedal pulses
D) Presence of a positive Homans' sign
Answer: A
Rationale: Chronic venous insufficiency involves poor venous return from the lower
extremities. The pain is typically described as a dull aching or heaviness that is
worse with dependency and relieved by elevation. The skin may have a brownish
discoloration (hemosiderin staining), edema, and ulcers near the medial
malleolus .
7. A client is prescribed clopidogrel (Plavix). Which statement by the client
indicates they understand the medication teaching?
A) "I will take this medication with a full glass of orange juice."
B) "I need to have my blood tested regularly to check my levels."
C) "I will need to avoid any immunizations while taking this drug."
D) "I will watch for signs of bleeding, like dark, tarry stools."
Answer: D
Rationale: Clopidogrel is an antiplatelet agent that inhibits platelet aggregation,
UPDATE | WITH COMPLETE SOLUTIONS.
,SECTION 1: PERFUSION & VASCULAR DISORDERS
1. A nurse is assessing a client with peripheral arterial disease (PAD). Which
finding is most consistent with this diagnosis?
A) Warm, pink skin on the lower extremities
B) Thick, hardened nails and hair loss on the lower legs
C) Edema and brownish discoloration around the ankles
D) Full, bounding pedal pulses
Answer: B
Rationale: PAD is characterized by reduced arterial blood flow, leading to poor
tissue perfusion. Classic signs include hair loss on the lower extremities, thick and
hardened nails, dry and shiny skin, and diminished or absent pedal pulses. The skin
is typically pale and cool to the touch .
2. A client on continuous heparin infusion for a deep vein thrombosis (DVT) has
an aPTT of 98 seconds. What is the nurse's priority action?
A) Document the finding as normal
B) Notify the provider to increase the infusion rate
C) Notify the provider to decrease the infusion rate
D) Administer protamine sulfate as ordered
Answer: C
Rationale: The therapeutic aPTT for heparin therapy is typically 1.5 to 2.5 times
the normal control value (about 60-80 seconds). An aPTT of 98 seconds is elevated
and indicates the client is at a significantly increased risk for bleeding. The nurse
should notify the provider to decrease the infusion rate to bring the aPTT back into
the therapeutic range .
,3. Which instruction is most important to include in the teaching plan for a client
prescribed warfarin (Coumadin)?
A) "Take the medication with a full glass of milk."
B) "Increase your intake of leafy green vegetables."
C) "Report any unusual bleeding or bruising to your healthcare provider."
D) "Avoid using an electric razor for shaving."
Answer: C
Rationale: Warfarin is an anticoagulant that increases the risk of bleeding. The
most critical patient education is to report any signs of abnormal bleeding (e.g.,
bruising, bleeding gums, dark or tarry stools, blood in urine). Clients should be
educated to maintain a consistent intake of Vitamin K-rich foods (like leafy green
vegetables), not increase it, as this can affect the INR .
4. A client with a pulmonary embolism (PE) is receiving enoxaparin (Lovenox)
injections. Which statement by the client indicates a need for further teaching?
A) "I should not take this medication if I have any bleeding."
B) "I will rub the injection site gently to help the medicine absorb."
C) "I may feel some mild bruising at the injection site."
D) "I need to watch for signs of unusual bleeding."
Answer: B
Rationale: Enoxaparin is a low-molecular-weight heparin given subcutaneously. It
should be administered in the abdomen, and the injection site should not be
rubbed after administration, as this can cause bruising and tissue damage. The
site should be pressed gently with a gauze pad, but not rubbed .
5. A nurse is caring for a client who had an angioplasty with a stent placed.
Which assessment finding is the highest priority to report to the provider?
A) Slight oozing of blood at the catheter insertion site
B) Pain rated as 2 on a scale of 0-10 at the insertion site
, C) A palpable, pulsatile mass in the groin area
D) The client reports being tired after the procedure
Answer: C
Rationale: A palpable, pulsatile mass in the groin area after a catheterization
procedure is a sign of a pseudoaneurysm. This is a serious complication that occurs
when the arterial puncture site does not seal properly, allowing blood to collect in
the surrounding tissue. It requires immediate intervention, such as ultrasound-
guided compression or surgical repair .
6. The nurse is performing an assessment on a client with chronic venous
insufficiency. Which finding is characteristic of this condition?
A) Pain that is relieved by elevation of the legs
B) Pale, cool skin with decreased hair growth
C) Diminished or absent pedal pulses
D) Presence of a positive Homans' sign
Answer: A
Rationale: Chronic venous insufficiency involves poor venous return from the lower
extremities. The pain is typically described as a dull aching or heaviness that is
worse with dependency and relieved by elevation. The skin may have a brownish
discoloration (hemosiderin staining), edema, and ulcers near the medial
malleolus .
7. A client is prescribed clopidogrel (Plavix). Which statement by the client
indicates they understand the medication teaching?
A) "I will take this medication with a full glass of orange juice."
B) "I need to have my blood tested regularly to check my levels."
C) "I will need to avoid any immunizations while taking this drug."
D) "I will watch for signs of bleeding, like dark, tarry stools."
Answer: D
Rationale: Clopidogrel is an antiplatelet agent that inhibits platelet aggregation,
