EVOLVE ELSEVIER MEDICAL SURGICAL NURSING
EXAM PREP |ACTUAL QUESTIONS AND VERIFIED
ANSWERS|BRAND NEW 2026-2027
UPDATE|GRADED A+
Question 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.
Question 2
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.
1
,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 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.
Question 3
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
2
, 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.
Question 4
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
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.
Question 5
3
, 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 tissues and may cause gangrene of the toes; the drug is
effective when the toes are warm to the touch and the color of the toes is similar to the
color of the body.
Question 6
The client admitted with peripheral vascular disease (PVD) asks the nurse why her legs
hurt when she walks. The nurse bases a response on the knowledge that the main
characteristic of PVD is:
1. Decreased blood flow.
2. Increased blood flow.
3. Slow blood flow.
4
EXAM PREP |ACTUAL QUESTIONS AND VERIFIED
ANSWERS|BRAND NEW 2026-2027
UPDATE|GRADED A+
Question 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.
Question 2
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.
1
,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 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.
Question 3
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
2
, 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.
Question 4
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
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.
Question 5
3
, 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 tissues and may cause gangrene of the toes; the drug is
effective when the toes are warm to the touch and the color of the toes is similar to the
color of the body.
Question 6
The client admitted with peripheral vascular disease (PVD) asks the nurse why her legs
hurt when she walks. The nurse bases a response on the knowledge that the main
characteristic of PVD is:
1. Decreased blood flow.
2. Increased blood flow.
3. Slow blood flow.
4
