Exam 4 - Lewis Ch 41 Vascular Disorders UPDATED ACTUAL
Questions and CORRECT Answers
When discussing risk factor modification for a patient d. Uncontrolled hypertension
who has a 5-cm abdominal aortic aneurysm, the nurse
will focus teaching on which patient risk factor? All of the factors contribute to the patient's risk, but only hypertension can
a. Male gender potentially be modified to decrease the patient's risk for further expansion of the
b. Turner syndrome aneurysm.
c. Abdominal trauma history
d. Uncontrolled hypertension
A patient is hopitalized with a suspected abdominal b. angiography
aortic aneurysm. Which test will be used to image the
entire aortic system? Contrast media, which gives contrast images to map the entire aortic system is
a. xray used in angiography.
b. angiography pg 940, 941
c. ultrasound
d. electrocardiogram
A patient has a 6-cm thoracic aortic aneurysm that was b. trouble swallowing.
discovered during a routine chest x-ray. When obtaining
an admission history from the patient, it will be most Difficulty swallowing may occur with a thoracic aneurysm because of pressure on
important for the nurse to ask about the esophagus. The other symptoms will be important to assess for in patients
a. low back pain. with abdominal aortic aneurysms.
b. trouble swallowing.
c. abdominal tenderness.
d. changes in bowel habits.
The nurse is caring for a patient after an acute aortic b. morphine
dissection. The patient reports a pain level of 8 on a pain
scale of 0-10. Which medication would the nurse Patients with acute aortic dissection are managed in the ICU. An IV b-blocker (ex.
administer? esmolol) is titrated to a target HR under 60 beats/ min or SBP between 100 and
a. diltiazem 110mm Hg. A calcium channel blocker (ex. diltiazem) can be used to lower HR if a
b. morphine b-blocker is contraindicated. Morphine decreases sympathetic nervous system
c. verapamil stimulation and relieves pain. pg. 946
d. tinzaparin
Several hours after a patient had an open surgical repair d. increased IV infusion rate.
of an abdominal aortic aneurysm, the UAP reports to the
nurse that urinary output for the past 2 hours has been 45 The decreased urine output suggests decreased renal perfusion and monitoring
mL. The nurse notifies the health care provider and of renal function is needed. There is no indication that infection is a concern, so
anticipates an order for a(n) antibiotic therapy and a WBC count are not needed. The IV rate may be increased
because hypovolemia may be contributing to the patient's decreased urinary
a. hemoglobin count. output.
b. additional antibiotic.
c. serum creatinine level.
d. increased IV infusion rate.
, A patient in the outpatient clinic has a new diagnosis of a. Statins
peripheral artery disease (PAD). Which group of drugs
will the nurse plan to include when teaching about PAD Research indicates that statin use by patients with PAD improves multiple
management? outcomes. There is no research that supports the use of the other drug categories
a. Statins in PAD.
b. Antibiotics
c. Thrombolytics
d. Anticoagulants
An older patient with chronic atrial fibrillation develops d. keep the patient in bed in the supine position.
sudden severe pain, pulselessness, pallor, and coolness
in the right leg. The nurse should notify the health care The patient's history and clinical manifestations are consistent with acute arterial
provider and immediately occlusion, and resting the leg will decrease the O2 demand of the tissues and
a. apply a compression stocking to the leg. minimize ischemic damage until circulation can be restored. Elevating the leg or
b. elevate the leg above the level of the heart. applying an elastic wrap will further compromise blood flow to the leg. Exercise
c. assist the patient in gently exercising the leg. will increase oxygen demand for the tissues of the leg.
d. keep the patient in bed in the supine position.
A patient at the clinic says, "I always walk after dinner, but d. palpate for the presence of dorsalis pedis and posterior tibial pulses.
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 assess for other clinical manifestations of peripheral arterial
The nurse should disease in a patient who describes intermittent claudication. Changes in skin
a. look for the presence of tortuous veins bilaterally on color that occur in response to cold are consistent with Raynaud's phenomenon.
the legs. Tortuous veins on the legs suggest venous insufficiency. Unilateral leg swelling,
b. ask about any skin color changes that occur in redness, and tenderness indicate venous thromboembolism.
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.
The nurse performing an assessment of a patient who has c. prolonged capillary refill in all the toes.
chronic peripheral artery disease (PAD) of the legs and
an ulcer on the right second toe would expect to find Capillary refill is prolonged in PAD because of the slower and decreased blood
a. dilated superficial veins. flow to the periphery. The other listed clinical manifestations are consistent with
b. swollen, dry, scaly ankles. chronic venous disease.
c. prolonged capillary refill in all the toes.
d. serosanguineous drainage from the ulcer.
When evaluating the discharge teaching for a patient with a. "I will use a heating pad on my feet at night to increase the circulation."
chronic peripheral artery disease (PAD), the nurse
determines a need for further instruction when the Because the patient has impaired circulation and sensation to the feet, the use of
patient says, "I will a heating pad could lead to burns. The other patient statements are correct and
a. "I will use a heating pad on my feet at night to increase indicate that teaching has been successful.
the circulation."
b. buy some loose clothes that do not bind across my
legs or waist."
c. walk to the point of pain, rest, and walk again for at
least 30 minutes 3 times a week."
d. change my position every hour and avoid long periods
of sitting with my legs crosse
Questions and CORRECT Answers
When discussing risk factor modification for a patient d. Uncontrolled hypertension
who has a 5-cm abdominal aortic aneurysm, the nurse
will focus teaching on which patient risk factor? All of the factors contribute to the patient's risk, but only hypertension can
a. Male gender potentially be modified to decrease the patient's risk for further expansion of the
b. Turner syndrome aneurysm.
c. Abdominal trauma history
d. Uncontrolled hypertension
A patient is hopitalized with a suspected abdominal b. angiography
aortic aneurysm. Which test will be used to image the
entire aortic system? Contrast media, which gives contrast images to map the entire aortic system is
a. xray used in angiography.
b. angiography pg 940, 941
c. ultrasound
d. electrocardiogram
A patient has a 6-cm thoracic aortic aneurysm that was b. trouble swallowing.
discovered during a routine chest x-ray. When obtaining
an admission history from the patient, it will be most Difficulty swallowing may occur with a thoracic aneurysm because of pressure on
important for the nurse to ask about the esophagus. The other symptoms will be important to assess for in patients
a. low back pain. with abdominal aortic aneurysms.
b. trouble swallowing.
c. abdominal tenderness.
d. changes in bowel habits.
The nurse is caring for a patient after an acute aortic b. morphine
dissection. The patient reports a pain level of 8 on a pain
scale of 0-10. Which medication would the nurse Patients with acute aortic dissection are managed in the ICU. An IV b-blocker (ex.
administer? esmolol) is titrated to a target HR under 60 beats/ min or SBP between 100 and
a. diltiazem 110mm Hg. A calcium channel blocker (ex. diltiazem) can be used to lower HR if a
b. morphine b-blocker is contraindicated. Morphine decreases sympathetic nervous system
c. verapamil stimulation and relieves pain. pg. 946
d. tinzaparin
Several hours after a patient had an open surgical repair d. increased IV infusion rate.
of an abdominal aortic aneurysm, the UAP reports to the
nurse that urinary output for the past 2 hours has been 45 The decreased urine output suggests decreased renal perfusion and monitoring
mL. The nurse notifies the health care provider and of renal function is needed. There is no indication that infection is a concern, so
anticipates an order for a(n) antibiotic therapy and a WBC count are not needed. The IV rate may be increased
because hypovolemia may be contributing to the patient's decreased urinary
a. hemoglobin count. output.
b. additional antibiotic.
c. serum creatinine level.
d. increased IV infusion rate.
, A patient in the outpatient clinic has a new diagnosis of a. Statins
peripheral artery disease (PAD). Which group of drugs
will the nurse plan to include when teaching about PAD Research indicates that statin use by patients with PAD improves multiple
management? outcomes. There is no research that supports the use of the other drug categories
a. Statins in PAD.
b. Antibiotics
c. Thrombolytics
d. Anticoagulants
An older patient with chronic atrial fibrillation develops d. keep the patient in bed in the supine position.
sudden severe pain, pulselessness, pallor, and coolness
in the right leg. The nurse should notify the health care The patient's history and clinical manifestations are consistent with acute arterial
provider and immediately occlusion, and resting the leg will decrease the O2 demand of the tissues and
a. apply a compression stocking to the leg. minimize ischemic damage until circulation can be restored. Elevating the leg or
b. elevate the leg above the level of the heart. applying an elastic wrap will further compromise blood flow to the leg. Exercise
c. assist the patient in gently exercising the leg. will increase oxygen demand for the tissues of the leg.
d. keep the patient in bed in the supine position.
A patient at the clinic says, "I always walk after dinner, but d. palpate for the presence of dorsalis pedis and posterior tibial pulses.
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 assess for other clinical manifestations of peripheral arterial
The nurse should disease in a patient who describes intermittent claudication. Changes in skin
a. look for the presence of tortuous veins bilaterally on color that occur in response to cold are consistent with Raynaud's phenomenon.
the legs. Tortuous veins on the legs suggest venous insufficiency. Unilateral leg swelling,
b. ask about any skin color changes that occur in redness, and tenderness indicate venous thromboembolism.
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.
The nurse performing an assessment of a patient who has c. prolonged capillary refill in all the toes.
chronic peripheral artery disease (PAD) of the legs and
an ulcer on the right second toe would expect to find Capillary refill is prolonged in PAD because of the slower and decreased blood
a. dilated superficial veins. flow to the periphery. The other listed clinical manifestations are consistent with
b. swollen, dry, scaly ankles. chronic venous disease.
c. prolonged capillary refill in all the toes.
d. serosanguineous drainage from the ulcer.
When evaluating the discharge teaching for a patient with a. "I will use a heating pad on my feet at night to increase the circulation."
chronic peripheral artery disease (PAD), the nurse
determines a need for further instruction when the Because the patient has impaired circulation and sensation to the feet, the use of
patient says, "I will a heating pad could lead to burns. The other patient statements are correct and
a. "I will use a heating pad on my feet at night to increase indicate that teaching has been successful.
the circulation."
b. buy some loose clothes that do not bind across my
legs or waist."
c. walk to the point of pain, rest, and walk again for at
least 30 minutes 3 times a week."
d. change my position every hour and avoid long periods
of sitting with my legs crosse
