Complete Questions and Guide Answers
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1. A nurse is caring for a client who has chronic venous insufficiency and a
prescription for thigh high compression stockings. Which action should the nurse
take?
a. elevate legs for 10 min, 2-3 times a day while wearing stockings
b. apply the stockings in the morning upon awakening and before getting out of bed
c. roll the stockings down to the knees to relieve discomfort on the legs
d. remove the stockings while out of bed for 1 hour, 4 times a day, to allow the legs to
rest
Answer B. Applying the stockings in the morning upon waking up before getting out of bed reduces venous stasis and assists in
the venous return of blood to the heart.
2. A nurse is assessing a client who has PAD. Which of the following should the nurse
expect?
a. edema around ankles and feet
,b. ulceration around the medial malleoli
c. scaling edema of the lower legs with stasis dermatitis
d. pallor on elevation of the limbs, and rubber when the limbs are dependent
Answer D. In a client who has PAD, pallor is seen in the extremities when the limbs are elevated, and rubor occurs when they are
lowered
3. A nurse is teaching a client who has a new diagnosis of severe peripheral arterial
disease. Which should the nurse include?
a. Wear tightly fitting insulated socks with shoes when going outside
b. elevate both legs above heart when resting
c. apply a heating pad to both legs for comfort
d. place both legs in dependent position while sleeping
Answer D. Such as hanging ott of the bed. This can alleviate swelling and discomfort of the legs
4. A nurse is teaching a client who has a new prescription for clopidogrel. Select all that
the nurse should include.
a. avoid consumption of grapefruit
b. monitor black and tarry stools
c. take this when you have pain
,d. schedule weekly PT test
e. Limit food sources containing vit. K while taking this
Answer A, B
5. A nurse is caring for a client who has a DVT and has been taking heparin for a week. Two
days ago, the provider also prescribed warfarin. The client asks the nurse about
receiving both at the same time. What should the nurse say?
a. I will remind your provider that you are already receiving heparin
b. your lab findings indicate that 2 anticoagulants are needed
c. it takes 3-4 days for the therapeutic effects of warfarin, and then heparin can be
discontinued
d. only one of these medications are being given to treat your DVT
Answer C. warfarin depresses synthesis of clotting factors but does not have an ettect on clotting factors that are present. It takes 3-
4 days for the clotting factors that are present to decay and for the therapeutic ettects of warfarin to occur.
6. A nurse in an outpatient clinic is assessing a client who reports night sweats and
fatigue. He states he had a cough along with nausea and diarrhea. His temperature is
38.1 C orally. The client is afraid he has HIV. Which action should the nurse take? Select all
that apply.
a. perform a physical assessment
, b. determine when s/s began
c. teach the client about HIV transmission
d. draw blood for HIV testing
e. obtain a sexual history
Answer a, b, e
7. a nurse is caring for a client who is suspected of having HIV. The nurse should identify
that which of the following DX tests and lab values are used to confirm HIV infection?
Select all that apply.
a. western blot
b. Indirect immunofluorescence assay
c. CD4+ T-lymphocyte count
d. HIV RNA quantification test
e. CSF analysis
Answer a, b
8. a nurse is providing teaching for a client who has stage 3 HIV disease. Which of the
following statements by the client should indicate to the nurse an understanding of
the teaching?