Chapter 27--Vascular Dysfunction: Nursing Management

Chapter 27--Vascular Dysfunction: Nursing Management MULTIPLE CHOICE 1. Which of the following should the nurse instruct a client in order to reduce the risk factors for developing arteriosclerosis? 1. Limit die ...

Chapter 27--Vascular Dysfunction: Nursing Management MULTIPLE CHOICE 1. Which of the following should the nurse instruct a client in order to reduce the risk factors for developing arteriosclerosis? 1. Limit diet to contain less than 40% fat 2. Restrict exercise 3. Stop smoking 4. Avoid prescription medications PTS: 1 DIF: Apply REF: Arteriosclerosis and Atherosclerosis: Planning and Implementation: Goals 2. The nurse is concerned that an elderly client has evidence of arteriosclerosis since the client’s capillary refill is greater than: 1. 3 seconds. 2. 4 seconds. 3. 5 seconds. 4. 6 seconds. PTS: 1 DIF: Analyze REF: Arteriosclerosis and Atherosclerosis: Assessment with Clinical Manifestations 3. When instructing a client on ways to lower his cholesterol levels, which of the following should the nurse include? 1. Eat more meat and eggs. 2. Consume less meat and eggs. 3. Incorporate more vegetables. 4. Limit fruits. PTS: 1 DIF: Apply REF: Arteriosclerosis and Atherosclerosis: Planning and Implementation: Nutrition 4. A client diagnosed with arteriosclerosis is prescribed an anticoagulant. For which of the following should the nurse assess in this client? 1. Respiratory distress 2. Skin breakdown 3. Decreased urine output 4. Bruising and bleeding PTS: 1 DIF: Apply REF: Table 27-2 Pharmacology Facts: Pharmacology Therapy for Management of Arteriosclerosis and Atherosclerosis 5. The nurse is assessing a client diagnosed with an abdominal aortic aneurysm. Which of the following sounds did the nurse auscultate during the assessment? 1. Pleural rub 2. Hyperactive bowel sounds 3. Crackles 4. Bruit PTS: 1 DIF: Analyze REF: Aneurysms and Aortic Dissections: Assessment with Clinical Manifestations 6. A client is admitted with abdominal aortic aneurysm. For which of the following complications should the nurse be concerned? 1. Hypotension 2. Cardiac arrhythmias 3. Aneurysm rupture 4. Loss of bowel sounds PTS: 1 DIF: Analyze REF: Aneurysms and Aortic Dissections: Assessment with Clinical Manifestations 7. A client who has experienced signs of Virchow’s triad has developed a deep vein thrombosis. Which of the following is not a part of this triad? 1. Venous stasis 2. Vessel wall injury 3. Alteration in blood clotting 4. Pregnancy PTS: 1 DIF: Analyze REF: Thrombophlebitis: Pathophysiology 8. A client is diagnosed with Buerger’s disease. Which of the following should the nurse instruct the client regarding this disorder? 1. It is a common disorder. 2. It appears in women more than in men. 3. Smoking exacerbates the disease. 4. It is more common in African Americans. PTS: 1 DIF: Apply REF: Buerger's Disease: Epidemiology; Etiology 9. A client is diagnosed with Raynaud’s disease. Which of the following will the nurse most likely assess in this client? 1. Elevated blood pressure 2. Pain, cyanosis, and numb, cold extremities 3. Absent peripheral pulses 4. Increase in varicose veins PTS: 1 DIF: Apply REF: Raynaud's Phenomenon: Assessment with Clinical Manifestations 10. A client is diagnosed with acute peripheral arterial occlusion. The nurse should prepare to provide which of the following interventions for this client? 1. Administer oxygen. 2. Assist with ambulation. 3. Administer heparin as prescribed. 4. Restrict fluids. PTS: 1 DIF: Apply REF: Peripheral Arterial Occlusive Disease: Pharmacology 11. A client receiving a heparin infusion is demonstrating signs of acute bleeding. Which of the following should the nurse prepare to administer to this client? 1. Aspirin 2. Vitamin K 3. Protamine sulfate 4. Narcan PTS: 1 DIF: Apply REF: Thrombophlebitis: Pharmacology 12. A client’s blood pressure measurements have a 20 mmHg difference between the upper extremity readings. Which of the following does this assessment finding suggest to the nurse? 1. Arteriosclerosis 2. Aortic aneurysm 3. Deep vein thrombosis 4. Subclavian steal syndrome PTS: 1 DIF: Analyze REF: Subclavian Steal Syndrome: Assessment with Clinical Manifestations 13. The nurse is assessing a client for risks in the development of varicose veins. Which of the following findings would increase this client’s risk? 1. Normal weight 2. Prolonged standing 3. Engages in golf three times a week 4. Eats several servings of fruits and vegetables each day PTS: 1 DIF: Analyze REF: Varicose Veins: Etiology MULTIPLE RESPONSE 1. A client is having laboratory tests conducted to confirm a diagnosis of arteriosclerosis. Which of the following laboratory values would support this client’s medical diagnosis? (Select all that apply.) 1. Serum cholesterol 300 mg/dL 2. LDL 125 mg/dL 3. Blood glucose 90 mg/dL 4. HDL 45 mg/dL 5. Triglycerides 400 mg/dL 6. Serum potassium 4.0 mEq/L PTS: 1 DIF: Analyze REF: Table 27-1 Laboratory Tests: Recommended Cholesterol Screening Levels for Patients with Arteriosclerosis and Atherosclerosis 2. The nurse is assessing a client diagnosed with a peripheral arterial occlusion. Which of the following will the nurse assess in this client? (Select all that apply.) 1. Pulselessness 2. Pain 3. Pallor 4. Paresthesia 5. Paralysis 6. Petechiae PTS: 1 DIF: Apply REF: Peripheral Arterial Occlusive Disease: Assessment with Clinical Manifestations 3. The nurse is instructing a client recovering from arterial aneurysm repair. Which of the following should be included in these instructions? (Select all that apply.) 1. Do not lift anything heavier than 15 to 20 lbs. 2. Limit activity for up to 8 weeks after the surgery. 3. Use a pillow to splint when coughing. 4. Driving is permitted 1 week after surgery. 5. Notify the physician for pain, redness, or swelling around the incision. 6. Avoid pain medication. PTS: 1 DIF: Apply REF: Aneurysms and Aortic Dissections: Patient and Family Teaching 4. The nurse is utilizing the Wells Scale to assess a client for deep vein thrombosis. Which of the following is assessed when using this scale? (Select all that apply.) 1. Treatment for cancer 2. Recent immobility for greater than 3 days 3. Recovery from surgery with general anesthesia within 12 weeks 4. Entire leg edematous 5. Pitting edema of the symptomatic leg 6. Blood pressure 130/86 mmHg PTS: 1 DIF: Apply REF: Table 27-4 Modified Wells Clinical Score 5. A client is diagnosed with a venous stasis ulcer on the foot. Which of the following will be included in this client’s plan of care? (Select all that apply.) 1. Administer oral antibiotics if infection is present. 2. Keep the foot open to the air. 3. Cover the foot with a hydrocolloidal dressing. 4. Provide pain medication with debridement. 5. Restrict fluids. 6. Instruct the client to ambulate without shoes. PTS: 1 DIF: Apply REF: Venous Stasis Ulcer: Planning and Implementation