Scribd Logo
Upload

Welcome to Scribd!

  • 111 views

    Peripheral Vascular Diseases NCLEX

    Uploaded by

    Potchiee Pfizer
    The document contains a 20-item NCLEX review quiz on peripheral vascular diseases. It covers topics such as the pathophysiology of peripheral arterial disease, venous thrombosis, and treatments like anticoagulation therapy. Some key points addressed are the mechanisms of action and therapeutic effects of heparin and warfarin, assessment findings associated with conditions like deep vein thrombosis and abdominal aortic aneurysm, and nursing care for patients undergoing treatments for peripheral vascular issues.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    Peripheral Vascular Diseases NCLEX

    Uploaded by

    Potchiee Pfizer
    111 views6 pages
    The document contains a 20-item NCLEX review quiz on peripheral vascular diseases. It covers topics such as the pathophysiology of peripheral arterial disease, venous thrombosis, and treatments like anticoagulation therapy. Some key points addressed are the mechanisms of action and therapeutic effects of heparin and warfarin, assessment findings associated with conditions like deep vein thrombosis and abdominal aortic aneurysm, and nursing care for patients undergoing treatments for peripheral vascular issues.

    Copyright

    © © All Rights Reserved

    Available Formats

    PDF, TXT or read online from Scribd

    Did you find this document useful?

    Is this content inappropriate?

    The document contains a 20-item NCLEX review quiz on peripheral vascular diseases. It covers topics such as the pathophysiology of peripheral arterial disease, venous thrombosis, and treatments like anticoagulation therapy. Some key points addressed are the mechanisms of action and therapeutic effects of heparin and warfarin, assessment findings associated with conditions like deep vein thrombosis and abdominal aortic aneurysm, and nursing care for patients undergoing treatments for peripheral vascular issues.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    111 views6 pages

    Peripheral Vascular Diseases NCLEX

    Uploaded by

    Potchiee Pfizer
    The document contains a 20-item NCLEX review quiz on peripheral vascular diseases. It covers topics such as the pathophysiology of peripheral arterial disease, venous thrombosis, and treatments like anticoagulation therapy. Some key points addressed are the mechanisms of action and therapeutic effects of heparin and warfarin, assessment findings associated with conditions like deep vein thrombosis and abdominal aortic aneurysm, and nursing care for patients undergoing treatments for peripheral vascular issues.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    You are on page 1of 6

    Peripheral Vascular Diseases NCLEX

    1. The most important factor in regulating the caliber of blood vessels, which
    determines resistance to flow, is:

    1. Hormonal secretion
    2. Independent arterial wall activity.
    3. The influence of circulating chemicals
    4. The sympathetic nervous system

    2. With peripheral arterial insufficiency, leg pain during rest can be reduced by:

    1. Elevating the limb above heart level


    2. Lowering the limb so it is dependent
    3. Massaging the limb after application of cold compresses
    4. Placing the limb in a plane horizontal to the body

    3. Buerger’s disease is characterized by all of the following except:

    1. Arterial thrombosis formation and occlusion


    2. Lipid deposits in the arteries
    3. Redness or cyanosis in the limb when it is dependent
    4. Venous inflammation and occlusion

    4. A significant cause of venous thrombosis is:

    1. Altered blood coagulation


    2. Stasis of blood
    3. Vessel wall injury
    4. All of the above

    5. When caring for a patient who has started anticoagulant therapy with
    warfarin (Coumadin), the nurse knows not to expect therapeutic benefits for:

    1. At least 12 hours
    2. The first 24 hours
    3. 2-3 days
    4. 1 week

    6. Mike, a 43-year old construction worker, has a history of hypertension. He


    smokes two packs of cigarettes a day, is nervous about the possibility of being
    unemployed, and has difficulty coping with stress. His current concern is calf
    pain during minimal exercise that decreased with rest. The nurse assesses Mike’s
    symptoms as being associated with peripheral arterial occlusive disease. The
    nursing diagnosis is probably:

    1. Alteration in tissue perfusion related to compromised circulation


    2. Dysfunctional use of extremities related to muscle spasms
    3. Impaired mobility related to stress associated with pain
    4. Impairment in muscle use associated with pain on exertion.
    7. A 24-year old man seeks medical attention for complaints of claudication in
    the arch of the foot. A nurse also notes superficial thrombophlebitis of the lower
    leg. The nurse would next assess the client for:

    1. Familial tendency toward peripheral vascular disease


    2. Smoking history
    3. Recent exposures to allergens
    4. History of insect bites

    8. Intravenous heparin therapy is ordered for a client. While implementing this


    order, a nurse ensures that which of the following medications is available on the
    nursing unit?

    1. Vitamin K
    2. Aminocaproic acid
    3. Potassium chloride
    4. Protamine sulfate

    9. A client who has been receiving heparin therapy also is started on warfarin
    sodium (coumadin). The client asks the nurse why both medications are being
    administered. In formulating a response, the nurse incorporates the
    understanding that warfarin sodium:

    1. Stimulates the breakdown of specific clotting factors by the liver, and it takes 2-3
    days for this is exhibit an anticoagulant effect.
    2. Inhibits synthesis of specific clotting factors in the liver, and it takes 3 to 4 days for
    this medication to exert an anticoagulation effect.
    3. Stimulates production of the body’s own thrombolytic substances, but it takes 2-4
    days for it to begin.
    4. Has the same mechanism action of heparin, and the crossover time is needed for the
    serum level of warfarin sodium to be therapeutic.

    10. A nurse has an order to begin administering warfarin sodium (coumadin) to


    a client. While implementing this order, the nurse ensures that which of the
    following medications is available on the nursing unit as the antidote for
    Coumadin?

    1. Vitamin K
    2. Aminocaproic acid
    3. Potassium chloride
    4. Protamine sulfate

    11. A nurse is assessing the neurovascular status of a client who returned to the
    surgical nursing unit 4 hours ago after undergoing aortoiliac bypass graft. The
    affected leg is warm, and the nurse notes redness and edema. The pedal pulse is
    palpable and unchanged from admission. The nurse interprets that the
    neurovascular status is:

    1. Normal because of the increased blood flow through the leg


    2. Slightly deteriorating and should be monitored for another hour
    3. Moderately impaired, and the surgeon should be called.
    4. Adequate from the arterial approach, but venous complications are arising.

    12. A client is admitted with a venous stasis leg ulcer. A nurse assesses the ulcer,
    expecting to note that the ulcer:

    1. Has a pale colored base


    2. Is deep, with even edges
    3. Has little granulation tissue
    4. Has brown pigmentation around it.

    13. In preparation for discharge of a client with arterial insufficiency and


    Raynaud’s disease, client teaching instructions should include:

    1. Walking several times each day as an exercise program.


    2. Keeping the heat up so that the environment is warm
    3. Wearing TED hose during the day
    4. Using hydrotherapy for increasing oxygenation

    14. A client comes to the outpatient clinic and tells the nurse that he has had legs
    pains that began when he walks but cease when he stops walking. Which of the
    following conditions would the nurse assess for?

    1. An acute obstruction in the vessels of the legs


    2. Peripheral vascular problems in both legs
    3. Diabetes
    4. Calcium deficiency

    15. Which of the following characteristics is typical of the pain associated with
    DVT?

    1. Dull ache
    2. No pain
    3. Sudden onset
    4. Tingling

    16. Cancer can cause changes in what component of Virchow’s triad?

    1. Blood coagulability
    2. Vessel walls
    3. Blood flow
    4. Blood viscosity

    17. Varicose veins can cause changes in what component of Virchow’s triad?

    1. Blood coagulability
    2. Vessel walls
    3. Blood flow
    4. Blood viscosity
    18. Which technique is considered the gold standard for diagnosing DVT?

    1. Ultrasound imaging
    2. Venography
    3. MRI
    4. Doppler flow study

    19. A nurse is assessing a client with an abdominal aortic aneurysm. Which of


    the following assessment findings by the nurse is probably unrelated to the
    aneurysm?

    1. Pulsatile abdominal mass


    2. Hyperactive bowel sounds in that area
    3. Systolic bruit over the area of the mass
    4. Subjective sensation of “heart beating” in the abdomen.

    20. A nurse is caring for a client who had a percutaneous insertion of an inferior
    vena cava filter and was on heparin therapy before surgery. The nurse would
    inspect the surgical site most closely for signs of:

    1. Thrombosis and infection


    2. Bleeding and infection
    3. Bleeding and wound dehiscence.
    4. Wound dehiscence and evisceration.

    Answers and Rationale

    1. Answer: 4. The sympathetic nervous system

    2. Answer: 2. Lowering the limb so it is dependent

    3. Answer: 2. Lipid deposits in the arteries

    4. Answer: 4. All of the above

    5. Answer: 3. 2-3 days

    6. Answer: 1. Alteration in tissue perfusion related to compromised circulation

    7. Answer: 2. Smoking history

    The mixture of arterial and venous manifestations (claudication and phlebitis,


    respectively) in the young male client suggests Buerger’s disease. This is an
    uncommon disorder characterized by inflammation and thrombosis of smaller arteries
    and veins. This disorder typically is found in young adult males who smoke. The
    cause is not known precisely but is suspected to have an autoimmune component.

    8. Answer: 4. Protamine sulfate


    The antidote to heparin is protamine sulfate and should be readily available for use if
    excessive bleeding or hemorrhage should occur

    9. Answer: 2. Inhibits synthesis of specific clotting factors in the liver, and it


    takes 3 to 4 days for this medication to exert an anticoagulation effect.

    Warfarin sodium works in the liver and inhibits synthesis of four vitamin K-
    dependent clotting factors (X, IX, VII, and II), but it takes 3 to 4 days before the
    therapeutic effect of warfarin is exhibited.

    10. Answer: 1. Vitamin K

    The antidote to warfarin (Coumadin) is Vitamin K and should be readily available for
    use if excessive bleeding or hemorrhage should occur.

    11. Answer: 1. Normal because of the increased blood flow through the leg

    An expected outcome of surgery is warmth, redness, and edema in the surgical


    extremity because of increased blood flow. Options 2, 3, and 4 are incorrect
    interpretations.

    12. Answer: 4. Has brown pigmentation around it.

    Venous leg ulcers, also called stasis ulcers, tend to be more superficial than arterial
    ulcers, and the ulcer bed is pink. The edges of the ulcer are uneven, and granulation
    tissue is evident. The skin has a brown pigmentation from accumulation of metabolic
    waste products resulting from venous stasis. The client also exhibits peripheral
    edema. (options 1, 2, and 3 is due to tissue malnutrition; and thus us an arterial
    problem)

    13. Answer: 2. Keeping the heat up so that the environment is warm

    The client’s instructions should include keeping the environment warm to prevent
    vasoconstriction. Wearing gloves, warm clothes, and socks will also be useful when
    preventing vasoconstriction, but TED hose would not be therapeutic. Walking would
    most likely increase pain.

    14. Answer: 2. Peripheral vascular problems in both legs

    Intermittent claudication is a condition that indicates vascular deficiencies in the


    peripheral vascular system. If an obstruction were present, the leg pain would persist
    when the client stops walking. Low calcium levels may cause leg cramps but would
    not necessarily be related to walking.

    15. Answer: 3. Sudden onset

    DVT is associated with deep leg pain of sudden onset, which occurs secondary to the
    occlusion. A dull ache is more commonly associated with varicose veins. A tingling
    sensation is associated with an alteration in arterial blood flow. If the thrombus is
    large enough, it will cause pain.
    16. Answer: 1. Blood coagulability

    17. Answer: 3. Blood flow

    18. Answer: 2. Venography

    19. Answer: 2. Hyperactive bowel sounds in that area

    Not all clients with abdominal aortic aneurysms exhibit symptoms. Those who do
    describe a feeling of the “heart beating” in the abdomen when supine or be able to feel
    the mass throbbing. A pulsatile mass may be palpated in the middle and upper
    abdomen. A systolic bruit may be auscultated over the mass. Hyperactive bowel
    sounds are not related specifically to an abdominal aortic aneurysm.

    20. Answer: 2. Bleeding and infection

    After inferior vena cava insertion, the nurse inspects the surgical site for bleeding and
    signs and symptoms of infection. Otherwise, care is the same as for any post-op
    client.

    You might also like