1. A 50-year-old woman weighs 95 kg and has a history of tobacco use, high blood pressure, high sodium intake, and sedentary lifestyle. When developing an individualized care plan for her, the nurse determines that the most important risk factors for peri
1. Correct answer: c
Rationale: Significant risk factors for peripheral artery disease include tobacco use, hyperlipidemia, elevated levels of high-sensitivity C-reactive protein, diabetes mellitus, and uncontrolled hypertension; the most important is tob
2. Rest pain is a manifestation of PAD that occurs due to a chronic
a. vasospasm of small cutaneous arteries in the feet.
b. increase in retrograde venous blood flow in the legs.
c. decrease in arterial blood flow to the nerves of the feet.
d. constrictio
2. Correct answer: c
Rationale: Rest pain most often occurs in the forefoot or toes and is aggravated by limb elevation. Rest pain occurs when blood flow is insufficient to meet basic metabolic requirements of the distal tissues. Rest pain occurs more oft
3. A patient with infective endocarditis develops sudden left leg pain with pallor, paresthesia, and a loss of peripheral pulses. The nurse's initial action should be to
a. elevate the leg to promote venous return.
b. start anticoagulant therapy with IV h
3. Correct answer: c
Rationale: The patient has potentially developed acute arterial ischemia (sudden interruption in the arterial blood supply to the extremity), caused by an embolism from a cardiac thrombus that occurred as a complication of infective e
4. Which clinical manifestations are seen in patients with either Buerger's disease or Raynaud's phenomenon (select all that apply)?
a. Intermittent fevers
b. Sensitivity to cold temperatures
c. Gangrenous ulcers on fingertips
d. Color changes of fingers
4. Correct answers: b, c, d
Rationale: Both Buerger's disease and Raynaud's phenomenon have the following clinical manifestations in common: cold sensitivity, ischemic and gangrenous ulcers on fingertips, and color changes of the distal extremity (fingers
5. A patient is admitted to the hospital with a diagnosis of abdominal aortic aneurysm. Which signs and symptoms would suggest that his aneurysm has ruptured?
a. Rapid onset of shortness of breath and hemoptysis
b. Sudden, severe low back pain and bruisin
5. Correct answer: b
Rationale: The clinical manifestations of a ruptured abdominal aortic aneurysm include severe back pain, back or flank ecchymosis (Grey Turner's sign), and hypovolemic shock (tachycardia, hypotension, pale clammy skin, decreased urine
6. What are the priority nursing interventions after an abdominal aortic aneurysm repair?
a. Assessment of cranial nerves and mental status
b. Administration of IV heparin and monitoring of PT
c. Administration of IV fluids and monitoring of kidney functi
6. Correct answer: c
Rationale: Postoperative priorities include administration of IV fluids and maintenance of renal perfusion. An adequate blood pressure is important for maintaining graft patency, and administration of IV fluids and blood components (a
7. The first priority of interprofessional care of a patient with a suspected acute aortic dissection is to
a. reduce anxiety.
b. monitor for chest pain.
c. control blood pressure.
d. increase myocardial contractility.
7. Correct answer: c
Rationale: The initial goals of therapy for acute aortic dissection without complications are blood pressure (BP) control and pain management. BP control reduces stress on the aortic wall by reducing systolic BP and myocardial contrac
8. The patient at highest risk for venous thromboembolism (VTE) is
a. a 62-year-old man with spider veins who is having arthroscopic knee surgery.
b. a 32-year-old woman who smokes, takes oral contraceptives, and is planning a trip to Europe.
c. a 26-year
8. Correct answer: b
Rationale: Three important factors (called Virchow's triad) in the etiology of venous thrombosis are (1) venous stasis, (2) damage of the endothelium (inner lining of the vein), and (3) hypercoagulability of the blood. Patients at ris
9. Which are clinical findings in a person with an acute lower extremity VTE (select all that apply)?
a. Pallor and coolness of foot and calf
b. Mild to moderate calf pain and tenderness
c. Grossly diminished or absent pedal pulses
d. Unilateral edema and
9. Correct answers: b, d
Rationale: The patient with lower extremity venous thromboembolism (VTE) may or may not have unilateral leg edema, extremity pain, a sense of fullness in the thigh or calf, paresthesias, warm skin, erythema, or a systemic temperat
10. The recommended treatment for an initial VTE in an otherwise healthy person with no significant co-morbidities would include
a. IV argatroban (Acova) as an inpatient.
b. IV unfractionated heparin as an inpatient.
c. subcutaneous unfractionated heparin
10. Correct answer: d
Rationale: Patients with confirmed VTE should receive initial treatment with low-molecular-weight heparin (LMWH), unfractionated heparin (UH), fondaparinux, or rivaroxaban, followed by warfarin for 3 months to maintain the internatio
11. A key aspect of teaching for the patient on anticoagulant therapy includes which instructions?
a. Monitor for and report any signs of bleeding.
b. Do not take acetaminophen (Tylenol) for a headache.
c. Decrease your dietary intake of foods containing
11. Correct answer: a
Rationale: Patients taking anticoagulants should be taught to monitor and report any signs of bleeding, which can be a serious complication. Other important patient teaching includes maintenance of a consistent intake of foods contai
12. In planning care and patient teaching for the patient with venous leg ulcers, the nurse recognizes that the most important intervention in healing and control of this condition is
a. discussing activity guidelines.
b. using moist environment dressings
12. Correct answer: d
Rationale: Compression is essential for treating chronic venous insufficiency (CVI), healing venous ulcers, and preventing ulcer recurrence. Use of custom-fitted graduated compression stockings is one option for compression therapy.
1. A 50-year-old woman weighs 95 kg and has a history of tobacco use, high blood pressure, high sodium intake, and sedentary lifestyle. When developing an individualized care plan for her, the nurse determines that the most important risk factors for peri
1. Correct answer: c
Rationale: Significant risk factors for peripheral artery disease include tobacco use, hyperlipidemia, elevated levels of high-sensitivity C-reactive protein, diabetes mellitus, and uncontrolled hypertension; the most important is tob
2. Rest pain is a manifestation of PAD that occurs due to a chronic
a. vasospasm of small cutaneous arteries in the feet.
b. increase in retrograde venous blood flow in the legs.
c. decrease in arterial blood flow to the nerves of the feet.
d. constrictio
2. Correct answer: c
Rationale: Rest pain most often occurs in the forefoot or toes and is aggravated by limb elevation. Rest pain occurs when blood flow is insufficient to meet basic metabolic requirements of the distal tissues. Rest pain occurs more oft
3. A patient with infective endocarditis develops sudden left leg pain with pallor, paresthesia, and a loss of peripheral pulses. The nurse's initial action should be to
a. elevate the leg to promote venous return.
b. start anticoagulant therapy with IV h
3. Correct answer: c
Rationale: The patient has potentially developed acute arterial ischemia (sudden interruption in the arterial blood supply to the extremity), caused by an embolism from a cardiac thrombus that occurred as a complication of infective e
4. Which clinical manifestations are seen in patients with either Buerger's disease or Raynaud's phenomenon (select all that apply)?
a. Intermittent fevers
b. Sensitivity to cold temperatures
c. Gangrenous ulcers on fingertips
d. Color changes of fingers
4. Correct answers: b, c, d
Rationale: Both Buerger's disease and Raynaud's phenomenon have the following clinical manifestations in common: cold sensitivity, ischemic and gangrenous ulcers on fingertips, and color changes of the distal extremity (fingers
5. A patient is admitted to the hospital with a diagnosis of abdominal aortic aneurysm. Which signs and symptoms would suggest that his aneurysm has ruptured?
a. Rapid onset of shortness of breath and hemoptysis
b. Sudden, severe low back pain and bruisin
5. Correct answer: b
Rationale: The clinical manifestations of a ruptured abdominal aortic aneurysm include severe back pain, back or flank ecchymosis (Grey Turner's sign), and hypovolemic shock (tachycardia, hypotension, pale clammy skin, decreased urine
6. What are the priority nursing interventions after an abdominal aortic aneurysm repair?
a. Assessment of cranial nerves and mental status
b. Administration of IV heparin and monitoring of PT
c. Administration of IV fluids and monitoring of kidney functi
6. Correct answer: c
Rationale: Postoperative priorities include administration of IV fluids and maintenance of renal perfusion. An adequate blood pressure is important for maintaining graft patency, and administration of IV fluids and blood components (a
7. The first priority of interprofessional care of a patient with a suspected acute aortic dissection is to
a. reduce anxiety.
b. monitor for chest pain.
c. control blood pressure.
d. increase myocardial contractility.
7. Correct answer: c
Rationale: The initial goals of therapy for acute aortic dissection without complications are blood pressure (BP) control and pain management. BP control reduces stress on the aortic wall by reducing systolic BP and myocardial contrac
8. The patient at highest risk for venous thromboembolism (VTE) is
a. a 62-year-old man with spider veins who is having arthroscopic knee surgery.
b. a 32-year-old woman who smokes, takes oral contraceptives, and is planning a trip to Europe.
c. a 26-year
8. Correct answer: b
Rationale: Three important factors (called Virchow's triad) in the etiology of venous thrombosis are (1) venous stasis, (2) damage of the endothelium (inner lining of the vein), and (3) hypercoagulability of the blood. Patients at ris
9. Which are clinical findings in a person with an acute lower extremity VTE (select all that apply)?
a. Pallor and coolness of foot and calf
b. Mild to moderate calf pain and tenderness
c. Grossly diminished or absent pedal pulses
d. Unilateral edema and
9. Correct answers: b, d
Rationale: The patient with lower extremity venous thromboembolism (VTE) may or may not have unilateral leg edema, extremity pain, a sense of fullness in the thigh or calf, paresthesias, warm skin, erythema, or a systemic temperat
10. The recommended treatment for an initial VTE in an otherwise healthy person with no significant co-morbidities would include
a. IV argatroban (Acova) as an inpatient.
b. IV unfractionated heparin as an inpatient.
c. subcutaneous unfractionated heparin
10. Correct answer: d
Rationale: Patients with confirmed VTE should receive initial treatment with low-molecular-weight heparin (LMWH), unfractionated heparin (UH), fondaparinux, or rivaroxaban, followed by warfarin for 3 months to maintain the internatio
11. A key aspect of teaching for the patient on anticoagulant therapy includes which instructions?
a. Monitor for and report any signs of bleeding.
b. Do not take acetaminophen (Tylenol) for a headache.
c. Decrease your dietary intake of foods containing
11. Correct answer: a
Rationale: Patients taking anticoagulants should be taught to monitor and report any signs of bleeding, which can be a serious complication. Other important patient teaching includes maintenance of a consistent intake of foods contai
12. In planning care and patient teaching for the patient with venous leg ulcers, the nurse recognizes that the most important intervention in healing and control of this condition is
a. discussing activity guidelines.
b. using moist environment dressings
12. Correct answer: d
Rationale: Compression is essential for treating chronic venous insufficiency (CVI), healing venous ulcers, and preventing ulcer recurrence. Use of custom-fitted graduated compression stockings is one option for compression therapy.