Chapter 37: Vascular Disorders
Linton: Introduction to Medical–Surgical Nursing, 6th Edition
MULTIPLE CHOICE
1. What is a normal age-related change in older adults that makes them susceptible to
cardiovascular disease?
a.
Increase in cardiac output
b.
Increase in stroke volume
c.
Stiff peripheral vessels
d.
Oxygen capacity improvement
2. What should a nurse ask a patient related to past history of deep-vein thrombosis (DVT) and
other vascular problems?
a.
An aneurysm
b.
Rheumatoid arthritis
c.
A peptic ulcer
d.
Recurring chest pain
3. A 69-year-old patient reports a burning, aching pain in the legs when walking to the mailbox.
These symptoms are relieved with rest. What should the nurse suspect?
a.
Venous insufficiency
b.
Claudication
c.
Phlebitis
d.
Rest pain
4. A nurse records the assessment of stasis dermatitis on an intake assessment for a patient with
peripheral vascular disease (PVD). What is the best way to describe this finding?
a.
Brownish skin discoloration on the lower legs
b.
Ulceration on medial surface of the lower legs
c.
Edema in the lower legs
d.
Purple rash on medial surface of the lower legs
5. A nurse assesses a patient’s capillary refill time as less than 3 seconds. What does this
assessment indicate?
a.
Hypertension
b.
Tissue perfusion
c.
Excess fluid volume
d.
Increased blood viscosity
6. A nurse performs Homans maneuver by flexing the knee and sharply dorsiflexing the foot.
What response indicates a positive Homans sign?
a.
Cramping of the toes
b.
Resisting dorsiflexion
c.
Pain in the calf area
d.
Blanching of the sole
7. Which technique should the nurse implement when performing the Allen test on a patient to
evaluate the adequacy of circulation in the radial artery?
a.
Asks the patient to relax the hand by the side
b.
Compresses only the ulnar artery to blanch the hand
c.
Releases pressure on both arteries at the same time
d.
Observes whether the color is returning to the hand, which indicates perfusion
8. A nurse records that a patient has a 3+ edema to the right foot. How deep did the nurse’s
thumb depress the edematous area?
a.
More than 1 inch
b.
To 1 inch
c.
To inch
d.
Less than inch
9. A nurse notes ulcerations on the surfaces of a patient’s toes. What should this assessment
most likely indicate?
a.
Skin breakdown from pressure
b.
Nutritional deficit
c.
Venous stasis
d.
Arterial stasis
10. What is a characteristic of a venous stasis ulcer?
a.
Painlessness
b.
Poikilothermy
c.
Pale color
d.
Location near the groin
11. A nurse is caring for a patient who has had an angiogram. What should the nurse make a point
of care to assess and document on this patient?
a.
Fluid intake
b.
Peripheral pulses in the affected leg
c.
Inquiring about an allergy to iodine
d.
Decreased blood pressure
12. A nurse is educating a patient regarding a stress test on a treadmill. Teaching includes that this
test is a noninvasive procedure. What additional information is appropriate for the nurse to
include?
a.
Is monitored continuously by blood pressure and an electrocardiogram
b.
Will last about 1 hour
c.
Is meant to stimulate claudication and dyspnea
d.
Will require a period of bedrest afterward
13. A patient inquires how something as simple as walking could help his venous vascular
disorder. What is the best response by the nurse when explaining the benefits of walking?
a.
Improves the strength of the vascular walls
b.
Boosts venous circulation through leg muscle activity
c.
Increases cardiac output
d.
Clears plaques from the veins
14. What is contraindicated for a patient performing Buerger-Allen exercises?
a.
Lying on the stomach
b.
Raising legs for 2 minutes until they blanch
c.
Lowering the legs until the color returns
d.
Keeping legs flat for 5 minutes and then repeat the exercise
15. A nurse cautions a patient with peripheral vascular disease (PVD) that continued smoking
causes detrimental vasoconstriction for up to ____ after only one cigarette.
a.
10 minutes
b.
20 minutes
c.
30 minutes
d.
1 hour
16. A nurse is performing an intake examination on a patient with peripheral vascular disease
(PVD). Which lifestyle information identified by the patient aggravates vascular disease?
a.
Riding a bicycle to work
b.
Drinking red wine every day
c.
Being employed as an air traffic controller
d.
Eating chocolate candy every day
17. Vascular disease disorders often require the use of elastic stockings. Which action should the
nurse implement when caring for a patient with elastic stockings?
a.
Apply the stockings and roll down the cuff.
b.
Remove the stockings for skin inspection two times a day.
c.
Remove the stockings when the patient is ambulating.
d.
Inspect the skin for pressure or irritation daily.
18. Which instruction is most appropriate for a patient with arterial insufficiency?
a.
Frequently allow the legs to dangle dependently.
b.
Rub the legs vigorously.
c.
Stand often to keep blood flow in the legs.
d.
Walk barefoot.
19. A nurse is preparing to administer low-molecular-weight heparin (LMWH). What is a major
advantage related to the administration of LMWH?
a.
It can be given orally.
b.
It is provided fixed doses.
c.
It is given only after partial thromboplastin time (PTT) laboratory work.
d.
It provides an immediate effect.
20. Which statement made by a patient indicates to the nurse that a teaching plan for the use of
warfarin was not effective?
a.
“I don’t take aspirin anymore.”
b.
“I read that grapefruit interferes with warfarin.”
c.
“I’m drinking too much tea. My urine looks like tea.”
d.
“I wear my medical alert bracelet all the time.”
21. A patient has returned from a vein ligation and stripping. What are the appropriate instructions
for a nurse to provide?
a.
Dangle the legs to prevent edema.
b.
Cross the legs to apply pressure.
c.
Wear compression stockings to promote circulation.
d.
Remove the drain after 24 hours.
22. What medication obtained in a patient’s history will lessen the effects of warfarin
(Coumadin)?
a.
Iron supplement for anemia
b.
Simvastatin (Zocor) for the control of cholesterol
c.
Furosemide (Lasix) for fluid retention
d.
Yaz (drospirenone/estradiol) as an oral contraceptive
23. An obese postsurgical patient complains of sudden discomfort in her leg. The nurse assesses
the leg and finds it cold and pale with no pedal or popliteal pulse. What should the nurse
suspect?
a.
Venous thrombosis
b.
Arterial occlusion
c.
Vascular spasm
d.
Paresthesia
24. Which postoperative sign should a nurse report immediately when caring for a patient with an
endarterectomy with a synthetic graft?
a.
Headache
b.
Fever
c.
Edema
d.
Pain
25. A patient with Raynaud disease has a nursing diagnosis of “Ineffective tissue perfusion,
related to vasoconstriction” and is being given discharge instructions. What should the nurse
include when providing this information?
a.
Avoid sun exposure.
b.
Wear gloves and warm socks when outdoors.
c.
Chafe hands frequently to warm them.
d.
Wash dishes in warm water.
26. What assessment should a nurse perform on a patient after the repair of an abdominal aortic
aneurysm?
a.
Periorbital edema
b.
Tremor or facial twitching
c.
Rising blood pressure
d.
Bowel sounds
27. What patient teaching should be included for a patient with varicose veins?
a.
Weight reduction
b.
Decreasing exercise
c.
Wearing a panty girdle
d.
Standing rather than sitting
MULTIPLE RESPONSE
28. Why do older persons adapt more slowly to changes in the peripheral vascular system? (Select
all that apply.)
a.
Slowing heart rate
b.
Decreasing cardiac output
c.
Increasing stroke volume
d.
Stiffening of blood vessels
e.
Thickening of aorta
29. A nurse suspects a circulatory disorder in one leg. Which assessments should the nurse
include when comparing both legs? (Select all that apply.)
a.
Color
b.
Warmth
c.
Muscle strength
d.
Pulse quality
e.
Hair loss on extremity
COMPLETION
30. A nurse explains that the lining of a vessel that allows for smooth blood flow and also reduced
resistance in the vessel is the _____ of the vessel.
31. A nurse explains that when a patient history reveals a recent episode of vomiting and diarrhea,
the nurse anticipates that this fluid loss will cause _____ and increased blood viscosity.