Chapter 38: Nursing Management: Vascular Disorders

Chapter 38: Nursing Management: Vascular Disorders

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

MULTIPLE CHOICE
1. When discussing risk factor modification for a 60-year-old patient who has a 4-cm
abdominal aortic aneurysm, the nurse will focus patient teaching on which of these
patient risk factors?
a. Male gender
b. Marfan syndrome
c. Abdominal trauma history
d. Uncontrolled hypertension
ANS: D
All of the factors contribute to the patient’s risk, but only the hypertension can potentially
be modified to decrease the patient’s risk for further expansion of the aneurysm.
DIF: Cognitive Level: Application REF: 867-869
TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity
2. A patient has a 5-cm thoracic aortic aneurysm that was discovered during a routine chest
x-ray. When obtaining a nursing history from the patient, it will be most important to ask
about
a. back or lumbar pain.
b. difficulty swallowing.
c. abdominal tenderness.
d. changes in bowel habits.
ANS: B
Difficulty swallowing may occur with a thoracic aneurysm because of pressure on the
esophagus. The other symptoms will be important to assess for in patients with
abdominal aortic aneurysms.
DIF: Cognitive Level: Application REF: 868-869
TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity
3. Several hours after an open surgical repair of an abdominal aortic aneurysm, the patient
develops a urinary output of 20 mL/hr for 2 hours. The nurse notifies the health care
provider and anticipates orders for
a. an additional antibiotic.
b. a white blood cell (WBC) count.
c. a decrease in IV infusion rate.
d. a blood urea nitrogen (BUN) level.
ANS: D
Test Bank 38-2
The decreased urine output suggests decreased renal perfusion, and monitoring of renal
function is needed. There is no indication that infection is a concern, so antibiotic therapy
and a WBC count are not needed. The IV rate may be increased because hypovolemia
may be contributing to the patient’s decreased urinary output.
DIF: Cognitive Level: Application REF: 871-872 TOP: Nursing Process:
Planning
MSC: NCLEX: Physiological Integrity
4. A patient in the outpatient clinic has a new diagnosis of peripheral artery disease (PAD).
Which medication category will the nurse plan to include when providing patient
teaching about PAD management?
a. Statins
b. Vitamins
c. Thrombolytics
d. Anticoagulants
ANS: A
Current research indicates that statin use by patients with PAD improves multiple
outcomes. There is no research that supports the use of the other medication categories in
PAD.
DIF: Cognitive Level: Application REF: 875-876 TOP: Nursing Process:
Planning
MSC: NCLEX: Physiological Integrity
5. A patient with chronic atrial fibrillation develops sudden severe pain, pulselessness,
pallor, and coolness in the left leg. The nurse should notify the health care provider and
a. elevate the left leg on a pillow.
b. apply an elastic wrap to the leg.
c. assist the patient in gently exercising the leg.
d. keep the patient in bed in the supine position.
ANS: D
The patient’s history and clinical manifestations are consistent with acute arterial
occlusion, and resting the leg will decrease the oxygen demand of the tissues and
minimize ischemic damage until circulation can be restored. Elevating the leg or applying
an elastic wrap will further compromise blood flow to the leg. Exercise will increase
oxygen demand for the tissues of the leg.
DIF: Cognitive Level: Application REF: 880-881
TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity