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NR 304 Exam 1 Study Slides Questions
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What is PVD? -It's a blood circulation disorder that causes the blood vessels in the peripheral areas of the body (outside of the heart and brain specifically) to narrow, block, or spasm. -It can occur in both arteries and veins. (Ch. 20 pp, slide 2) What is PAD? Peripheral Artery Disease -Occurs only in the arteries (Ch 20 pp, slide 2) Which statement is true regarding the arterial system? A. Arteries are large-diameter vessels. B. The arterial system is a high-pressure system. C. The walls of arteries are thinner than those of the veins. D. Arteries can greatly expand to accommodate a large blood volume increase. B (Text, pg 509)
The nurse is reviewing the blood supply to the arm. The major artery supplying the arm is the _____ artery. A: Ulnar B: Radial C: Brachial D: Deep palmar C. (Text, pg 509) The nurse is preparing to assess the dorsalis pedis artery. Where is the correct location for palpation? A:Behind the knee B: Over the lateral malleolus C: In the groove behind the medial malleolus D: Lateral to the extensor tendon of the great toe D. (Text, pg 522) A 65-year-old patient is experiencing pain in his left calf when he exercises that disappears after resting for a few minutes. The nurse recognizes that this description is most consistent with _______ the left leg. A: Venous obstruction of your mom B: Claudication due to venous abnormalities C:Ischemia caused by a partial blockage of an artery supplying blood.
D: Increased thoracic pressure and decreased abdominal pressure facilitate venous return to the heart. A (Text, pg 511) Which vein(s) is (are) responsible for most of the venous return in the arm? A: Deep B: Ulnar C: Subclavian D: Superficial D (Text, pg 209) A 70-year-old patient is scheduled for open-heart surgery. The surgeon plans to use the great saphenous vein for the coronary bypass grafts. The patient asks, "What happens to my circulation when this vein is removed?" The nurse should reply: A: "Venous insufficiency is a common problem after this type of surgery." B: "Oh, you have lots of veins—you won't even notice that it has been removed." C: "You will probably experience decreased circulation after the vein is removed." D: "This vein can be removed without harming your circulation because the deeper veins in your leg are in good condition."
D
(Text pg 509) The nurse is reviewing the risk factors for venous disease. Which of these situations best describes a person at highest risk for the development of venous disease? Woman in her second month of pregnancy Person who has been on bed rest for 4 days Person with a 30-year, 1 pack per day smoking habit Older adult taking anticoagulant medication B (The book says smoking is the greatest risk which is not in alignment with the answer B being listed as correct. See text pg 513 under culture and genetics) The nurse is teaching a review class on the lymphatic system. A participant shows correct understanding of the material with which statement? "Lymph flow is propelled by the contraction of the heart." "The flow of lymph is slow, compared with that of the blood." "One of the functions of the lymph is to absorb lipids from the biliary tract." "Lymph vessels have no valves; therefore, lymph fluid flows freely from the tissue spaces into the bloodstream." B (Text pg 513)
B: the inguinal nodes are located near the groin and therefore would drain the left foot, which is the location of the infection. This would cause them to be enlarged and tender. -The cervical nodes are in the neck, and any hard and fixed lymph nodes are a serious indication of a disease process such as cancer
- Bilateral enlargement is incorrect as the infection is noted to only be present in the left foot. -The supraclavicular region is to far superior to be associated with a foot infection. (Text, pg 513) The nurse is examining the lymphatic system of a healthy 3- year-old child. Which finding should the nurse expect? Excessive swelling of the lymph nodes Presence of palpable lymph nodes No palpable nodes because of the immature immune system of a child Fewer numbers and a smaller size of lymph nodes compared with those of an adult B -The lymphatic system develops very quickly in children and is fully developed by six. This means they are large in size in proportion to their body, allowing many of the superficial nodes to be palpated in childhood. (Text pg 513)
During an assessment of an older adult, the nurse should expect to notice which finding as a normal physiologic change associated with the aging process? Hormonal changes causing vasodilation and a resulting drop in blood pressure Progressive atrophy of the intramuscular calf veins, causing venous insufficiency Peripheral blood vessels growing more rigid with age, producing a rise in systolic blood pressure Narrowing of the inferior vena cava, causing low blood flow and increases in venous pressure resulting in varicosities C (Text, pg 513 under the Aging Adult) A 67-year-old patient states that he recently began to have pain in his left calf when climbing the 10 stairs to his apartment. This pain is relieved by sitting for approximately 2 minutes; then he is able to resume his activities. The nurse interprets that this patient is most likely experiencing: Claudication. Sore muscles. Muscle cramps. Venous insufficiency A "With PAD, blood flow cannot match muscle demand during exercise; therefore people feel muscle fatigue or pain when walking (claudication). But only 10% of those with PAD have
During an assessment, the nurse uses the profile sign to detect: Pitting edema. Early clubbing. Symmetry of the fingers. Insufficient capillary refill. B Looking at the nail from the side (profile) is known as the profile sign and allows for assessment of early clubbing signs. (Text page 513) We have an expert-written solution to this problem! The nurse is performing an assessment on an adult. The adult's vital signs are normal, and capillary refill time is 5 seconds. What should the nurse do next? Ask the patient about a history of frostbite. Suspect that the patient has venous insufficiency. Consider this a delayed capillary refill time, and investigate further. Consider this a normal capillary refill time that requires no further assessment.
C
-A normal capillary refill time should be less than 2 seconds as we learned last session in 302. (Text pg 516, second box down on the right side) When assessing a patient, the nurse notes that the left femoral pulse as diminished, 1+/4+. What should the nurse do next? Document the finding. Auscultate the site for a bruit. Check for calf pain. Check capillary refill in the toes. B -If a pulse is weak in this area, you can auscultate for a bruit. (Text pg 520) When performing a peripheral vascular assessment on a patient, the nurse is unable to palpate the ulnar pulses. The patient's skin is warm and capillary refill time is normal. Next, the nurse should: Check for the presence of claudication. Refer the individual for further evaluation. Consider this finding as normal, and proceed with the peripheral vascular evaluation. Ask the patient if he or she has experienced any unusual cramping or tingling in the arm.
Unilateral cool foot Thin, shiny, atrophic skin Pallor of the toes and cyanosis of the nail beds Brownish discoloration to the skin of the lower leg D "-Brownish discoloration occurs with venous stasis due to deposits of hemosiderin from red blood cell degradation." (Text pg 519) The nurse is attempting to assess the femoral pulse in a patient who is obese. Which of these actions would be most appropriate? The patient is asked to assume a prone position. The patient is asked to bend his or her knees to the side in a frog like position. The nurse firmly presses against the bone with the patient in a semi-Fowler position. The nurse listens with a stethoscope for pulsations; palpating the pulse in an obese person is extremely difficult. B (Text pg 520) When auscultating over a patient's femoral arteries, the nurse notices the presence of a bruit on the left side. The nurse knows
that bruits: Are often associated with venous disease. Occur in the presence of lymphadenopathy. In the femoral arteries are caused by hypermetabolic states. Occur with turbulent blood flow, indicating partial occlusion. D (Text pg 520) How should the nurse document mild, slight pitting edema the ankles of a pregnant patient? 1+/0-4+ 3+/0-4+ 4+/0-4+ Brawny edema A. (Text pg 523) A patient has hard, nonpitting edema of the left lower leg and ankle. The right leg has no edema. Based on these findings, the nurse recalls that: Nonpitting, hard edema occurs with lymphatic obstruction. Alterations in arterial function will cause edema. Phlebitis of a superficial vein will cause bilateral edema. Long-standing arterial obstruction will cause pitting edema A -This is also sometimes called "Brawny edema" (Text pg 523)
Color returning to the feet within 20 seconds of assuming a sitting position. B (Text pg 523) During a visit to the clinic, a woman in her seventh month of pregnancy complains that her legs feel "heavy in the calf" and that she often has foot cramps at night. The nurse notices that the patient has dilated, tortuous veins apparent in her lower legs. Which condition is reflected by these findings? Deep-vein thrombophlebitis Varicose veins Lymphedema Raynaud phenomenon B (Text pg 531) We have an expert-written solution to this problem! During an assessment, the nurse notices that a patient's left arm is swollen from the shoulder down to the fingers, with nonpitting brawny edema. The right arm is normal. The patient had a left-sided mastectomy 1 year ago. The nurse suspects which problem? Venous stasis
Lymphedema Arteriosclerosis Deep-vein thrombosis B (Text pg 531) The nurse is preparing to assess the ankle-brachial index (ABI) of a patient. Which statement about the ABI is true? Normal ABI indices are from 0.5 to 1.0. Normal ankle pressure is slightly lower than the brachial pressure. The ABI is a reliable measurement of peripheral vascular disease in individuals with diabetes. An ABI of 0.9 to 0.7 indicates the presence of peripheral vascular disease and mild claudication. D (Text pg 525) Here's a youtube link from Stanford's School of Medicine that explains the process of of obtaining the ABI. https://www.youtube.com/watch?v=KnJDrmfIXGw The nurse is performing a well-child check up on a 5-year-old boy. He has no current condition that would lead the nurse to suspect an illness. His health history is unremarkable, and he received immunizations 1 week ago. Which of these findings
The nurse is describing a weak, thready pulse on the documentation flow sheet. Which statement is correct? "Is easily palpable; pounds under the fingertips." "Has greater than normal force, then suddenly collapses." "Is hard to palpate, may fade in and out, and is easily obliterated by pressure." "Rhythm is regular, but force varies with alternating beats of large and small amplitude." C (Text pg 516) During an assessment, a patient tells the nurse that her fingers often change color when she goes out in cold weather. She describes these episodes as her fingers first turning white, then blue, then red with a burning, throbbing pain. The nurse suspects that she is experiencing: Lymphedema. Raynaud disease. Deep-vein thrombosis. Chronic arterial insufficiency B (Text pg 530) We have an expert-written solution to this problem!
During a routine office visit, a patient takes off his shoes and shows the nurse "this awful sore that won't heal." On inspection, the nurse notes a 3-cm round ulcer on the left great toe, with a pale ischemic base, well-defined edges, and no drainage. The nurse should assess for other signs and symptoms of: Varicosities. Venous stasis ulcer. Arterial ischemic ulcer. Deep-vein thrombophlebitis. C (Text pg 531) The nurse is reviewing an assessment of a patient's peripheral pulses and notices that the documentation states that the radial pulses are "2+." The nurse recognizes that this reading indicates what type of pulse? A. Bounding B. Normal C. Weak D. Absent B (Text pg 516) We have an expert-written solution to this problem!
