Review Peripheral vascular disease

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Peripheral vascular disease

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Question 1:

A client reports experiencing leg pain while walking that improves with rest. The nurse should suspect which peripheral vascular disease?

A. Deep vein thrombosis (DVT) B. Peripheral artery disease (PAD) C. Raynaud's disease D. Varicose veins

Answer and Explanation

Choice A:

This choice is incorrect because deep vein thrombosis (DVT) is a condition where a blood clot forms in a deep vein, typically in the legs. DVT is characterized by swelling, warmth, and redness in the affected leg, but it does not cause leg pain that improves with rest.

Choice B:

This choice is correct. Peripheral artery disease (PAD) is a condition where there is a narrowing or blockage of the arteries in the extremities, leading to reduced blood flow. The hallmark symptom of PAD is intermittent claudication, which is leg pain that occurs during walking or physical activity and improves with rest.

Choice C:

This choice is incorrect because Raynaud's disease is a disorder that affects the blood vessels in the fingers and toes, causing them to spasm and turn white, then blue, and finally red. It is not characterized by leg pain while walking.

Choice D:

This choice is incorrect because varicose veins are enlarged and twisted veins, usually in the legs, that can cause discomfort and cosmetic concerns. However, they do not typically cause leg pain that improves with rest.

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Question 2:

A nurse is assessing a client with suspected peripheral vascular disease. Which finding is most concerning and requires immediate intervention?

A. Swelling and tenderness in the calf B. Intermittent claudication during physical activity C. Cold, pale, and numb fingers or toes D. Ulceration on the lower leg with foul-smelling discharge

Answer and Explanation

Choice A:

This choice is concerning and may indicate deep vein thrombosis (DVT). Swelling and tenderness in the calf can be a sign of a blood clot, and immediate evaluation is required to prevent potential complications such as a pulmonary embolism. However, it is not as critical as the finding in option D.

Choice B:

This choice is concerning and may indicate peripheral artery disease (PAD). Intermittent claudication during physical activity suggests reduced blood flow to the extremities, but it does not require immediate intervention.

Choice C:

This choice is concerning and may indicate Raynaud's disease. Raynaud's disease involves the fingers or toes turning white, then blue, and finally red due to blood vessel spasms, but it is not as urgent as the finding in option D.

Choice D:

This choice is correct. Ulceration on the lower leg with foul-smelling discharge indicates a severe complication of peripheral vascular disease, possibly related to peripheral artery disease (PAD) or venous insufficiency. Ulcers that have an unpleasant odor and are not healing require immediate intervention to prevent infection and further tissue damage.

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Question 3:

A client has a history of smoking, diabetes, and hypertension. The nurse should recognize that these risk factors contribute to the development of which peripheral vascular disease?

A. Deep vein thrombosis (DVT) B. Raynaud's disease C. Peripheral artery disease (PAD) D. Varicose veins

Answer and Explanation

Choice A:

This choice is incorrect because while smoking can be a risk factor for deep vein thrombosis (DVT), diabetes and hypertension are not significant risk factors for this condition. DVT is more commonly associated with prolonged immobility, surgery, or trauma.

Choice B:

This choice is incorrect because Raynaud's disease is not directly related to smoking, diabetes, or hypertension. Raynaud's disease involves blood vessel spasms and is more commonly associated with exposure to cold temperatures or stress.

Choice C:

This choice is correct. Peripheral artery disease (PAD) involves the narrowing or blockage of arteries in the extremities, leading to reduced blood flow. Smoking, diabetes, and hypertension are significant risk factors for the development of PAD. Smoking damages blood vessels, diabetes increases the risk of atherosclerosis (plaque buildup in arteries), and hypertension can lead to arterial damage and narrowing.

Choice D:

This choice is incorrect because varicose veins are typically caused by weakened or damaged valves in the veins, leading to the pooling of blood and the development of enlarged and twisted veins. Smoking, diabetes, and hypertension are not primary risk factors for varicose veins.

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Question 4:

A nurse is providing education to a client with peripheral vascular disease about ways to improve blood circulation. Which activity should the nurse recommend?

A. Elevating the legs above heart level while sitting. B. Applying direct heat to the affected extremities. C. Crossing the legs while seated to improve venous return. D. Limiting physical activity to avoid exacerbating symptoms.

Answer and Explanation

Choice A:

This choice is correct. Elevating the legs above heart level while sitting can improve venous return, reducing swelling and promoting blood circulation in the legs. This position helps counteract the effects of gravity on blood flow.

Choice B:

This choice is incorrect because applying direct heat to the affected extremities is not a recommended method for improving blood circulation in peripheral vascular disease. Heat can cause vasodilation, which may exacerbate symptoms such as swelling and pain.

Choice C:

This choice is incorrect because crossing the legs while seated can impede venous return and contribute to blood pooling in the legs. It is not a recommended activity for individuals with peripheral vascular disease.

Choice D:

This choice is incorrect because limiting physical activity is not recommended for individuals with peripheral vascular disease. Regular physical activity, such as walking, can actually improve blood circulation and overall vascular health. However, individuals with peripheral vascular disease should be cautious not to overexert themselves and should consult with their healthcare provider regarding appropriate levels of physical activity.Questions

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Question 5:

A nurse is teaching a client about the contributing factors to peripheral vascular diseases. The nurse explains that the most common cause of peripheral artery disease (PAD) is:

A. Smoking. B. Sedentary lifestyle. C. Family history of PAD. D. High dietary sodium intake.

Answer and Explanation

Choice A:

This choice is correct. Smoking is the most significant risk factor for peripheral artery disease (PAD). Smoking damages blood vessels, promotes atherosclerosis (plaque buildup in arteries), and narrows blood vessels, leading to reduced blood flow to the extremities.

Choice B:

This choice is incorrect because while a sedentary lifestyle can be a contributing factor to peripheral vascular diseases, it is not the most common cause of PAD.

Choice C:

This choice is incorrect because while family history can play a role in the development of PAD, it is not the most common cause. Other modifiable risk factors, such as smoking and diabetes, have a more significant impact on PAD.

Choice D:

This choice is incorrect because high dietary sodium intake is not a direct cause of PAD. However, reducing sodium intake can benefit overall cardiovascular health, especially for individuals with hypertension.

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Question 6:

A client with diabetes asks a nurse about the increased risk of peripheral vascular disease (PAD) in diabetes. The nurse explains that diabetes contributes to PAD primarily through:

A. Decreased blood glucose levels. B. Increased insulin production. C. Impaired blood vessel function. D. Elevated white blood cell count.

Answer and Explanation

Choice A:

This choice is incorrect because decreased blood glucose levels are not associated with an increased risk of peripheral vascular disease (PAD) in diabetes. In fact, hypoglycemia (low blood glucose levels) can lead to acute complications but is not a significant factor in the development of PAD.

Choice B:

This choice is incorrect because increased insulin production is not a primary factor contributing to PAD in diabetes. Insulin is essential for glucose metabolism but does not directly impact blood vessel function.

Choice C:

This choice is correct. Diabetes can lead to impaired blood vessel function, primarily through the process of atherosclerosis. High blood glucose levels can damage blood vessel walls, leading to plaque buildup and narrowing of the arteries, reducing blood flow to the extremities and contributing to PAD.

Choice D:

This choice is incorrect because an elevated white blood cell count is not directly related to the increased risk of PAD in diabetes. While chronic inflammation and white blood cell count can play a role in atherosclerosis, it is not the primary factor contributing to PAD in diabetes.

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Question 7:

A nurse is assessing a client with peripheral vascular disease. Which condition is a significant risk factor for the development of venous insufficiency?

A. Hypertension B. Atherosclerosis C. Deep vein thrombosis (DVT) D. Raynaud's disease

Answer and Explanation

Choice A:

This choice is incorrect because hypertension (high blood pressure) is not a significant risk factor for venous insufficiency. Venous insufficiency involves the impairment of venous valves and blood flow in the veins, not arterial hypertension.

Choice B:

This choice is incorrect because atherosclerosis is associated with peripheral artery disease (PAD), not venous insufficiency. Atherosclerosis involves the buildup of plaque in the arteries, leading to reduced blood flow in the extremities.

Choice C:

This choice is correct. Deep vein thrombosis (DVT) is a condition where a blood clot forms in a deep vein, most commonly in the legs. DVT can lead to damage to the venous valves and veins, causing venous insufficiency and complications such as chronic venous insufficiency and venous ulcers.

Choice D:

This choice is incorrect because Raynaud's disease primarily affects the fingers and toes, causing them to spasm and change color in response to cold or stress. It is not directly related to the development of venous insufficiency.

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Question 8:

A client with a history of hypertension, hyperlipidemia, and obesity is at risk for developing peripheral vascular disease (PAD) due to:

A. Increased blood viscosity. B. Hypercoagulability of the blood. C. Impaired cardiac function. D. Formation of atherosclerotic plaques.

Answer and Explanation

Choice A:

This choice is incorrect because increased blood viscosity (thickness) is not primarily associated with hypertension, hyperlipidemia, or obesity. It is more commonly associated with conditions such as polycythemia or dehydration.

Choice B:

This choice is incorrect because hypercoagulability of the blood is not a direct risk factor associated with hypertension, hyperlipidemia, or obesity. Hypercoagulability is more commonly associated with conditions such as certain clotting disorders.

Choice C:

This choice is incorrect because impaired cardiac function is not a direct risk factor for the development of PAD in the context of hypertension, hyperlipidemia, or obesity. However, impaired cardiac function can contribute to heart-related peripheral vascular diseases, such as congestive heart failure.

Choice D:

This choice is correct. Hypertension, hyperlipidemia, and obesity are significant risk factors for the formation of atherosclerotic plaques in the arteries. Atherosclerosis involves the buildup of plaque, including cholesterol and other substances, on the arterial walls, leading to narrowed and hardened arteries, reducing blood flow to the extremities and contributing to PAD.

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Question 9:

A nurse is educating a client about risk factors for peripheral vascular diseases. The client asks about the role of age in developing these conditions. The nurse explains that as individuals age, the risk of peripheral vascular diseases:

A. Increases due to the weakening of arterial walls. B. Decreases due to improved physical fitness. C. Remains stable with no significant changes. D. Varies depending on gender and ethnicity.

Answer and Explanation

Choice A:

This choice is correct. As individuals age, the risk of peripheral vascular diseases increases due to several factors, including the weakening of arterial walls and the accumulation of plaque in the arteries (atherosclerosis). Aging is associated with changes in blood vessels, such as decreased elasticity and increased stiffness, which can contribute to the development of peripheral vascular diseases.

Choice B:

This choice is incorrect because while physical fitness can influence the risk of cardiovascular diseases, age-related changes in blood vessels can still increase the risk of peripheral vascular diseases, even in physically fit individuals.

Choice C:

This choice is incorrect because the risk of peripheral vascular diseases does not remain stable with no significant changes. Aging is associated with various physiological changes that can impact cardiovascular health and increase the risk of peripheral vascular diseases.

Choice D:

This choice is incorrect because while gender and ethnicity can influence the risk of certain conditions, age is a significant independent risk factor for the development of peripheral vascular diseases. The age-related changes in blood vessels apply to individuals of all genders and ethnicities.Questions

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Question 10:

A client with peripheral vascular disease (PAD) reports experiencing pain in their legs that occurs with walking and is relieved by rest. The nurse recognizes this symptom as:

A. Intermittent claudication. B. Deep vein thrombosis (DVT). C. Raynaud's phenomenon. D. Chronic venous insufficiency.

Answer and Explanation

Choice A:

This choice is correct. Intermittent claudication is a hallmark symptom of peripheral arterial disease (PAD). It refers to pain, cramping, or weakness in the legs that occurs during physical activity and is relieved by rest. This symptom is due to reduced blood flow and oxygen supply to the muscles during exercise.

Choice B:

This choice is incorrect because deep vein thrombosis (DVT) typically presents with symptoms such as swelling, warmth, and tenderness in the affected leg, but it does not cause pain that is relieved by rest.

Choice C:

This choice is incorrect because Raynaud's phenomenon primarily affects the fingers and toes, causing them to turn white, then blue, and finally red due to blood vessel spasms in response to cold or stress. It is not associated with pain in the legs during walking.

Choice D:

This choice is incorrect because chronic venous insufficiency involves symptoms such as leg swelling, skin changes, and the development of venous ulcers, but it is not characterized by pain that occurs with walking and is relieved by rest.

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Question 11:

A nurse is assessing a client with suspected peripheral vascular disease. Which finding is most concerning and requires immediate intervention?

A. Non-healing ulcer on the lower leg. B. Occasional leg cramps at night. C. Mild coolness of the feet bilaterally. D. Visible varicose veins on the calves.

Answer and Explanation

Choice A:

This choice is correct. A non-healing ulcer on the lower leg is a significant concern and requires immediate intervention. Non-healing ulcers can be a complication of peripheral vascular disease and may indicate impaired blood flow and tissue damage. Prompt assessment and treatment are necessary to prevent infection and promote wound healing.

Choice B:

This choice is incorrect because occasional leg cramps at night can be a common symptom, especially in older adults, and are not typically indicative of an acute medical emergency.

Choice C:

This choice is incorrect because mild coolness of the feet bilaterally can be a sign of reduced blood flow, but it is not an immediate concern requiring urgent intervention. However, it should be further assessed to determine the severity of the vascular condition.

Choice D:

This choice is incorrect because visible varicose veins on the calves, while often a cosmetic concern, are not typically associated with immediate risks. Varicose veins are dilated and twisted veins that result from venous insufficiency but are not an urgent medical condition.

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Question 12:

A nurse is teaching a client with peripheral vascular disease about skin care. The nurse should instruct the client to:

A. Use heating pads to warm cold feet. B. Avoid moisturizing the skin to prevent infections. C. Inspect the feet daily for any changes. D. Elevate the legs above heart level for extended periods.

Answer and Explanation

Choice A:

This choice is incorrect because using heating pads to warm cold feet can cause burns or injuries, especially in clients with impaired sensation due to peripheral vascular disease. Clients with PAD may experience cold feet due to reduced blood flow, but external heating sources should be used with caution.

Choice B:

This choice is incorrect because moisturizing the skin is essential for individuals with peripheral vascular disease to prevent dryness and cracking, which can lead to skin breakdown and infections. Proper skin care is important to maintain skin integrity and prevent complications.

Choice C:

This choice is correct. Clients with peripheral vascular disease should inspect their feet daily for any changes, such as cuts, sores, blisters, or signs of infection. Reduced blood flow can slow down wound healing, and prompt identification and treatment of foot problems are crucial to prevent infections and potential complications.

Choice D:

This choice is incorrect because while elevating the legs above heart level can temporarily improve blood flow and reduce swelling, prolonged elevation can impede blood flow and is not recommended for extended periods. Clients with PAD should be encouraged to perform regular, moderate physical activity to improve blood circulation.

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Question 13:

A client with peripheral vascular disease (PAD) reports experiencing numbness and tingling in their feet. The nurse should suspect:

A. Arterial insufficiency. B. Venous insufficiency. C. Peripheral nerve compression. D. Systemic inflammation.

Answer and Explanation

Choice A:

This choice is correct. Numbness and tingling in the feet are symptoms associated with arterial insufficiency in peripheral vascular disease (PAD). Reduced blood flow to the extremities can lead to sensory changes and discomfort, including numbness and tingling.

Choice B:

This choice is incorrect because venous insufficiency is more commonly associated with symptoms such as leg swelling, skin changes, and the development of venous ulcers, but it does not typically cause numbness and tingling in the feet.

Choice C:

This choice is incorrect because peripheral nerve compression can cause localized numbness and tingling, but it is not a primary symptom of peripheral vascular disease. Peripheral nerve compression may occur due to various factors, such as nerve impingement or entrapment.

Choice D:

This choice is incorrect because systemic inflammation is not a direct cause of numbness and tingling in the feet in peripheral vascular disease. Systemic inflammation can contribute to other conditions, but it is not the primary cause of sensory changes associated with PAD.

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Question 14:

A client with peripheral vascular disease (PAD) is prescribed cilostazol, a medication that improves blood flow in the legs. The nurse should instruct the client to:

A. Increase the dosage if experiencing leg pain. B. Take the medication on an empty stomach. C. Avoid grapefruit juice while on cilostazol. D. Use compression stockings to promote blood flow.

Answer and Explanation

Choice A:

Increasing the dosage of cilostazol without consulting a healthcare provider is not recommended and can be dangerous.

Choice B:

This choice is incorrect because cilostazol can be taken with or without food. The client may choose to take the medication with food if they experience gastrointestinal upset, but it is not necessary to take it on an empty stomach.

Choice C:

Cilostazol can be taken with or without food, so taking it on an empty stomach is not necessary.

Choice D:

While compression stockings can be used for some individuals with PAD, their use should be discussed with the healthcare provider and is not specific to cilostazol instructions.

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Question 15:

A nurse is preparing a client for a non-invasive test to assess blood flow and blood pressure in the legs. The nurse informs the client that this test is called:

A. Angiography. B. Venography. C. Doppler ultrasound. D. Magnetic resonance imaging (MRI).

Answer and Explanation

Choice A:

This choice is incorrect because angiography is an invasive procedure that involves the injection of contrast dye into the blood vessels to visualize their structure and blood flow. It is not a non-invasive test.

Choice B:

This choice is incorrect because venography is an imaging test that involves the injection of contrast dye into a vein to visualize its flow. It is not commonly used to assess blood flow and blood pressure in the legs.

Choice C:

This choice is correct. Doppler ultrasound is a non-invasive test that uses sound waves to assess blood flow and blood pressure in the legs. It helps identify areas of reduced blood flow, blockages, and abnormalities in the blood vessels.

Choice D:

This choice is incorrect because magnetic resonance imaging (MRI) is a diagnostic imaging technique that provides detailed images of the body's internal structures using a magnetic field and radio waves. While it can be used to assess blood vessels, it is not the primary test for evaluating blood flow in peripheral vascular diseases.

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Question 16:

A client with suspected peripheral vascular disease is scheduled for an ankle-brachial index (ABI) test. The nurse explains that this test measures:

A. Blood pressure in the arms and legs. B. Oxygen saturation in the extremities. C. Blood glucose levels before and after meals. D. Blood flow through the heart's chambers.

Answer and Explanation

Choice A:

This choice is correct. The ankle-brachial index (ABI) is a non-invasive test that compares the blood pressure in the arms and legs. The test involves using a blood pressure cuff and Doppler ultrasound to measure blood pressure in the ankles and arms. The ratio of ankle to brachial pressure helps assess the severity of peripheral vascular disease and determine if there is reduced blood flow to the legs.

Choice B:

This choice is incorrect because oxygen saturation in the extremities is not directly measured with an ankle-brachial index (ABI) test. Oxygen saturation is commonly measured using pulse oximetry, which assesses the percentage of hemoglobin in the blood that is saturated with oxygen.

Choice C:

This choice is incorrect because an ankle-brachial index (ABI) test is not used to measure blood glucose levels before and after meals. Blood glucose levels are typically assessed using a blood test or fingerstick glucose monitoring in clients with diabetes.

Choice D:

This choice is incorrect because an ankle-brachial index (ABI) test does not evaluate blood flow through the heart's chambers. It focuses on assessing blood pressure and blood flow in the arms and legs to diagnose peripheral vascular disease.

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Question 17:

A nurse is reviewing the medical history of a client with suspected peripheral vascular disease. Which condition is a significant risk factor for the development of atherosclerosis and peripheral vascular disease?

A. Asthma B. Osteoarthritis C. Hypothyroidism D. Hypercholesterolemia

Answer and Explanation

Choice A:

This choice is incorrect because asthma is not directly associated with an increased risk of atherosclerosis or peripheral vascular disease. Asthma is a chronic respiratory condition that affects the airways, not the blood vessels.

Choice B:

This choice is incorrect because osteoarthritis is a degenerative joint disease and is not directly linked to an increased risk of atherosclerosis or peripheral vascular disease.

Choice C:

This choice is incorrect because while hypothyroidism can impact cardiovascular health, it is not a primary risk factor for atherosclerosis or peripheral vascular disease. Hypothyroidism can lead to elevated cholesterol levels, but hypercholesterolemia is the specific condition related to increased cholesterol levels and atherosclerosis.

Choice D:

This choice is correct. Hypercholesterolemia, characterized by high levels of cholesterol in the blood, is a significant risk factor for atherosclerosis, which is the buildup of plaque in the arterial walls. Atherosclerosis is a common cause of peripheral vascular disease, leading to reduced blood flow to the extremities and various cardiovascular complications.

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Question 18:

A client with peripheral vascular disease is scheduled for an arteriography. The nurse should provide pre-procedure education, including informing the client that:

A. The procedure is performed using a small incision in the leg. B. It is essential to keep the leg immobile after the procedure. C. The procedure uses sound waves to visualize blood flow. D. There is a risk of allergic reaction to contrast dye.

Answer and Explanation

Choice A:

This choice is incorrect because arteriography is an invasive procedure that involves the insertion of a catheter through a blood vessel, typically in the groin or arm, to inject contrast dye directly into the arteries. It is not performed using a small incision in the leg.

Choice B:

This choice is incorrect because keeping the leg immobile after an arteriography is not necessary. However, the client will be asked to rest and avoid strenuous activities for a few hours following the procedure.

Choice C:

This choice is incorrect because the procedure that uses sound waves to visualize blood flow is a Doppler ultrasound, not an arteriography. Arteriography involves the use of contrast dye and X-rays to visualize the arterial blood vessels.

Choice D:

This choice is correct. Arteriography requires the use of contrast dye to enhance the visualization of blood vessels during X-ray imaging. There is a risk of an allergic reaction to the contrast dye, and clients should be informed about this potential complication before the procedure. Precautions may be taken, and the client's medical history should be reviewed to identify any contraindications to the use of contrast dye.

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Question 19:

A nurse is assessing a client with peripheral vascular disease. Which non-invasive test can the nurse use to assess blood flow in the legs and detect blockages?

A. Cardiac catheterization B. Electrocardiogram (ECG/EKG) C. Magnetic resonance angiography (MRA) D. Pulmonary function test (PFT)

Answer and Explanation

Choice A:

This choice is incorrect because cardiac catheterization is an invasive procedure that involves the insertion of a catheter into the heart chambers or coronary arteries. It is used to assess the heart's structure and function, not blood flow in the legs.

Choice B:

This choice is incorrect because an electrocardiogram (ECG/EKG) is a non-invasive test that records the electrical activity of the heart to assess heart rate and rhythm. It is not used to assess blood flow in the legs.

Choice C:

This choice is correct. Magnetic resonance angiography (MRA) is a non-invasive imaging technique that uses a magnetic field and radio waves to create detailed images of blood vessels. It can assess blood flow in the legs, identify blockages, and provide valuable information about the vascular status of the extremities.

Choice D:

This choice is incorrect because a pulmonary function test (PFT) is a test used to assess lung function and diagnose respiratory conditions. It is not used to assess blood flow in the legs or detect peripheral vascular disease.Questions

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Question 20:

A client with peripheral vascular disease (PAD) is prescribed cilostazol. The nurse should instruct the client to report which adverse effect immediately?

A. Headache. B. Diarrhea. C. Muscle cramps. D. Dizziness.

Answer and Explanation

Choice A:

This choice is incorrect because headache is a common side effect of cilostazol but is generally not a severe adverse reaction that requires immediate reporting. Headaches can be managed with over-the-counter pain relievers if needed.

Choice B:

This choice is incorrect because diarrhea is a known side effect of cilostazol but is not typically severe or life-threatening. Clients should be encouraged to stay hydrated and notify their healthcare provider if it becomes bothersome.

Choice C:

This choice is incorrect because muscle cramps can occur as a side effect of cilostazol, but they are not considered an urgent adverse reaction. Mild muscle cramps can often be managed with stretching and hydration.

Choice D:

This choice is correct. Dizziness is a significant adverse effect of cilostazol and should be reported immediately. Cilostazol can cause a drop in blood pressure, leading to dizziness, lightheadedness, and a risk of falls. If a client experiences severe dizziness or fainting, they should seek medical attention promptly.

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Question 21:

A nurse is caring for a client with chronic venous insufficiency (CVI). Which intervention should the nurse include in the client's plan of care?

A. Encouraging prolonged standing to promote blood flow. B. Elevating the legs above heart level when resting. C. Applying warm compresses to the legs to reduce swelling. D. Wearing tight-fitting compression stockings.

Answer and Explanation

Choice A:

This choice is incorrect because encouraging prolonged standing can worsen symptoms of chronic venous insufficiency (CVI). Prolonged standing increases venous pressure in the legs and can lead to further swelling and discomfort.

Choice B:

This choice is correct. Elevating the legs above heart level when resting is a beneficial intervention for individuals with chronic venous insufficiency (CVI). Elevating the legs helps improve venous return and reduces swelling in the legs.

Choice C:

This choice is incorrect because applying warm compresses to the legs may provide temporary relief for some individuals, but it is not a primary intervention for managing chronic venous insufficiency (CVI).

Choice D:

This choice is incorrect because tight-fitting compression stockings are commonly used to manage chronic venous insufficiency (CVI), but they should be fitted appropriately by a healthcare professional. Wearing overly tight compression stockings can impede blood flow and cause discomfort.

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Question 22:

A client with peripheral arterial disease (PAD) has a non-healing ulcer on the foot. The nurse should prioritize which action in the client's plan of care?

A. Administering analgesics for pain relief. B. Initiating prophylactic antibiotics. C. Elevating the affected foot. D. Promoting regular foot inspections.

Answer and Explanation

Choice A:

This choice is incorrect because while administering analgesics for pain relief is important for the client's comfort, it is not the priority in this situation. The non-healing ulcer may require further assessment and interventions beyond pain relief.

Choice B:

This choice is correct. In a client with peripheral arterial disease (PAD) and a non-healing foot ulcer, there is a risk of infection due to reduced blood flow and compromised tissue healing. Initiating prophylactic antibiotics is a priority to prevent or manage infection and promote wound healing.

Choice C:

This choice is incorrect because elevating the affected foot can be beneficial to improve blood flow in individuals with venous insufficiency or edema but may not be as effective for individuals with peripheral arterial disease (PAD).

Choice D:

This choice is incorrect because promoting regular foot inspections is essential for clients with peripheral vascular diseases, but in this case, the non-healing ulcer requires immediate attention. Proper wound care, including assessment, cleaning, and dressing, should be part of the client's plan of care, but antibiotic therapy is the priority in this situation.

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Question 23:

A nurse is caring for a client with peripheral vascular disease (PAD) who undergoes angioplasty with stent placement. Which post-procedure instruction should the nurse include in the client's education?

A. Limiting fluid intake to prevent swelling. B. Avoiding walking for the first 24 hours. C. Taking dual antiplatelet therapy as prescribed. D. Applying ice packs to the incision site.

Answer and Explanation

Choice A:

This choice is incorrect because limiting fluid intake is not a standard post-procedure instruction following angioplasty with stent placement. Adequate hydration is important for recovery and overall health.

Choice B:

This choice is incorrect because walking is generally encouraged following angioplasty with stent placement. Early mobilization helps prevent complications such as blood clots and promotes blood flow through the treated vessel.

Choice C:

This choice is correct. After angioplasty with stent placement, clients are often prescribed dual antiplatelet therapy, which typically includes aspirin and another antiplatelet medication such as clopidogrel. Dual antiplatelet therapy helps prevent blood clots from forming around the stent and reduces the risk of stent re-narrowing (restenosis).

Choice D:

This choice is incorrect because applying ice packs to the incision site is not a standard post-procedure instruction after angioplasty with stent placement. Ice packs are not typically used for this type of procedure, and the incision site is usually managed with sterile dressings and wound care.Questions

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Question 24:

A nurse is providing education to a client with peripheral vascular disease (PAD) about lifestyle modifications. Which dietary recommendation should the nurse include in the client's plan of care?

A. Increasing sodium intake to prevent dehydration. B. Limiting fluid intake to reduce leg swelling. C. Following a low-fat and low-cholesterol diet. D. Consuming high amounts of caffeine to improve blood flow.

Answer and Explanation

Choice A:

This choice is incorrect because increasing sodium intake can lead to fluid retention and exacerbate swelling, which is counterproductive for clients with peripheral vascular disease (PAD).

Choice B:

This choice is incorrect because limiting fluid intake can lead to dehydration and is not typically recommended for individuals with PAD. Adequate hydration is important for overall health and vascular function.

Choice C:

This choice is correct. A low-fat and low-cholesterol diet is essential for individuals with peripheral vascular disease (PAD) to reduce the buildup of plaque in the arteries (atherosclerosis) and improve blood flow. Lowering dietary intake of saturated fats and cholesterol helps manage cardiovascular risk factors.

Choice D:

This choice is incorrect because consuming high amounts of caffeine can lead to increased heart rate and blood pressure, which may be detrimental for clients with PAD. Moderate caffeine intake is generally recommended.

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Question 25:

A client with peripheral vascular disease (PAD) is experiencing intermittent claudication and reports difficulty walking. What should the nurse encourage the client to do to improve exercise tolerance?

A. Avoiding all physical activity to prevent leg pain. B. Walking until the pain becomes severe, then stopping. C. Engaging in a daily high-intensity exercise regimen. D. Gradually increasing walking distance over time.

Answer and Explanation

Choice A:

This choice is incorrect because avoiding all physical activity can lead to deconditioning and worsen exercise tolerance over time. Regular exercise is beneficial for individuals with peripheral vascular disease (PAD) to improve blood flow and manage symptoms.

Choice B:

This choice is incorrect because waiting until the pain becomes severe and then stopping (known as the "stop-and-rest" method) is not recommended for individuals with PAD. This approach can lead to inadequate exercise and may not provide the benefits of regular walking.

Choice C:

This choice is incorrect because engaging in a daily high-intensity exercise regimen is not appropriate for individuals with PAD, especially if they experience intermittent claudication. High-intensity exercise can exacerbate leg pain and may not be well-tolerated.

Choice D:

This choice is correct. Gradually increasing walking distance over time is a recommended approach for individuals with PAD to improve exercise tolerance and manage intermittent claudication. The goal is to push the limits of walking distance without causing severe pain, allowing the individual to gradually build endurance and improve blood flow.

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Question 26:

A nurse is providing education to a client with chronic venous insufficiency (CVI) about self-care strategies. What should the nurse recommend to the client to promote venous return?

A. Crossing the legs while sitting to reduce leg swelling. B. Elevating the legs above heart level when resting. C. Applying warm compresses to the legs to relieve discomfort. D. Wearing tight-fitting compression stockings throughout the day.

Answer and Explanation

Choice A:

This choice is incorrect because crossing the legs while sitting can impede blood flow and worsen symptoms of chronic venous insufficiency (CVI). Clients with CVI should avoid crossing their legs and keep them uncrossed to promote blood flow.

Choice B:

This choice is correct. Elevating the legs above heart level when resting is a beneficial self-care strategy for individuals with chronic venous insufficiency (CVI). Elevating the legs helps improve venous return, reduce swelling, and alleviate discomfort.

Choice C:

This choice is incorrect because while applying warm compresses may provide temporary relief for some individuals with CVI, it is not a primary self-care strategy for promoting venous return. Warm compresses may be more suitable for acute injuries or inflammation.

Choice D:

This choice is incorrect because while wearing compression stockings is a recommended intervention for individuals with CVI, tight-fitting compression stockings can impede blood flow and cause discomfort. Compression stockings should be fitted appropriately by a healthcare professional to ensure optimal efficacy.

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Question 27:

A client with peripheral vascular disease (PAD) is experiencing cold feet due to reduced blood flow. Which self-care measure should the nurse recommend to the client?

A. Soaking the feet in hot water to increase circulation. B. Wearing thick socks to insulate the feet. C. Using an electric blanket to keep warm. D. Avoiding exposure to cold temperatures.

Answer and Explanation

Choice A:

This choice is incorrect because soaking the feet in hot water is not recommended for individuals with peripheral vascular disease (PAD) or cold feet. Hot water can cause burns or injuries, especially in clients with reduced sensation due to PAD.

Choice B:

This choice is incorrect because while wearing thick socks can provide some insulation, it is not a comprehensive solution for managing cold feet caused by reduced blood flow.

Choice C:

This choice is incorrect because using an electric blanket may not be specific to the feet and may not effectively address the issue of cold feet due to PAD.

Choice D:

This choice is correct. Avoiding exposure to cold temperatures is a recommended self-care measure for individuals with peripheral vascular disease (PAD) experiencing cold feet. Cold temperatures can further constrict blood vessels and reduce blood flow to the extremities. Clients should keep their feet warm and protect them from cold weather using appropriate footwear and clothing.

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Question 28:

A nurse is caring for a client with peripheral vascular disease (PAD) who has a history of smoking. The nurse should prioritize which intervention to promote vascular health?

A. Recommending nicotine replacement therapy. B. Encouraging the client to switch to smokeless tobacco. C. Providing education on the benefits of smoking cessation. D. Advising the client to smoke fewer cigarettes per day.

Answer and Explanation

Choice A:

This choice is incorrect because while nicotine replacement therapy can be helpful for individuals trying to quit smoking, it is not the priority intervention. The primary goal is to promote smoking cessation itself, as it provides the most significant health benefits.

Choice B:

This choice is incorrect because smokeless tobacco is not a safe alternative to smoking and is not recommended for promoting vascular health. Smokeless tobacco still contains harmful substances that can damage blood vessels and increase cardiovascular risks.

Choice C:

This choice is correct. Providing education on the benefits of smoking cessation is a priority intervention for a client with peripheral vascular disease (PAD) who has a history of smoking. Smoking is a significant risk factor for PAD and other cardiovascular diseases. Quitting smoking can lead to immediate and long-term health improvements, including improved blood flow and reduced risk of complications.

Choice D:

This choice is incorrect because advising the client to smoke fewer cigarettes per day is not sufficient to address the adverse effects of smoking on vascular health . Smoking cessation is the most effective approach to improve vascular health and reduce the risk of PAD-related complications.Questions

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Question 29:

A nurse is caring for a client with peripheral vascular disease (PAD) who experiences intermittent claudication. What should the nurse encourage the client to do during episodes of leg pain?

A. Lie down and elevate the legs. B. Perform deep breathing exercises. C. Continue walking to build endurance. D. Use a heating pad on the affected area.

Answer and Explanation

Choice A:

This choice is incorrect because lying down and elevating the legs during episodes of intermittent claudication may provide temporary relief, but it does not address the underlying issue. Encouraging the client to stop and rest perpetuates the pain cycle and may hinder progress in managing PAD symptoms.

Choice B:

This choice is incorrect because deep breathing exercises are not directly related to managing intermittent claudication. While deep breathing exercises can be beneficial for relaxation and stress reduction, they do not specifically address the leg pain experienced during walking.

Choice C:

This choice is correct. Encouraging the client to continue walking during episodes of intermittent claudication helps build endurance and improves blood flow to the legs. Gradual increases in walking distance and duration can help the client tolerate longer periods of activity before experiencing pain.

Choice D:

This choice is incorrect because using a heating pad on the affected area is not recommended for managing intermittent claudication. Heat may not provide significant pain relief, and it does not address the underlying vascular issues causing the pain.

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Question 30:

A client with chronic venous insufficiency (CVI) presents with edema and skin changes in the lower legs. What should the nurse include in the plan of care to manage these symptoms?

A. Elevating the legs above heart level for 15 minutes daily. B. Applying compression bandages to the legs. C. Soaking the legs in hot water to reduce swelling. D. Encouraging long periods of standing to promote circulation.

Answer and Explanation

Choice A:

This choice is incorrect because elevating the legs above heart level for only 15 minutes daily may not provide sufficient benefit for managing edema and skin changes in clients with chronic venous insufficiency (CVI). Continuous and prolonged elevation, along with compression therapy, is more effective in reducing swelling.

Choice B:

This choice is correct. Applying compression bandages or stockings is a standard intervention for managing edema and skin changes in clients with chronic venous insufficiency (CVI). Compression helps improve venous return and reduce swelling in the lower legs.

Choice C:

This choice is incorrect because soaking the legs in hot water is not recommended for clients with chronic venous insufficiency (CVI). Hot water may cause skin irritation and worsen skin changes associated with CVI.

Choice D:

This choice is incorrect because encouraging long periods of standing can worsen symptoms in clients with CVI. Prolonged standing increases venous pressure in the legs and can lead to further swelling and discomfort.

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Question 31:

A nurse is providing discharge education to a client following peripheral artery bypass surgery. Which sign should the nurse instruct the client to report immediately?

A. Mild incisional pain. B. Mild swelling in the feet. C. Pallor and coolness of the affected foot. D. Tingling sensation in the legs.

Answer and Explanation

Choice A:

This choice is incorrect because mild incisional pain is common after peripheral artery bypass surgery and may be managed with prescribed pain medications. However, severe or worsening pain should be reported to the healthcare provider.

Choice B:

This choice is incorrect because mild swelling in the feet is a common post-operative finding after peripheral artery bypass surgery and may resolve with time. However, excessive or sudden swelling should be reported to the healthcare provider.

Choice C:

This choice is correct. Pallor (pale color) and coolness of the affected foot may indicate reduced blood flow to the extremity, which could be a sign of a complication such as graft occlusion or clot formation. These signs should be reported immediately for prompt evaluation and intervention.

Choice D:

This choice is incorrect because tingling sensation in the legs is common after surgery and may be related to changes in blood flow or nerve irritation. It is not typically a sign that requires immediate reporting unless it is severe or accompanied by other concerning symptoms.

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Question 32:

A client with peripheral vascular disease (PAD) is scheduled for a percutaneous transluminal angioplasty (PT with stent placement. What pre-procedure information should the nurse provide to the client?

A. Instructing the client to avoid eating or drinking for 24 hours before the procedure. B. Informing the client of the need for general anesthesia during the procedure. C. Explaining that the procedure involves making a large incision in the abdomen. D. Informing the client that a catheter will be inserted through a blood vessel.

Answer and Explanation

Choice A:

This choice is incorrect because avoiding eating or drinking for 24 hours before the procedure is not typically required for a percutaneous transluminal angioplasty (PTA) with stent placement. The client may be instructed to avoid eating or drinking for a few hours before the procedure to prevent aspiration during sedation, but a 24-hour fast is not necessary.

Choice B:

This choice is incorrect because percutaneous transluminal angioplasty (PTA) with stent placement is typically performed under local anesthesia or conscious sedation, not general anesthesia. General anesthesia is not required for this procedure.

Choice C:

This choice is incorrect because percutaneous transluminal angioplasty (PTA) with stent placement is a minimally invasive procedure that does not involve making a large incision in the abdomen. It is usually performed using small punctures or incisions in the groin or arm to insert a catheter.

Choice D:

This choice is correct. A percutaneous transluminal angioplasty (PTA) with stent placement involves the insertion of a catheter through a blood vessel, typically in the groin or arm, to reach the narrowed or blocked artery. The catheter is used to inflate a small balloon and place a stent to open the artery and improve blood flow. Providing information about the catheter insertion is essential for the client's understanding of the procedure.

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Question 33:

A client with peripheral vascular disease (PAD) is at risk of developing complications related to impaired skin integrity. What should the nurse include in the plan of care to prevent skin breakdown?

A. Encouraging the client to massage the legs daily. B. Applying adhesive tape to secure dressings. C. Inspecting the skin regularly for redness or signs of breakdown. D. Using a donut-shaped cushion for sitting.

Answer and Explanation

Choice A:

This choice is incorrect because encouraging the client to massage the legs daily may not be appropriate for individuals with peripheral vascular disease (PAD). Vigorous massage can damage fragile blood vessels and exacerbate skin breakdown or injury.

Choice B:

This choice is incorrect because applying adhesive tape directly to the skin can cause skin trauma and increase the risk of skin breakdown. Dressings should be secured using appropriate medical tapes or dressings that are designed for skin protection.

Choice C:

This choice is correct. Regularly inspecting the skin for redness, discoloration, or signs of breakdown is crucial for early detection of impaired skin integrity in clients with peripheral vascular disease (PAD). Prompt identification and intervention can help prevent the development of pressure ulcers or wounds.

Choice D:

This choice is incorrect because using a donut-shaped cushion for sitting is generally not recommended for preventing skin breakdown. Donut cushions can increase pressure on the area around the coccyx and may cause more harm than good. Clients at risk of skin breakdown should be repositioned regularly and encouraged to shift their weight to relieve pressure on vulnerable areas.Questions

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Question 34:

A nurse is providing education to a client about peripheral vascular diseases. The nurse explains that these diseases primarily affect which body system?

A. Respiratory system B. Cardiovascular system C. Nervous system D. Gastrointestinal system

Answer and Explanation

Choice A:

This choice is incorrect because peripheral vascular diseases primarily affect the cardiovascular system, not the respiratory system. The respiratory system involves the lungs and the exchange of gases, while the cardiovascular system involves the heart and blood vessels.

Choice B:

This choice is correct. Peripheral vascular diseases are conditions that affect the blood vessels outside the heart and brain, including the arteries and veins in the extremities (arms and legs). These diseases can lead to reduced blood flow, pain, and various complications.

Choice C:

This choice is incorrect because peripheral vascular diseases do not primarily affect the nervous system. While some peripheral vascular diseases may have neurological implications, they are not primarily neurological disorders.

Choice D:

This choice is incorrect because peripheral vascular diseases do not primarily affect the gastrointestinal system. The gastrointestinal system involves the digestion and absorption of nutrients, which is not directly related to peripheral vascular diseases.

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Question 35:

A nurse is providing education to a client with peripheral vascular disease (PAD). The nurse should instruct the client to perform which exercise to improve blood flow in the legs?

A. Weightlifting. B. Running. C. High-impact aerobics. D. Walking.

Answer and Explanation

Choice A:

This choice is incorrect because weightlifting is not typically recommended for individuals with peripheral vascular disease (PAD). High-intensity weightlifting can increase blood pressure and may not be suitable for clients with cardiovascular conditions.

Choice B:

This choice is incorrect because running, especially high-impact running, may be too strenuous for individuals with PAD and could lead to discomfort or injury. Low-impact exercises are generally preferred.

Choice C:

This choice is incorrect because high-impact aerobics can be too intense for individuals with PAD and may not be well-tolerated, especially if they experience leg pain during exercise.

Choice D:

This choice is correct. Walking is a low-impact exercise that can be beneficial for individuals with peripheral vascular disease. It promotes blood flow in the legs, increases circulation, and helps manage intermittent claudication (pain during walking) associated with PAD. Gradually increasing walking distance and duration can improve cardiovascular fitness and overall health.

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