Question 1

In arteriosclerosis, commonly referred to as hardening of the arteries, the rigid arterial vessels fail to stretch. This has the potential for what?

Accepted Answer

Arteriosclerosis can lead to a reduced volume of oxygenated blood being delivered to the major organs of the body because the rigid arterial vessels cannot expand to accommodate the increase in blood flow that occurs during physical activity or stress. This can ultimately contribute to the development of conditions such as heart disease and stroke.

Question 2

You are caring for a client who is suspected of having coronary artery disease. The client is scheduled to have a nuclear stress test using thallium. When would the thallium be injected to determine narrowing of the coronary arteries?

Accepted Answer

Thallium is injected during exercise electrocardiography to assess blood flow to the heart muscle during activity, and images are taken a few hours after exercise to see how the heart recovers, helping to identify coronary artery narrowing.

Question 3

You suspect that your client has coronary artery disease (CAD). What diagnostic tests would you expect to be ordered for this client? Select all that apply.

Accepted Answer

A composite lipid profile study would measure cholesterol levels and triglycerides in the blood, which are risk factors for CAD. Exercise electrocardiography would evaluate the heart's response to physical activity, which can help detect CAD. Cardiac catheterization is an invasive procedure that involves inserting a catheter into the heart to measure pressures and evaluate blood flow, which can confirm a diagnosis of CAD. Stress angiography and veinography are not typically used to diagnose CAD.

Question 4

You are caring for a client at risk for thrombosis. What is an appropriate nursing action when evaluating this client?

Accepted Answer

Assessing the client's extremities for skin color, capillary refill time, and tissue integrity is important when evaluating for thrombosis, as these factors may indicate poor circulation or clot formation. Examining mental and emotional status, pain around the shoulder and neck region, and skin lesions may be important for other assessments, but are not specific to evaluating for thrombosis.

Question 5

You are presenting a workshop at the senior citizens center about how the changes of aging predisposes clients to vascular occlusive disorders. What would you name as the most common cause of peripheral arterial problems in the older adult?

Accepted Answer

Atherosclerosis is the most common cause of peripheral arterial problems in the older adult. It is a condition caused by the buildup of plaque on the inner walls of arteries, which can restrict blood flow and increase the risk of cardiovascular diseases such as coronary artery disease and stroke. Arteriosclerosis and coronary thrombosis are related to atherosclerosis but are more specific to the arteries of the heart. Raynaud's disease is a condition that affects the blood vessels in the fingers and toes, causing them to narrow and reduce blood flow, but it is not the most common cause of peripheral arterial problems in the older adult.

Question 6

You are caring for a client with CAD. What is an appropriate nursing action when evaluating a client with coronary artery disease (CAD)?

Accepted Answer

Assessing the characteristics of the client's chest pain, such as location, duration, intensity, and radiation, can help determine if the client is experiencing angina or a myocardial infarction. This information is important in guiding the client's treatment and interventions. Assessing the client's mental and emotional status, skin, and presence of drug abuse may also be important but are not the most priority actions in evaluating a client with CAD.

Question 7

The nursing instructor is talking about myocardial infarctions (MI) to her junior nursing class. What would the instructor tell the students is the most common cause of an MI?

Accepted Answer

The most common cause of an MI is a coronary thrombosis, which occurs when a blood clot forms in one of the vessels that supply the heart muscle with blood and oxygen. Venous stasis and stroke are not causes of MI, and while arteriosclerosis can contribute to the development of MI, it is not the most common cause.

Question 8

The nurse is working with a client who has just been diagnosed with an aneurysm. What advice should the nurse provide to this client?

Accepted Answer

Aneurysms are weakened areas of a blood vessel that may bulge outward or rupture. Straining during bowel movements, coughing, or lifting heavy objects could cause the aneurysm to rupture. Therefore, the nurse should advise the client to avoid straining during bowel movements and coughing to prevent the aneurysm from getting worse.

Question 9

As the clinic nurse caring for a client with varicose veins, what is an appropriate nursing action for this client?

Accepted Answer

Elastic support stockings can help alleviate symptoms of varicose veins by compressing and supporting the veins. As the clinic nurse, demonstrating how to apply and remove them is a key nursing action to improve this client's condition. The other options, such as IV infusion and assessing for bleeding or skin integrity, are not as relevant to the care of a client with varicose veins.

Question 10

What is a characteristic of atherosclerosis?

Accepted Answer

Atherosclerosis is characterized by the buildup of fatty deposits (plaques) in the inner lining (endothelium) of arteries, causing them to narrow and restrict blood flow. This can eventually lead to coronary artery disease, stroke, and other cardiovascular issues.

Question 11

A client is admitted to your unit with a diagnosis of phlebothrombosis. When you assess this client, what would you expect to find?

Accepted Answer

Phlebothrombosis, which is a condition where a blood clot forms in a vein without inflammation, often presents with a positive Homans' sign, which is pain in the calf upon dorsiflexion of the foot.

Question 12

You are caring for a client with varicose veins. What diagnostic test evaluates varicose veins?

Accepted Answer

The Brodie-Trendelenburg test is used to evaluate varicose veins. During the test, the client is placed in a supine position and the affected leg is elevated. The healthcare provider then occludes the superficial vein of the leg, and the client is asked to stand up. If the varicose veins disappear or decrease in size, it suggests that the damaged valves in the superficial vein are causing the pooling of blood in the veins. Other diagnostic tests such as ultrasound or venography may also be used to evaluate varicose veins.

Question 13

A client asks the clinic nurse what the difference is between arteriosclerosis and atherosclerosis. What is the nurse's best response?

Accepted Answer

Arteriosclerosis is a general term for the loss of elasticity, or hardening, of the arteries. Atherosclerosis specifically refers to the buildup of plaque in the inner lining of the arteries, leading to narrowing and hardening of the arteries.

Question 14

For a client with thrombosis, what does the nurse do if pulses cannot be palpated?

Accepted Answer

If pulses cannot be palpated in a client with thrombosis, the nurse should use a Doppler ultrasound device to assess blood flow and determine if there is a blockage caused by the thrombus. Computed tomography, radiography, and magnetic resonance imaging may provide information about the presence of a thrombus, but they do not provide information about blood flow or the severity of the blockage.

Question 15

A client with venous insufficiency asks the nurse what they can do to decrease their risk of complications. What advice should the nurse provide to clients with venous insufficiency?

Accepted Answer

Elevating the legs periodically for at least 15 to 20 minutes can help decrease venous insufficiency complications by improving blood flow and reducing swelling in the legs. Avoiding foods with iodine or refraining from sexual activity are not related to preventing complications of venous insufficiency.

Question 16

The nurse is caring for a client with Raynaud's disease. What are important instructions for a client who is diagnosed with this disease to prevent an attack?

Accepted Answer

Raynaud's disease is characterized by episodes of vasospasm in the blood vessels of the hands and feet, leading to decreased blood flow and tissue ischemia. Therefore, it is important for the client to avoid situations that contribute to ischemic episodes, such as exposure to cold temperatures and smoking. Reporting changes in the usual pattern of chest pain is important for clients with cardiovascular diseases. Avoiding fatty foods and exercise would not prevent an attack of Raynaud's disease. Taking over-the-counter decongestants can actually exacerbate the symptoms of Raynaud's disease.

Question 17

You are giving an educational event for a local community group. You have been asked to speak on risk factors for diseases of the peripheral arteries. What risk factors would you list? Select all that apply.

Accepted Answer

The answer of You are giving an educational event for...

Question 18

You are preparing a client for a Brodie-Trendelenburg test. What is an appropriate nursing action while conducting this test for clients with varicose veins?

Accepted Answer

Applying the tourniquet to the upper thigh and determining the valve potency of the superficial veins is the appropriate nursing action during a Brodie-Trendelenburg test for clients with varicose veins. Encouraging the client to ask questions and offering assurance about the safety of the tourniquet can also be helpful, but they are not the primary nursing actions during the test. Discussing the client's anxiety with the physician may be necessary if the client is experiencing significant distress, but it is not directly related to the test itself.

Question 19

A client has had oral anticoagulation ordered. What should you monitor for when your client is taking oral anticoagulation?

Accepted Answer

When a client is taking oral anticoagulation, it is important to monitor their clotting factors through the use of PTT, PT, and INR. This allows for adjustments in medication dosages to prevent bleeding or clotting episodes. Monitoring vascular sites for bleeding and urine output may also be important, but these are not specific to monitoring oral anticoagulation. Hourly IV infusion is also not relevant to monitoring oral anticoagulation.

Question 20

A client comes to the Emergency Department (ED) complaining of precordial chest pain. In describing the pain, the client describes it as pressure with a sudden onset. What disease process would you suspect in this client?

Accepted Answer

The client's symptoms are suggestive of coronary artery disease, specifically angina pectoris. The pressure-like chest pain with a sudden onset is a classic manifestation of this condition, which is caused by inadequate blood flow to the heart muscles due to narrowed or blocked coronary arteries. Raynaud's Disease, cardiogenic shock, and venous occlusive disease are unlikely to present with these symptoms.

Quiz 25: Caring for Clients With Disorders of Coronary and Peripheral Blood Vessels